Perspectives on General Management in the National Health Service

Abstract

If general managers experience problems in establishing a dialogue with their various constituencies both inside and outside the NHS, they are not alone. Researchers of health policy and management experience similar difficulties in trying to engage in a mutually useful exchange of views with health service managers. Attempts to bring the two groups together in order to interweave their respective experience and knowledge have rarely been successful. The reasons are manifold but the chief problem is the existence of suspicion on each side: researchers suspect managers of being intellectual philistines or of being unduly defensive about perceived criticism of their activities; for their part, managers accuse academics of indulging in ‘intellectual mystification’ and peddling useless models or of making unwarranted generalisations on the basis of small and unrepresentative samples. The upshot of this divide is that each group tolerates the other but, with few exceptions, warily and without any real or shared comprehension.