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A rounded picture is what we need : rhetorical strategies, arguments, and the negotiation of change in a UK hospital trust

机译:我们需要的是一副完整的图景:英国医院信托中的修辞策略,争论和变革谈判

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摘要

This article is concerned with the introduction of the agenda of New Public Management (NPM) within the board of a UK Hospital Trust: West London Hospital (WLH). We discuss the literature on New Public Management, including its limitations for analysing the organizational reality of implementing NPM. But we will also be drawing on discourse theory and the literature on rhetoric. The main argument in this article is that in order to understand the reality of the NPM paradigm, we need to study the rhetorical strategies of protagonists involved in the negotiation of the NPM agenda. Rhetorical strategies are means of making general viewpoints more convincing, for example, by comparing 'our' organization with similar organizations. Rhetorical strategies show patterns, which reappear in conversations and arguments made by protagonists. Specifically, we identified three rhetorical strategies justifying why and what kind of a more 'rounded picture' was required: widening the argument to include national productivity comparisons with other hospitals; widening the argument away from a narrow focus on finance toward a strategic and political perspective; and, lastly, widening the argument to look at innovation in the whole clinical process.
机译:本文关注的是英国医院信托:西伦敦医院(WLH)董事会对新公共管理(NPM)议程的介绍。我们讨论有关新公共管理的文献,包括其在分析实施NPM的组织现实方面的局限性。但是,我们还将借鉴话语理论和修辞学文献。本文的主要论点是,为了理解NPM范式的现实,我们需要研究参与NPM议程谈判的主角的修辞策略。修辞策略是使一般观点更具说服力的手段,例如,通过将“我们的”组织与类似组织进行比较。修辞策略显示出模式,这种模式会再次出现在主角的对话和辩论中。具体来说,我们确定了三种修辞策略,这些理由证明了为什么以及需要什么样的“全面情况”是合理的:扩大论点以包括与其他医院进行全国生产率比较;将论点从狭finance的金融角度扩展到战略和政治角度;最后,扩大了在整个临床过程中研究创新的论点。

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