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“…the NHS is unique. To name but a few of its characteristics, it is in the public sector, exceptionally large in terms of its resources, activities and numbers employed; domestic not international in its operations; its tasks are infinitely varied, complex and difficult; its goals are unclear; it is subject to an exceptionally wide range of political and economic influences; and it is an organisation uniquely and specially close to the hearts (metaphorically), minds and bodies (physically) of British people. It is run by ‘special' kinds of people too: dedicated, yet often ambitious, highly qualified and skilled, often bloody-minded and usually tough-minded, yet also caring and even tender.”(Glover and Leopold 1996:256)

The NHS is the largest employer in Europe, employing over a million clinical, infrastructure and support personnel (The Information Centre 2006). Whilst remaining close to the people's heart in terms of its founding values of a universal and comprehensive health care with its service delivery freely and equally available to all in society (Rivett 1997; Talbot-Smith and Pollock 2006), it is also close to the people's pockets, with billions of pounds having been invested into the NHS in the last ten years (Appelby 2007). In addition to providing a health service to the population, it is also claimed that ‘health and healthcare play a key role in generating social cohesion, productive workforce, employment and hence economic growth' (Harrison 2005) and for this reason, as Bach notes, the means to reform health care systems effectively is an issue that confronts policy makers worldwide. (2001:1) As such, the challenges facing the NHS in terms of management, change and efficiency are important to an audience far wider than the UK and those who use and work within the organisation.

In consuming around ￡50 billion per annum it is no wonder that successive British governments have attempted throughout the history of the NHS to dictate from the centre the ‘minutia' of the NHS's activities. A key problem however is that due to the complexity of the organisation itself and the politics that surround it, the methods used are considered by many to consist merely of ‘a plethora of complicated targets and initiatives that confound those who are charged to implement them' (Bradshaw 2003:90). In recognising the obvious public concern over the management, and expenditure, of the NHS both the previous Conservative and Labour governments and current New Labour invest considerable time, and tax-payers' money, into attempting to improve the service. Yet it is considered increasingly apparent that in responding to health deficiencies ‘by throwing money at them to see the quick, comfortable resolution of the political conflict that these inevitably cause' (Duncan-Smith 2002), continual change ‘for change's sake' has become the focus at the expense of the ultimate ‘telos' that created the health service (Kelly and Glover 1996:31).In consuming around ￡50 billion per annum本论文由英语论文网提供整理，提供论文代写，英语论文代写，代写论文，代写英语论文，代写留学生论文，代写英文论文，留学生论文代写相关核心关键词搜索。