A Critical Analysis of Change & Resistance Within the Nhs

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“A Critical Analysis of Change & Resistance within the NHS.”


The rate of economic and political change in recent decades has been dramatic. The Anglo-Saxon emphasis on neo-liberal economic ideology has drifted East, with the (Brown, 2000) ‘rise of China’ and other emerging economies. The trend in recent decades has focussed on the need to privatise great swathes of the economy and to reduce trade barriers, leading to less protectionism. This emphasis on private sector control became apparent in the 1980’s with (Hutchinson, 2008) ‘Thatcherism’ and ‘Reaganism’ seeking to reform the post-War consensus. The dramatic changes in America and the United Kingdom were not restricted to those economies however. The European Union (Salmon et al, 1997) progressively looked to integrate politically and economically placing more emphasis on ‘free trade’ and market based solutions. The power of the Soviet Union was beginning to diminish, with the collapse of the Berlin Wall and in China (Ruan et al, 1995) Deng Xiaoping was moving the communist party of China towards considering economic reforms that would lead to a drift towards market based solutions away from the Centrally-planned ideology. All of these enormous changes resulted in significant conflict within respective Countries, societies and organisations. The results of these changes have seen debates rage about the positives and negatives of globalisation in the 21st Century. There is an argument that Western society has sought to (Learmonth, 1999) ‘exclude and marginalise others’ in the pursuit of hierarchical pre-eminence to traditional Western thought, in the process organisations and Government have ‘neo-colonial logical and ontological assumptions’ Banerjee et al (2004, pp. 226-227) of different viewpoints, however there are those that believe there are moves to respect the pragmatic plurality of opinion and formulate organisational strategy that focuses on understanding local conditions. Academics like Thomas L. Friedman (2005) believe the forces of globalisation have benefitted most societies and made the World ‘flatter’ as a result. The reason I chose the NHS as the focus of my empirical case is that in 2008 the NHS became 60 years old, throughout all the economic change the Nationalised Health Service has remained relatively free from competition and even the most reforming Governments like the Conservative Government of the 1980’s has never strongly considered breaking up the State monopoly. However, in the 60 years there has been significant change in the way the NHS is run and Management has often been the source of both implementation of change and the focus of resistance to change. I believe it is necessary to take a critical view of issues related to change that has impacts on productivity, quality of service and staff morale within the NHS.

Literature Review

To develop change strategies in the new Globalised World, it my belief that (Hassard et al, 1993) “modernist” values that question the long-established (Guillen, 2006) ‘Taylorist’ scientific theories are more effective both in motivating workers and helping to deliver change with less resistance. In my estimation organisations are intrinsically pluralistic in nature, especially in the contemporary age. Rose (2008, p. 29) argues that conflict is therefore both ‘rational and inevitable.’ In my estimation this places prominence on the managers’ role becoming more conciliatory in nature, therefore facilitating more knowledge transfer. The economic climate is still volatile this intensifies the need for incremental change and innovative outlooks in (Fitzroy, 2007) Strategy and Corporate Governance. The successful global firms have sought to implement strategy that Mullins (2008) argues is responsive and able to anticipate change while maintaining good dialogue with all stakeholders within the organisation on any changes. Reduction in dialogue can lead to (Fitzroy, 2007) increased...
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