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A critical account of the rise and spread of 'leadership': The case of UK healthcare

By Graham P. Martin and Mark Learmonth

Abstract

This paper considers the rise of ‘leadership’ in discourses relating to the British health service, and the application of the term to increasingly heterogeneous actors. Analysing interviews with NHS chief executives from the late 1990s, and key policy documents published since, we highlight how leadership has become a term of choice among policymakers, with positive cultural valences which previously predominant terms such as ‘management’ now lack. We note in particular how leadership is increasingly conferred not only on those in positions of formal power but on frontline clinicians, patients and even the public, and how not just the implementation but the design of policy is now constructed as being led by these groups. Such constructions of the distribution of power in the health service, however, contradict the picture drawn by academic work. We suggest, therefore, that part of the purpose of leadership discourse is to align the subjectivities of health-service stakeholders with policy intentions, making their implementation not just everyone’s responsibility, but part of everyone’s sense of self. Given the realities of organizational life for many of the subjects of leadership discourse, however, the extent to which leadership retains its current positive associations and ubiquity remains to be seen.Peer-reviewedPost-prin

Topics: UK, Leadership, Discourse, Policy, Management, Decentralization, Empowerment, Darzi
Publisher: Elsevier
Year: 2010
DOI identifier: 10.1016/j.socscimed.2010.12.002
OAI identifier: oai:lra.le.ac.uk:2381/10035
Journal:

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Citations

  1. (2001). A new beginning for care for elderly people?
  2. (2010). Co-optation, commodification and the medical model: governing UK medicine since doi
  3. (2007). Creating Citizen-Consumers. doi
  4. (2006). Discourses of leadership: gender, identity and contradiction in a UK public sector organization. doi
  5. (2005). Distributed leadership. doi
  6. (2000). Distributed properties: a new architecture for leadership. doi
  7. (2005). Doing things with words: the case of management and administration. doi
  8. (2003). Foundation hospitals: a new direction for NHS reform? doi
  9. (2009). Girls‟ working together without „teams‟: how to avoid the colonization of management language. doi
  10. (1990). Governing the Soul. doi
  11. (1985). Leadership and Performance beyond Expectations. doi
  12. (2008). Leadership as Identity. doi
  13. (1999). Leadership in organizations. In doi
  14. (2007). Leadership research in healthcare.
  15. (2009). Leadership, service reform, and public-service networks: the case of cancer-genetics pilots in the English NHS. doi
  16. (2008). Leadership: a categorical mistake? Human Relations, doi
  17. (1982). Leadership: the management of meaning. doi
  18. (1989). Leading in the NHS. doi
  19. (1996). Managers, doctors and culture: changing an English health district. doi
  20. (1999). Modernising Government. doi
  21. (2002). New identities? Professionalism, managerialism and the construction of self.
  22. (2000). New public management and equal opportunities in the NHS. doi
  23. (2008). Ordinary people only‟: knowledge, representativeness, and the publics of public participation in healthcare. doi
  24. (1989). Power and subjectivity at work: from degradation to subjugation in social relations. doi
  25. (2001). Shifting the Balance of Power within the NHS. London: Department of Health.
  26. (2003). Some of our concepts are missing: reflections on the absence of a sociology of organisations doi
  27. (2010). Some unintended effects of teamwork in healthcare. doi
  28. (2004). Structure, culture and anarchy: ordering the NHS.
  29. (2008). The Bevan-Morrison debate: the shape of things to come in the NHS?
  30. (2008). The British National Health Service 1948-2008: a review of the historiography. doi
  31. (2000). The bureaucratization of professional roles: the case of clinical directors in UK hospitals. doi
  32. (2008). The changing governance of the NHS: reform in a postKeynesian health service. doi
  33. (1996). The changing role of health care personnel in health and health care management. doi
  34. (2001). The dynamics of collective leadership and strategic change in pluralistic organizations. doi
  35. (2003). The great disappearing act: difficulties in doing „leadership‟. doi
  36. (1997). The language of management: an enduring challenge. doi
  37. (2001). The nature of leadership. doi
  38. (2006). The New Politics of the NHS. doi
  39. (2000). The role of leadership in the modernization and improvement of public services. doi
  40. (2010). The sacred in leadership: separation, sacrifice and silence. doi
  41. (2009). The symbolic violence of leadership: a critical hermeneutic study of leadership and succession in a British organization in the post-Soviet context. Human Relations, doi
  42. (2009). The transformational potential of public policy discourse. doi
  43. (1998). Theorizing subjectivity in organizations: the failure of Foucauldian studies? doi
  44. (2000). This is an electronic version of an article published
  45. (2012). This is an electronic version of an article published in Social Science & Medicine. ©
  46. (1999). We are all managers now‟; „we always were‟: on the development and demise of management. doi
  47. (2000). What is deconstruction?
  48. (2009). Whose health, whose care, whose say? Some comments on public involvement in new NHS commissioning arrangements. doi

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