Sambrook Sally
Bangor Business School, University of Wales, Bangor, UK.
J Health Organ Manag. 2007;21(4-5):418-31. doi: 10.1108/14777260710778943.
The purpose of this paper is to examine human resource development (HRD) in the UK National Health Service (NHS), and particularly in two Welsh NHS Trusts, to help illuminate the various ways in which learning, training and development are talked about. The NHS is a complex organisation, not least with its recent devolution and separation into the four distinct countries of the UK. Within this, there are multiple and often conflicting approaches to human resource development associated with the various forms of employee, professional (nursing, medical etc.), managerial and organisational development. How people are developed is crucial to developing a modern health service, and yet, with the diverse range of health workers, HRD is a complex process, and one which receives little attention. Managers have a key role and their perceptions of HRD can be analysed through the discursive resources they employ.
DESIGN/METHODOLOGY/APPROACH: From an interpretivist stance, the paper employs semi-structured interviews with seven Directorate-General Managers, and adopts discourse analysis to explore how HRD is talked about in two Welsh NHS Trusts.
The paper finds some of the different discourses used by different managers, including those with a nursing background and those without. It examines how they talk about HRD, and also explores their own (management) development and the impact this has had on their sense of identity.
ORIGINALITY/VALUE: The paper highlights some of the tensions associated with HRD in the NHS, including ambiguities between professional and managerial development, the functional and physical fragmentation of HRD, conflict between a focus on performance/service delivery and the need to learn, discursive dissonance between the use of the terms training and learning, a delicate balance between "going on courses" and informal, work-related learning, inequities regarding "protected time" and discourses shifting between competition and cooperation. These tensions are exposed to help develop a shared understanding of the complexities of HRD within the NHS. The paper concludes with a summary of the different discursive resources employed by senior managers to articulate and accomplish HRD. These are "surfaced" to enable managers and HRD practitioners, amongst others, to construct common repertoires and shared meaning.
本文旨在研究英国国民医疗服务体系(NHS)中的人力资源开发(HRD)情况,特别是威尔士的两家NHS信托机构,以帮助阐明人们谈论学习、培训与发展的各种方式。NHS是一个复杂的组织,尤其是其近期权力下放并划分为英国四个不同国家的情况。在此背景下,与员工、专业人员(护理、医疗等)、管理人员及组织发展的各种形式相关的人力资源开发存在多种且往往相互冲突的方法。人员如何发展对于构建现代医疗服务至关重要,然而,鉴于医疗工作者的多样性,人力资源开发是一个复杂的过程,且很少受到关注。管理者起着关键作用,他们对人力资源开发的认知可以通过他们所使用的话语资源进行分析。
设计/方法/途径:从解释主义立场出发,本文对七位总干事级经理进行了半结构化访谈,并采用话语分析来探究威尔士两家NHS信托机构中如何谈论人力资源开发。
本文发现了不同管理者(包括有护理背景和没有护理背景的管理者)使用的一些不同话语。研究了他们如何谈论人力资源开发,还探讨了他们自身的(管理)发展以及这对他们身份认同感的影响。
原创性/价值:本文强调了NHS中与人力资源开发相关的一些矛盾,包括专业发展与管理发展之间的模糊性、人力资源开发的功能和实际碎片化、关注绩效/服务提供与学习需求之间的冲突、培训和学习这两个术语使用上的话语不一致、“参加课程”与非正式的与工作相关的学习之间的微妙平衡、关于“保护时间”的不公平现象以及话语在竞争与合作之间的转换。揭示这些矛盾有助于形成对NHS内部人力资源开发复杂性的共同理解。本文最后总结了高级管理人员用于阐述和实现人力资源开发的不同话语资源。这些资源被“揭示出来”,以便管理者和人力资源开发从业者等构建共同的话术和共享的意义。