Martin Graeme, Beech Nic, MacIntosh Robert, Bushfield Stacey
Graduate School of Natural Resources Law Policy and Management, University of Dundee.
Sociol Health Illn. 2015 Jan;37(1):14-29. doi: 10.1111/1467-9566.12171. Epub 2014 Dec 20.
The discourse of leaderism in health care has been a subject of much academic and practical debate. Recently, distributed leadership (DL) has been adopted as a key strand of policy in the UK National Health Service (NHS). However, there is some confusion over the meaning of DL and uncertainty over its application to clinical and non-clinical staff. This article examines the potential for DL in the NHS by drawing on qualitative data from three co-located health-care organisations that embraced DL as part of their organisational strategy. Recent theorising positions DL as a hybrid model combining focused and dispersed leadership; however, our data raise important challenges for policymakers and senior managers who are implementing such a leadership policy. We show that there are three distinct forms of disconnect and that these pose a significant problem for DL. However, we argue that instead of these disconnects posing a significant problem for the discourse of leaderism, they enable a fantasy of leadership that draws on and supports the discourse.
医疗保健领域的领导主义话语一直是众多学术和实践争论的主题。最近，分布式领导（DL）已被采纳为英国国民医疗服务体系（NHS）政策的一个关键要素。然而，对于DL的含义存在一些混淆，并且在其应用于临床和非临床工作人员方面存在不确定性。本文通过借鉴来自三个将DL作为其组织战略一部分的同地医疗保健组织的定性数据，探讨了DL在NHS中的潜力。最近的理论将DL定位为一种结合了集中式和分散式领导的混合模式；然而，我们的数据给正在实施这种领导政策的政策制定者和高级管理人员带来了重大挑战。我们表明存在三种不同形式的脱节，并且这些脱节给DL带来了重大问题。然而，我们认为，这些脱节并非给领导主义话语带来重大问题，而是促成了一种利用并支持该话语的领导幻想。
