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Conflicts and context in managing the closure of a large psychiatric hospital

Published online by Cambridge University Press:  02 January 2018

Lorna McKee*
Affiliation:
Centre for Corporate Strategy and Change, University of Warwick
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The slow progress in providing community-based care for mentally ill people and thus closing large psychiatric institutions has been well researched and documented. The enquiries have typically sought to demonstrate the gap between national policy intent and reality and have highlighted the structural, financial and organisational barriers to achieving new forms of service provision. Equally, an important recent study has shown that there are marked intra-Britain differences in how the assumed unitary national policy is interpreted and implemented. There is general agreement that the present ‘statutory framework’ inhibits radical service change and, furthermore, that centralised planning, joint-working, joint-planning mechanisms are flawed and underpinned by a poorly formulated financial and manpower strategy. Some management ‘process’ factors have also been isolated such as the presence/absence of clear leadership and ‘committed local champions of change’. The issue of ‘interprofessional tensions’ has been only briefly alluded to, with even less recognition of how the other powerful organisational groups interrelate. Certainly, there has been little ethnographic detail of how these tensions between dominant groups are played out at a local level or indeed impinge on local decision-making and progress. More typically, existing accounts of the closure of the large institutions have had a structuralist bias, with more emphasis upon the impact of regional and national policy and on the machinery of collaboration than on internal politics or the effects of local power relations.

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Articles
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 1988

References

1 Audit Commission (1986) Making a Reality of Community Care. London: HMSO.Google Scholar
2 Hunter, D. & Wistow, G. (1987) Community Care in Britain: Variations on a Theme. London: Kings' Fund.Google Scholar
3 Korman, N. & Glennester, H. (1985) Closing a Hospital. London: Bedford Square Press.Google Scholar
4 Pettigrew, A. M. (1985) The Awakening Giant: Continuity and change in ICI. Oxford: Basil Blackwell.Google Scholar
5 Pettigrew, A. M., McKee, L. & Ferlie, E. (1988) Managing organisational change in the NHS, Public Administration, (to be published in September 1988).CrossRefGoogle Scholar
6 Cyert, R. M. & March, J. G. (1963) A Behavioural Theory of the Firm. Englewood-Cliffs: Prentice-Hall.Google Scholar
7 Pettigrew, A. M. (1973) The Politics of Organisational Decision-Making. London: Tavistock.Google Scholar
8 Thompson, D. (1987) Coalitions and conflict in the National Health Service: Some implications for general management, Sociology of Health and Illness, 9, 127153.CrossRefGoogle ScholarPubMed
9 Stocking, B. (1985) Innovation and Inertia in the NHS. London: Nuffield Provincial Hospitals Trust.Google Scholar
10 Hardy, C. (1985) The Management of Organisational Closure. Aldershot: Gower.Google Scholar
11 Goffman, E. (1961) Asylums. London: Pelican.Google Scholar
12 Foucault, M. (1971) Madness and Civilisation. London: Tavistock.Google Scholar
13 Scull, A. T. (1984) Museums of Madness — the Social Origins of Insanity in Nineteenth Century England. London: Penguin.Google Scholar
14 Busfield, J. (1986) Managing Madness: Changing Ideas and Practice. London: Hutchinson.Google Scholar
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