Skip to main content
×
×
Home

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

  • Lorna McKee (a1)
Extract

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.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Conflicts and context in managing the closure of a large psychiatric hospital
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Conflicts and context in managing the closure of a large psychiatric hospital
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

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

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Bulletin
  • ISSN: 0140-0789
  • EISSN: 2514-9954
  • URL: /core/journals/bjpsych-bulletin
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 8 *
Loading metrics...

Abstract views

Total abstract views: 11 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 24th June 2018. This data will be updated every 24 hours.

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

  • Lorna McKee (a1)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *