Crisis in the Health Service : The Politics of Management

This book (1980) explores the problems of the National Health Service and discusses approaches to promote change. It examines strategies adopted since the service’s creation in 1948, finding them inadequate, particularly management structures organized as if the institution operates like a private firm.

First published in 1980, Crisis in the Health Service explores the problems of the National Health Service and discusses approaches to promote change. It examines strategies adopted since the service’s creation in 1948, finding them inadequate, particularly management structures organized as if the institution operates like a private firm. By analyzing management processes within health authorities, the book demonstrates the limited impact of central preferences on local behaviour and the variance from rationalist/managerial models underlying official blueprints. Concluding that internal politics of health agencies remain the most important behavioural factor, it illustrates how insensitive, slow, and inadequate responses to changes in demand, social pressures, and economic prospects constitute the NHS’s major problem area, arguing for a strategic change appropriate to this definition.