NHS Management: Living on the boundary between the self as unitary manager and the self as intersectional ‘me’. Professor Nancy Harding (University of Bradford)
According to Prof Harding the notion of management was formally introduced into the NHS in the 1980s, following publication of the Griffiths Report. The instigation of New Public Management, as this came to be known, was interpreted variously. A more confusing term also appeared in the discourse around management practices, namely “talent management”. The succeeding quarter of a century has seen a legitimisation of the role of management in the NHS, an increase in the numbers of managers employed, and numerous attempts to improve the quality of managerial work. In all of this, the manager has been imagined to be a rational, logical, non-emotional, powerful and one-dimensional person. Intersectionality theory would warn against such a presumption.
However, two interview-based studies of NHS managers suggest they move fluidly and unquestioningly between an identity or sense of self of a rational manager working within an organizational structure, and an identity or sense of self as fluid, emergent, irrational and with multiple identities. It seems that their position(s) as managers, colleagues, friends and workers all coincide with the various intersecting aspects of being a manager that does not always fit the often ‘faceless’ aspects of management theory.
The paper drew on these studies looking at the the aesthetics of leadership and the introduction of talent management into the NHS, to explore how managers can move between a subject position (‘the rational manager’) and a living, embodied sense of self that is not only separate and distinct from the self as manager, but also contradicts that managerial self. Harding suggested that intersectionality theory challenges the presumption of theories of control and resistance that are highly influential in critical approaches to NHS management. Control and resistance are shown to require theories of categorisation that are confounded by the lived experience of working as a manager in the NHS.