Discourses, Rhetorical Strategies and Arguments: Conversations in an NHS Trust Hospital Board

Mueller, Frank, Sillince, John, Harvey, Charles and Howorth, Chris

(2004)

Mueller, Frank, Sillince, John, Harvey, Charles and Howorth, Chris (2004) Discourses, Rhetorical Strategies and Arguments: Conversations in an NHS Trust Hospital Board. Organization Studies, 25 (1).

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Abstract

This article is concerned with the introduction of the agenda of New Public
Management (NPM) within the board of a UK Hospital Trust: West London Hospital
(WLH). We discuss the literature on New Public Management, including its
limitations for analysing the organizational reality of implementing NPM. But we
will also be drawing on discourse theory and the literature on rhetoric. The main
argument in this article is that in order to understand the reality of the NPM paradigm,
we need to study the rhetorical strategies of protagonists involved in the negotiation
of the NPM agenda. Rhetorical strategies are means of making general viewpoints
more convincing, for example, by comparing ‘our’ organization with similar organizations.
Rhetorical strategies show patterns, which reappear in conversations and
arguments made by protagonists. Specifically, we identified three rhetorical strategies
justifying why and what kind of a more ‘rounded picture’ was required: widening the
argument to include national productivity comparisons with other hospitals; widening
the argument away from a narrow focus on finance toward a strategic and political
perspective; and, lastly, widening the argument to look at innovation in the whole
clinical process.

Information about this Version

This is a Published version
This version's date is: 01/01/2004
This item is peer reviewed

Link to this Version

https://repository.royalholloway.ac.uk/items/1fbaad67-8700-8d6f-c83d-e86864f3df53/1/

Item TypeJournal Article
TitleDiscourses, Rhetorical Strategies and Arguments: Conversations in an NHS Trust Hospital Board
AuthorsMueller, Frank
Sillince, John
Harvey, Charles
Howorth, Chris
Uncontrolled KeywordsNew Public Management, professional, managerial, hospital management, discourse, rhetorical strategies, arguments
DepartmentsResearch Groups and Centres\Management\Public Services Management
Faculty of History and Social Science\Management
Faculty of History and Social Science\Health and Social Care
Research Groups and Centres\Management\Organisation Studies and Human Resource Management

Identifiers

Deposited by () on 23-Dec-2009 in Royal Holloway Research Online.Last modified on 23-Dec-2009

Notes

The paper was published as '‘A Rounded Picture Is What We Need’: Rhetorical Strategies, Arguments, and the Negotiation of Change in a UK Hospital Trust ' Organization Studies 2004 25(1): 75–93

References

http://oss.sagepub.com/cgi/content/refs/25/1/75

Ackroyd, S., J. Hughes, and K. Soothill
1989 ‘Public sector services and their management’. Journal of Management Studies 26: 603–619.

Alvesson, M., and D. Karreman
2000 ‘Varieties of discourse: On the study of organizations through discourse analysis’. Human
Relations 53/9: 1125–1149.

Anderson-Gough, F., C. Grey, and K. Robson
1998 ‘“Work hard, play hard”: An analysis of organizational cliché in two accountancy practices’.
Organization 5/4: 565–592.

Arnold P. J., and L. S. Oakes
1998 ‘Accounting as discursive construction: The relationship between Statement of Financial
Accounting Standards No. 106 and the dismantling of retiree health bene.ts’. Accounting,
Organizations and Society 23/2: 129–153.

Ashburner, L., E. Ferlie, and L. FitzGerald
1996 ‘Organisational transformation and top-down change: The case of the NHS’. British Journal of Management 7: 1–16.

Bealing, W. E., Jr, M. W. Dirsmith, and T. Fogarty
1996 ‘Early regulatory actions by the SEC: An institutional theory perspective on the dramaturgy of political exchanges’. Accounting, Organizations and Society 21/4:
317–339.

Borum, F.
1999 ‘Ascribing rationales to concepts: Opening and closing windows of opportunities at a university hospital’. Paper presented at the 15th EGOS Colloquium, University of Warwick, 4–6 July.

Christensen, T., and P. Laegreid
1999 ‘New public management – design, resistance, or transformation? A study of how modern reforms are received in a civil service system’. Public Productivity and Management Review 23/2: 169–193.

Coffey, A., and P. Atkinson
1996 Making sense of qualitative data. London: Sage.

Denis, J.-L., L. Lamothe, and A. Langley
2001 ‘The dynamics of collective leadership and strategic change in pluralistic organizations’. Academy of Management Journal 44/4: 809–837.

