Leadership talk: From managerialism to leaderism in health care after the crash

Abstract

The economic downturn that began in 2008 led to massive cuts in spending targeted at managerial activities in the UK National Health Service (NHS). Although the appellation “manager” once conferred status in the NHS, managers have borne the brunt of reform and the term itself is in danger of falling into disrepute. Drawing upon perspectives on leadership that emphasize its constitutive nature, we examine the growing alternative emergent culture of “leaderism” in the NHS and how this relates to managerial practices and identity. Empirical case study research from three hospital trusts in the UK is presented. The findings highlight not only the many tensions associated with this purported shift toward “leaderism” in practice but also how interpretative flexibility associated with the concept of leadership has itself an important bearing upon understanding attempts to bridge long-standing managerial divides within health care.