UNDERSTANDING CHANGE IN THE NHS

This paper presents a novel and distinctive approach to the study of change within the NHS. Central to the paper's approach is the view that research on change in health care systems should be processual, comparative, pluralist, and historically based. Guiding such a view is a meta-analytical framework which contends that theoretically sound and practically useful research on change should involve the continuous interplay between ideas about the context , the process , and the content of change together with skill in regulating the relations between the three (Pettigrew 1985a, 1985b). The paper has five sections. Section one examines some of the contemporary pressures for change in the NHS and draws attention to the gap which often exists between statements of strategic intention and their operational implementation. Section two reveals our distinctive analytical approach to the study of service changes and clarifies the theoretical underpinnings of our work. Section three offers an extended critical review of recent research and writing on change in health care organizations. Section four summarizes our findings from the literature review and reaffirms the novelty and significance of our chosen approach. Section five provides an overview.     

THE MANAGEMENT OF CHANGE IN WHITEHALL: THE EXPERIENCE OF THE FMI

The Conservative government announced the Financial Management Initiative in 1982. This article is based on research into the genesis, development and impact of the FMI. The findings suggest that the FMI has contributed significantly to the institutionalization of resource management in general and cost awareness in particular. Implementation has been influenced, however, by the differentiation of departmental tasks and contexts, the inevitable tension between management and politics, and the difficulty of meeting the conditions for the successful engineering of cultural change.     

Just the Ticket? The Labour Party's Deputy Leadership Election of 2007

Although there were six contenders for Labour's Deputy Leadership contest, it was conducted with remarkably little personal animosity. Nor, for the most part, were there substantive policy differences between the challengers, with the notable exception of the Iraq War. Instead, there was a clear determination to 'move on' from Blairism, and an acknowledgement that changes or new priorities were now necessary in key areas of policy, albeit without lurching to the Left or reviving 'Old Labour'. As such, the main differences between the candidates derived from their differing perceptions of the role of the Deputy Leader, and what they would each contribute to the post if elected. The ballot also revealed the manner in which support for the six contenders varied across the three sections of Labour's electoral college, so that each candidate tended to be more popular among one section of the Party, but enjoyed less support from the other two sections.