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Su Maddock: Manchester Business School, University of Manchester, UK
Glenn Morgan: Manchester Business School, University of Manchester, UK
ACKNOWLEDGMENT: This paper was presented at the Second International Research Symposium on Public Service Management, Aston Business School, September 1997.
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There is a process of breakdown and the emergence of gaps not just in understanding but in terms of how to manage existing relationships. Old rules and frameworks are no longer working and new ways are being developed which may become established in new institutions. This process of breakdown is specific to particular social situations, as the impact of international competition has clearly varied in Britain (Morgan and Sturdy, 1997)."
Few now question the fact that the traditions and labour practices within the bureaucracies made it extremely hard to stimulate new services and innovation. What is questioned is whether the impact of contracting has improved care and services. For although the old administrations were undoubtedly unresponsive and highly inflexible, they did provide accessible and consistent service, and staff had a sense of security. In the 1970s and 1980s women managers found the traditions and labour practices within bureaucracies frustrating and innovation impossible. But, 15 years later, the impact of contracting has left many searching for new forms of organizations in an even more hostile and often macho environment. The restructuring of local government and the health service may have changed management practices and the method by which resources are allocated, but the underlying male values deeply embedded in the bureaucratic structures and within the professions remain intact within the contracting environment. Almost all professionals and policy makers within health and social care have come to agree that the delivery of quality services is dependent on the ability of staff to work collaboratively, in partnership within a framework which facilitates integrated and sensitive care (Audit Commission, 1997; Community Care Act, 1990; Green Paper on Mental Health Services, 1996).
There has been enormous structural change in health and social services over the last 15 years and what is needed now is a focus not just on implementation of better practice but on management frameworks which will overcome the deeply entrenched barriers to interagency and interprofessional joint practices and communication. For, whilst management theorists vehemently assert the need for...