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When people ask me what I do for a living … I say NHS manager with an uneasy laugh’ : the experiences of feeling demonised in troubled times
NHS managers in the UK work in an environment where roles and structures are increasingly under threat, where public expectations of and demands on the service continue to rise and where political and public discourse is highly critical. Facing regular headlines in papers like the Daily Mail - such as Bloated NHS to be stripped of 9, 000 managers (Daily Mail, 2010) - is having a negative effect on many NHS managers who are feeling vulnerable and undervalued. As commented, this is a group who are ‘a target for organisational redundancies and have experienced increased responsibility, closer monitoring of performance and heightened job insecurity’ (Preston and Loan-Clarke, 2000,101).
For those whose role also requires them to challenge inequalities and promote the needs of certain population groups, with whom they may personally identify, the current context can feel even more stark and ironic. Accountable to Government legislation concerning equalities, and at the same time, implementing Government change concerning cuts and restructuring, NHS managers who work within public health and health improvement are in a complex position where they may fear not only for their jobs, but also for continued genuine interest, beyond ticking-boxes, in tacking inequalities in such financially straightened times.
This presentation will explore how a number of managers working within the NHS in Scotland manage their personal values and identities alongside their work roles and responsibilities, whilst feeling under threat and not trusted by both those who commission and those who use the services that they plan and provide. The presentation will draw on an on-line survey and qualitative interviews that explores shifts and interchange between personal and political identities and the NHS workplace, and reflect a range of work and personal experiences and histories. Although NHS managers in Scotland face a different future to their counterparts in England due to more collective structures, public sector cuts are happening and Scottish Government announcements about NHS management reduction is further destablising this staff group who feel marginalised and not heard.
The presentation will present the voices of a range of managers who feel strongly about their work and the NHS but who may exemplify Preston and Loan-Clarke’s comment that ‘amongst this constant negativity it may be easy for managers to lose sight of their role in the wider scheme of bringing more accountability and effectiveness to NHS organisations’ (106).
Daily Mail, 2010. Bloated NHS to be stripped of 9, 000 managers, 17th June 2010.
Preston, D; Loan-Clarke, J. 2000. ‘The NHS manager : a view from the bridge’, Journal of Management in Medicine, 100 – 108.