Denis, J.-L., A. Langley, and L. Cazale
1996 ‘Leadership and strategic change under ambiguity’. Organization Studies 17/4: 673–699.

Eisenhardt, K.
1989 ‘Building theories from case study research’. Academy of Management Review 14: 532–550.

Ferlie, E., L. Ashburner, L. Fitzgerald, and A. Pettigrew
1996 The new public management in action. Oxford: Macmillan.
Greenwood, R., and C. R. Hinings
1993 ‘Understanding strategic change: The contribution of archetypes’. Academy of Management Journal
36: 1052–1081.

Greenwood, R., and Lachman, R.
1996 ‘Change as an underlying theme in professional service organizations: An introduction’. Organization Studies 17/4: 563–572.

Groot, T.
1999 ‘Budgetary reforms in the non-pro.t sector: A comparative analysis of experiences in health care and higher education in the Netherlands’. Financial Accountability and Management 15/3–4: 353–376.

Hardy, C., I. Palmer, and N. Phillips
2000 ‘Discourse as a strategic resource’. Human Relations 53/9: 1227–1248.

Harrison, S., and C. J. Pollitt
1994 Controlling health professionals. Buckingham: Open University Press.

Heracleous, L., and M. Barrett
2001 ‘Organizational change as discourse: Communicative action and deep structures in the context of information technology implementation’. Academy of Management Journal 44/4: 755–778.

Hood, C.
1995 ‘The “new public management” in the 1980s: Variations on a theme’. Accounting, Organizations and Society 20/2–3: 93–109.

Jespersen, P. K.
2000 ‘The institutionalization and management of quality in the Danish hospital .eld’. Paper presented at the 16th EGOS Colloquium, Helsinki, 2–5 July.

Jick, T. D., and V. V. Murray
1982 ‘The management of hard times: Budget cutbacks in public sector organizations’. Organization Studies 3/2: 141–169.

Kitchener, M.
1998 ‘Institutional change in U.K. hospitals’. Public Administration 76/1: 73–95.
Kitchener, M.
1999 ‘“All fur coat and no knickers”: Contemporary organisational change in United Kingdom hospitals’ in Restructuring the professional organisation: Accounting, health care and law.
D. Brock, M. Powell and C. R. Hinings (eds), 183–199. London: Routledge.

Kitchener, M.
2000 ‘The “bureaucratization” of professional roles: The case of clinical directors in UK hospitals’. Organization 7/1: 129–154.

Kitchener, M., I. Kirkpatrick, and R. Whipp
2000 ‘Supervising professional work under new public management: Evidence from an “invisible trade”’. British Journal of Management 11/3: 213–226.

Langley, A.
1999 ‘Strategies for theorizing from process data’. Academy of Management Review 24/4: 691–710.

Llewellyn, S.
1998 ‘Boundary work: Costing and caring in the social services’. Accounting, Organizations and Society 23/1: 23–47.

McNulty, T., and A. Pettigrew
1999 ‘Strategists on the board’. Organization Studies 20/1: 47–74.

Miles, M. B., and A. M. Huberman
1994 Qualitative data analysis. Newbury Park, CA: Sage.

Pentland, B. T.
1999 ‘Building process theory with narrative: From description to explanation’. Academy of Management Review 24: 711–724.

Pettigrew, A.
1985 The awakening giant: continuity and change at ICI. Oxford: Blackwell.

Pettigrew, A.
1992 ‘On studying managerial elites’. Strategic Management Journal 13: 163–182.

Pettigrew, A., E. Ferlie, and L. McKee
1992 Shaping strategic change: Making change in large organizations: The case of the National Health Service. London: Sage.

Richter, I.
1998 ‘Individual and organisational learning at the executive level’. Management Learning 29/3: 299–316.

Shapiro, B. P.
1998 ‘Toward a rational model of argumentation for critical accounting discussions’. Accounting, Organizations and Society 23/7: 641–663.

Silverman, D.
1993 Interpreting qualitative data: Methods for analyzing talk, text and interaction. London: Sage.
Starbuck, W. H., A. Greve, and B. L. T. Hedberg
1978 ‘Responding to crisis’. Journal of Business Administration 9: 111–137.

Strauss, A., and J. Corbin
1990 Basics of qualitative research: Grounded theory procedures and techniques. Newbury
Park, CA: Sage.

Whittington, R., T. McNulty, and R. Whipp
1994 ‘Market driven change in professional services – problems and processes’. Journal of Management Studies 31/6: 831–845.


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