Managing Doctors and Saving a Hospital: Irony, Rhetoric and Actor Networks

Abstract

This article examines the changing configuration of professional-management relations within the English health service, focusing on hospital doctors and managers. It draws on a case study of a hospital apparently under threat of closure during a period when management is pursuing a policy of attempting to rationalize medical work, for example, by expanding day surgery. At the same time, the strategies of medical staff for the defence of their professional interests are also explored. The usefulness of rhetoric, irony and actor-network theory for the analysis of the threatened hospital closure and the implications for professional-managerial relations is explored within the broader context of `governmentality' (Foucault).