The contestation of archetypes: negotiating scripts in a UK hospital trust board

F. Mueller, C. Harvey, C. Howorth

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

This paper deals with the aftermath of the creation of a new governance structure in the UK National Health Service. We conceptualize this new governance structure as a 'Trust Hospital Archetype' in order to establish the promises and limitations of an archetype transition framework. We find that the 'reality' of the 'Trust Hospital Archetype' is one involving a high degree of contestation. This is confirmed by evidence drawn from interviews, documents, observation and participant observation. In order to analyse contestation, we distinguish between three interpretive schemes - Ideological-New Public Management, Executive Pragmatism and Medical Professionalism; and we outline five scripts - challenging, critiquing, mediating, cautioning and defending. This diversity casts doubt on the usefulness of simplistic managerialism-professionalism dichotomies prevalent in much of the literature. It also suggests modifications to archetype transition theory, which lends too much weight to the role of dominant interpretive schemes.
Original languageEnglish
Pages (from-to)1971-1995
Number of pages24
JournalJournal of Management Studies
Volume40
Issue number8
DOIs
Publication statusPublished - 2003

Keywords

  • hospital trust
  • health management
  • change management
  • organisational change
  • public sector

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