Changing Relationships between Health Service Managers: Confrontation, Collusion and Collaboration

Abstract

This chapter focuses on relationships between human resource (HR) and clinical managers. It explores the policy and practice implications arising from research into changing human resource management (HRM) arrangements in the English National Health Service (NHS). The empirical data on which the discussion is founded concerns the enactment of HRM in the NHS as health care managers, many of whom are highly qualified clinical professionals, face increasing demands to fulfil HRM functions. Relationships between human resource and line managers have a turbulent history, with line managers generally being identified as vital intermediaries between HRM strategy and frontline workers (Purcell et al., 2003). Recently, attempts to devolve responsibility for HR functions to line managers whilst HR retains responsibility for managerial control have led to a change in relationships, with line managers being alternately cast as either unco-operative or lacking in competence (Whittaker and Marchington, 2003). As a result, the impression of a negative relationship between HR and line managers has been created. This general situation is mirrored in the English NHS where the potential for troubled relationships between HR and clinical managers has been highlighted as important, especially as a result of attempts to change NHS culture (Fitzgerald et al., 2006).