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The role of the professional representative in the management of the National Health Service

Perkins, D. A (1983) The role of the professional representative in the management of the National Health Service. Doctor of Philosophy (PhD) thesis, University of Kent. (doi:10.22024/UniKent/01.02.94580) (KAR id:94580)


The thesis is about the role of professional representatives in the management of a large organisation - the National Health Service. Members of professions frequently work in organisations the leadership of which must reconcile professional and administrative occupational ideologies if its ability to determine policy and ensure its implementation is not to be frustrated. Co-optation of professional representatives onto management executives is one means of attempting to reconcile such ideological tensions. The success of such co-optation is dependent upon the structure of the professions and the representative systems devised.

Since its inception, the National Health Service has encouraged participation by clinicians in advisory, administrative and managerial capacities. Until 1974 such participation was largely by hospital consultants rather than GPs. One of the chief objectives of the 1974 reorganisation of the NHS was to integrate the three branches of the service and so GPs were made full members of the district management team. The position of GPs within the production and distribution of services was seen to be central and therefore the success of integration depended upon the representative process.

The research reported in this thesis examines the role of the GP team member. Five national surveys were conducted of GP team members, District/Area Medical Committee Secretaries, District/Area Administrators, GPs, and Local Medical Committee Secretaries. Survey findings are used with interview data to examine a number of hypotheses about the representative process, co-optation in a large organisation, and co-optation and the 1974 reorganisation of the NHS.

Item Type: Thesis (Doctor of Philosophy (PhD))
DOI/Identification number: 10.22024/UniKent/01.02.94580
Additional information: This thesis has been digitised by EThOS, the British Library digitisation service, for purposes of preservation and dissemination. It was uploaded to KAR on 25 April 2022 in order to hold its content and record within University of Kent systems. It is available Open Access using a Creative Commons Attribution, Non-commercial, No Derivatives ( licence so that the thesis and its author, can benefit from opportunities for increased readership and citation. This was done in line with University of Kent policies ( If you feel that your rights are compromised by open access to this thesis, or if you would like more information about its availability, please contact us at and we will seriously consider your claim under the terms of our Take-Down Policy (
Uncontrolled keywords: Health services & community care services
Subjects: H Social Sciences > HM Sociology
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research
SWORD Depositor: SWORD Copy
Depositing User: SWORD Copy
Date Deposited: 04 Jul 2023 13:53 UTC
Last Modified: 04 Jul 2023 13:53 UTC
Resource URI: (The current URI for this page, for reference purposes)

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