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Making history critical.

Mark Learmonth1

  • 1Durham University Business School, Durham University , Durham, UK.

Journal of Health Organization and Management
|September 22, 2017
PubMed
Summary

The National Health Service (NHS) has evolved through distinct eras of administration, management, and leadership, shaped by evolving language and representational practices rather than inherent qualities. This study offers a discursive history of NHS management.

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Area of Science:

  • Health Services Management
  • Organizational History
  • Discourse Analysis

Background:

  • Traditional historical approaches to National Health Service (NHS) management often overlook the role of language.
  • The concept of 'management' within the NHS has been subject to evolving interpretations and practices.
  • Understanding the discursive construction of management is crucial for a comprehensive history of the NHS.

Purpose of the Study:

  • To explore the discursive history of National Health Service (NHS) "management".
  • To offer a counterpoint to traditional historical analyses of NHS management.
  • To examine how representational practices shape the understanding and reality of NHS leadership.

Main Methods:

  • Document analysis of relevant historical sources.
  • Interviews with chief executives from UK NHS trusts.
  • Discursive historical analysis focusing on language and representation.

Main Results:

  • The NHS has transitioned through identifiable eras: administration, management, and leadership.
  • These transitions are linked to shifts in discursive practices and representational conventions.
  • Current 'leaders' derive their status from conventional representational practices, not inherent traits.

Conclusions:

  • A discursive history recasts the narrative of NHS evolution, highlighting supported and denied interests.
  • The study emphasizes the power of language in constructing managerial and leadership identities.
  • Rethinking NHS management requires understanding the performative nature of its discourse.
Keywords:
ControlHistoryLanguageLeader-manager-administratorPerformativityPower

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