Changing forms of managerialism in the NHS: hierarchies, markets and networks

David Cox in his chapter on health service management in the 1991 edition of The Sociology of the Health Service (Cox 1991) argues that the organization and management of health care has been relatively neglected in the sociological literature. Today the picture is a more promising one. There have been some excellent sociologically driven studies of managerial challenges; for example, Flynn’s work on governmentality (Flynn 2002, 2004), Pope’s study of the management of waiting lists (Pope 1991), work by Hunter (2006) and Dent (1993) on the relationship between medicine and management to name but a few. However, whilst acknowledging this growing body of scholarship, some commentators have noted that ‘organization’ and ‘management’ remain a relatively neglected area within medical sociology. Davies, for example, in her extremely rigorous review of how the concept of ‘organizations’ has fared in the journal Sociology of Health and Illness in its first twenty-five years, concludes that organizations have remained a minor theme in the journal and notes there is still no strong sense of a growing corpus of work on the theme of organizations. Dopson and Fitzgerald (2005) have also pointed to the existence of unhelpful boundaries between the writers on health policy, organizational studies of health care and medical sociology.