Organization, cultures and the management of change in the National Health Service: case studies in one district health authority

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McNulty, T.H., 1990. Organization, cultures and the management of change in the National Health Service: case studies in one district health authority. PhD, Nottingham Trent University.

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Abstract

This thesis is concerned with the issues of managerial effectiveness, organizational change and cultures in the National Health Service. Using the micropolitical and cultural perspectives it is concerned to offer an approach which builds on existing organization, management and change theory in order to further an understanding of these issues in relation to National Health Service organizations as well as other contexts.

The focus of attention is on the relationship between structure and culture at both the official and unofficial levels of the organization. The three case studies of organizations undergoing organizational change have allowed the opportunity to understand the complexity of the relationship between the official and unofficial arrangements in the organization and the impact of this on managerial effectiveness and organizational change.

The main finding of the thesis is that within organizations, structure and culture are inextricably bound and their consonance at both official and unofficial levels of the organization is a necessary condition for managerial effectiveness. The types of organizational culture developed during the investigation indicate how the plurality of interests, beliefs and cultures within an organization make it difficult to achieve this condition.

Concerning National Health Service organizations, the researcher argues that the recommendations contained within the Griffiths Report (1983) have offered a model of management which is based on cultural assumptions which are different to those which have traditionally underpinned the managerial process in the NHS. Following this, the researcher demonstrates via the cases, that the introduction of these recommendations has served to offer greater scope for a diversity of managerial style and philosophy at Unit level. They have also served to raise conflict between cultures, in particular the medical and managerial, to the point that the conditions needed for achieving managerial effectiveness do not exist.

Item Type:

Thesis

Creators:

McNulty, T.H.

Date:

1990

ISBN:

9781369324105

Identifiers: