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Purpose

This paper aims to propose that healthcare is dominated by a managerialist ideology, powerfully shaped by business schools and embodied in the Masters in Business Administration. It suggests that there may be unconscious collusion between universities, healthcare employers and student leaders and managers.

Design/methodology/approach

Based on a review of relevant literature, the paper examines critiques of managerialism generally and explores the assumptions behind leadership development. It draws upon work which suggests that leading in healthcare organisations is fundamentally different and proposes that leadership development should be more practice-based.

Findings

The way forward for higher education institutions is to include work- or practice-based approaches alongside academic approaches.

Practical implications

The paper suggests that there is a challenge for higher education institutions to adopt and integrate practice-based development methods into their programme designs.

Originality/value

The paper provides a challenge to the future role of higher education institutions in developing leadership in healthcare.

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