NHS MANAGERS AS RHETORICIANS - A CASE OF CULTURE MANAGEMENT

In the wake of Peters and Waterman's In Search of Excellence few NHS m anagers are unaware of culture management as a tool for shaping organi sational change. Yet the first wave of post-Griffiths studies found li ttle evidence of 'culture management' in action. This paper draws on d ata from an ethnographic study carried out in 1988-90 to suggest that the symbolic facet of management action is an important, though neglec ted, element in the 1991 NHS reforms. It argues that rhetorical skills were a valuable resource for general managers overseeing the change p rocess, and explores some of the ways in which rhetoric may have influ enced cultural adaptation. However, many of the specific claims of the 'excellence genre', including ideas about the importance of strong, h omogeneous cultures, are rejected. Rhetoric is an aspect of micro-poli tical struggles over meaning, which rarely result in straightforward c ultural 'manipulation', and are more likely to re-shape organisations through pragmatic accommodation than to win the hearts and minds of me mbers.