Challenging NHS Corporate Mentality: Hospital-Management and Bureaucracy in London's Pandemic.

IF 1.5 3区 社会学 Q2 ANTHROPOLOGY Medical Anthropology Pub Date : 2024-04-02 Epub Date: 2024-03-28 DOI:10.1080/01459740.2024.2325606
Rebecca Irons
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Abstract

Whilst NHS Health Service management is usually characterized by hierarchized bureaucracy and profit-driven competitiveness, the COVID-19 pandemic drastically disrupted these ways of working and allowed London-based non-clinical management to experience their roles otherwise. This paper is based on 35 interviews with senior non-clinical management at a London-based NHS Trust during 'Alpha phase' of Britain's pandemic response (May-August 2020), an oft-overlooked group in the literature. I will draw upon Graeber's theory of "total bureaucratization" to argue that though the increasing neo-liberalization of the health-services has hitherto contributed toward a corporate mentality, the pandemic gave managers a chance to experience more collaboration and freedom than usual, which ultimately led to more effective realization of decision-making and change. The pandemic has shown NHS managers that there are alternatives to neoliberal logics of competition and hierarchy, and that those alternatives actually result in happier and effectively, more capable staff.

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挑战国家医疗服务体系的企业心态:伦敦大流行病中的医院管理和官僚主义。
英国国家医疗服务系统(NHS)医疗服务管理的特点通常是等级森严的官僚主义和以利润为导向的竞争性,而 COVID-19 大流行则极大地打破了这些工作方式,让总部位于伦敦的非临床管理层体验到了他们不同的角色。本文基于在英国应对大流行病的 "阿尔法阶段"(2020 年 5 月至 8 月)对一家总部位于伦敦的 NHS 信托公司的高级非临床管理层进行的 35 次访谈,在文献中,这一群体常常被忽视。我将借鉴格雷伯的 "全面官僚化 "理论,论证虽然医疗卫生服务的新自由化进程不断加快,导致了迄今为止的企业心态,但大流行病给了管理人员一个机会,让他们体验到比往常更多的合作和自由,最终更有效地实现决策和变革。大流行病向国家医疗服务系统的管理者们表明,除了新自由主义的竞争和等级逻辑之外,还有其他的选择,而这些选择实际上会带来更快乐、更有效、更有能力的员工。
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来源期刊
CiteScore
4.10
自引率
4.30%
发文量
57
期刊介绍: Medical Anthropology provides a global forum for scholarly articles on the social patterns of ill-health and disease transmission, and experiences of and knowledge about health, illness and wellbeing. These include the nature, organization and movement of peoples, technologies and treatments, and how inequalities pattern access to these. Articles published in the journal showcase the theoretical sophistication, methodological soundness and ethnographic richness of contemporary medical anthropology. Through the publication of empirical articles and editorials, we encourage our authors and readers to engage critically with the key debates of our time. Medical Anthropology invites manuscripts on a wide range of topics, reflecting the diversity and the expanding interests and concerns of researchers in the field.
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