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Purpose

The purpose of this paper is to explore a possible discursive history of National Health Service (NHS) “management” (with management, for reasons that will become evident, very much in scare quotes). Such a history is offered as a complement, as well as a counterpoint, to the more traditional approaches that have already been taken to the history of the issue.

Design/methodology/approach

Document analysis and interviews with UK NHS trust chief executives.

Findings

After explicating the assumptions of the method it suggests, through a range of empirical sources that the NHS has undergone an era of administration, an era of management and an era of leadership.

Research limitations/implications

The paper enables a recasting of the history of the NHS; in particular, the potential for such a discursive history to highlight the interests supported and denied by different representational practices.

Practical implications

Today’s so-called leaders are leaders because of conventional representational practices – not because of some essence about what they really are.

Social implications

New ideas about the nature of management.

Originality/value

The value of thinking in terms of what language does – rather than what it might represent.

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