An examination of the role of various management functions within the National Health Service (NHS) requires a knowledge and understanding of the complex multi-layered and multi-faceted history and structure that is the NHS. This paper attempts to unravel an element of this complex organisation in order to situate the status and role of Human Resource Management (HRM). A theoretical framework is suggested based upon the concept of 'vocabularies of motive', within which qualitative research will be presented in order to analyse the relationship between medical professionals and management. Qualitative research at an executive level demonstrates vocabularies of motives in action within the complex negotiated order of an NHS trust, where it appears that the role and status of HRM is potentially more dominant and influential than has previously been suggested. Data is limited to a small group of senior managers and medical professionals and, therefore, does not represent a complete picture but rather a snap-shot of action from the perspective of actors employed in senior roles in the NHS hospitals service. The paper offers insights into the complexities of change in a complex bureaucracy such as the NHS hospital service. It also suggests that government policy and management practice can benefit from an understanding of the various vocabularies of motive at play and how these may affect the successful interpretation of policy into practice. The paper offers original data and new conceptual framework which offers the potential for a more nuanced understanding of the implementation and interpretation of government policy in the NHS hospital service.
- national health hospital service
- new public sector management
- vocabularies of motive
- human resource management