1985 and After: Shifting the Frontier?
This final chapter has three main purposes. Firstly, it considers how far the Griffiths and related reforms have succeeded in shifting the location of NHS managers in terms of Figure 1.2; that is, can they now be regarded as agents of government rather than facilitators for doctors? The conclusion reached, though on the basis of rather unsystematic evidence, is that they probably can. In Alford’s (1975) terms, the managers are indeed the ‘corporate rationalisers’. But this does not necessarily make them (still in Alford’s terms) the dominant structural interest, and the second purpose of the chapter is therefore to consider how much of a shift has occurred in the ‘frontier of control’ between doctors and managers. The conclusion reached in this respect is that some change has taken place, but that this has been more to do with the form of relationships than with the substance.
KeywordsBritish Medical Journal Regional Health Authority British Medical Association Health Service Management Corporate Rationalisers
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