Abstract
Abstract In this paper it is claimed that the 1974 reorganization of the British National Health Service was based on an inappropriate rational‐bureau‐cratic model. An alternative was the arena‐negotiation model, first proposed in 1967. It is argued that the adoption of the latter would have resulted in an organizational system congruent with the therapeutic goals of the contemporary health care system. Now that the 1974 structure of the NHS is in process of being modified there is a strong case for looking again at these arena concepts, which are, in any event, emerging in health care systems. It is argued that the bureaucratic model is also creating 'sick’organizations in other fields. Accordingly, it is not only the health of the health care system, but also the health of the larger society which compels us to envisage all human organizations as central conglomerates relating, on a basis of‘negotiated order,’ to a multiplicity of relatively small interdisciplinary project teams, overlapping with each other and linked directly to the central structure without Intermediate tiers.
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