The popular image of an empowered, proactive leader fails to reflect the reality
of senior managers’ roles in public sector organizations in the UK at
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executives in the English National Health Service (NHS) between 2000 and 2002
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government introduced a ten-year modernization programme backed by substantial
increases in public funding. In previous years considerable interest had been
shown in the importance of leadership within public sector organizations.
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suspicious about the abilities of public sector managers in general, and those
within the NHS in particular, to deliver the reforms that they had deemed
essential. A series of interviews with NHS chief executives over the 2000-2
period recorded the pressures that they were subjected to: rather than being
given the scope to help lead the reform of the NHS, chief executives were
treated as little more than conduits for the policies of the centre. The
interviews illustrate how undermined and demoralized many of them came to feel.
Relating the episode to the broader literature on leaderships it is suggested
that the study of leadership in the public sector cannot be divorced from
broader study of the institutions of the state and, in this case, from the
centralized performance audit regime that government developed to drive forward
its modernization policy. In the light of such issues, the article draws
attention to the importance of ‘bureaucratic discretion’ to
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