| Abstract: | The reforms of the National Health Service arising from the White Paper Working for Patients , were predicated on a particular view of management and the implementation of the changes heralded by this act relied heavily on the actions of the managers charged with carrying them through. This article reports on work undertaken to discover how middle managers responded to this challenge. The views of middle managers concerning the values that guide their work are explored in the context of managing in the reformed NHS. Data were collected by means of a focused ethnography and analysed thematically. This process was informed, in part, by recourse to Weber's conceptualization of rationality. It was found that managers are struggling to reconcile the demands inherent in their role that arise from contrasting and often competing rationalities, which is a reflection of conflict over priorities in the wider health policy environment. |
