Contested terrain: the incomplete closure of managerialism in the health service.

Abstract

Focuses on feelings about culture and change in the health service and the impact of management development programmes on the change process. The issues raised in a series of semistructured interviews are taken forward to a case study, a medium-sized hospital Trust. The researcher "hangs around and listens into" a management development programme aimed at middle managers with a nursing background. The theme of ideological conflict comes into central focus. Analysis of outcomes suggests that the managerial assumptions on which the programme is based result in resistance from participants. They resist the attempts of facilitators to provide "closure" whereby managerial ways of doing things are suggested as the "obvious way ahead". Advocates that management education particularly in the health service should have a pluralistic orientation. As part of such pluralism, more critical approaches should be considered beyond conventional and problematic conceptions of knowledge relating to management. These are reductionist in considering a manager as "having a set of technical competences" rather than exhibiting "a way of being".