NHS managers as rhetoricians: a case of culture management?

In the wake of Peters and Waterman's In Search of Excellence few NHS managers are unaware of culture management as a tool for shaping organisational change. Yet the first wave of post-Griffiths studies found little evidence of ‘culture management’ in action. This paper draws on data from an ethnographic study carried out in 1988–90 to suggest that the symbolic facet of management action is an important, though neglected, element in the 1991 NHS reforms. It argues that rhetorical skills Iwere a valuable resource for general managers overseeing the change process, and explores some of the ways in which rhetoric may have influenced cultural adaptation. However, many of the specific claims of the ‘excellence genre’, including ideas about the importance of strong, homogeneous cultures, are rejected. Rhetoric is an aspect of micro-political struggles over meaning, which rarely result in straightforward cultural ‘manipulation’, and are more likely to re-shape organisations through pragmatic accommodation than to win the hearts and minds of members.