Challenging NHS Corporate Mentality: Hospital-Management and Bureaucracy in London’s Pandemic

Abstract

ABSTRACT Whilst NHS Health Service management is usually characterized by hierarchized bureaucracy and profit-driven competitiveness, the COVID-19 pandemic drastically disrupted these ways of working and allowed London-based non-clinical management to experience their roles otherwise. This paper is based on 35 interviews with senior non-clinical management at a London-based NHS Trust during ‘Alpha phase’ of Britain’s pandemic response (May-August 2020), an oft-overlooked group in the literature. I will draw upon Graeber’s theory of “total bureaucratization” to argue that though the increasing neo-liberalization of the health-services has hitherto contributed toward a corporate mentality, the pandemic gave managers a chance to experience more collaboration and freedom than usual, which ultimately led to more effective realization of decision-making and change. The pandemic has shown NHS managers that there are alternatives to neoliberal logics of competition and hierarchy, and that those alternatives actually result in happier and effectively, more capable staff.