Managing Diabetes, Managing Medicine: Chronic Disease and Clinical Bureaucracy in Post-War Britain

Managing diabetes, managing medicine explores how medical professionals' decision-making and labor became subject to bureaucratic regulation and managerial oversight in twentieth-century Britain. It positions managerial medicine as a co-constructed venture, driven by different motives, and involves doctors, nurses, professional bodies, government agencies, and international organizations.

Format: Hardback
Length: 320 pages
Publication date: 25 February 2019
Publisher: Manchester University Press

This book, available as an open-access ebook under a CC-BY-NC-ND license, presents a groundbreaking historical monograph that delves into the intricate process of how the decision-making and labor of medical professionals in twentieth-century Britain were subjected to bureaucratic regulation and managerial oversight. In contrast to the prevailing perception of healthcare management as either a political imposition or an assertion of medical control, this work presents a nuanced perspective, highlighting that managerial medicine emerged as a collaborative endeavor. While driven by distinct motives, doctors, nurses, professional bodies, government agencies, and international organizations played pivotal roles in the establishment of managerial systems. These stakeholders operated within a dynamic context characterized by profound professional, political, technological, economic, and cultural transformations.

The emergence of managerial medicine in twentieth-century Britain can be traced back to several key factors. One of the most significant drivers was the increasing demand for efficient and standardized healthcare delivery, driven by factors such as the growth of the population, the rise of chronic diseases, and the need to manage healthcare resources effectively. As a result, medical professionals began to recognize the importance of adopting management practices and techniques to improve the quality and efficiency of healthcare services.

Another important factor was the influence of professional bodies and organizations. Medical associations, such as the Royal College of Physicians and the Royal College of Nursing, played a crucial role in shaping the development of managerial medicine. They advocated for the adoption of management principles and practices, and they provided training and education to medical professionals in these areas. Professional bodies also developed guidelines and standards for healthcare management, which helped to standardize the practices of medical professionals and ensure quality care.

Government agencies also played a significant role in the development of managerial medicine. The introduction of healthcare policies and regulations, such as the National Health Service (NHS) in the United Kingdom, aimed to improve the quality and accessibility of healthcare services. These policies required medical professionals to adopt managerial practices and to work within a bureaucratic framework. Government agencies also provided funding and resources to support the development of managerial systems and practices.

International organizations also played a role in the development of managerial medicine. The World Health Organization (WHO) and other international health agencies provided guidance and support to countries in developing their healthcare systems. They advocated for the adoption of management principles and practices, and they provided training and education to medical professionals in these areas. International organizations also developed guidelines and standards for healthcare management, which helped to standardize the practices of medical professionals and ensure quality care.

The creation of managerial systems in twentieth-century Britain was a complex and multifaceted process. Doctors, nurses, professional bodies, government agencies, and international organizations worked together to develop and implement these systems. They faced numerous challenges and barriers, such as resistance from medical professionals, cultural differences, and technological constraints. However, they were able to overcome these challenges by collaborating and by developing innovative solutions.

One of the key features of managerial systems was the emphasis on standardization and control. Medical professionals were required to follow strict protocols and procedures, and they were monitored and evaluated based on their performance. This emphasis on control was driven by the need to ensure quality care and to manage healthcare resources effectively. However, it also led to concerns about the autonomy and independence of medical professionals, as they were increasingly subject to bureaucratic regulation and managerial oversight.

Another important aspect of managerial systems was the development of management roles. Medical professionals were required to develop new skills and competencies, such as project management, decision-making, and communication. They were also required to work in teams and to collaborate with other healthcare professionals to ensure effective care delivery. This development of management was driven by the need to improve the quality and efficiency of healthcare services and to meet the changing needs of patients.

Despite the benefits of managerial systems, they were not without their criticisms. Some medical professionals argued that they were overly bureaucratic and that they reduced the autonomy and independence of medical professionals. Others argued that they were driven by financial incentives and that they prioritized profits over patient care. There were also concerns about the impact of managerial systems on the quality of care, as they may lead to a reduction in the time spent with patients and a focus on standardized protocols and procedures rather than individual patient needs.

In conclusion, this book offers a comprehensive and insightful exploration of the historical development of managerial medicine in twentieth-century Britain. Through its study of diabetes care in this period, it demonstrates how the decision-making and labor of medical professionals became subject to bureaucratic regulation and managerial oversight. By presenting managerial medicine as a collaborative endeavor, it challenges the prevailing
prevailing perception of healthcare management as either a political imposition or an assertion of medical control. The book highlights the significant role played by doctors, nurses, professional bodies, government agencies, and international organizations in the creation of managerial systems, and it explores the complex and multifaceted challenges and barriers they faced in this process. It also examines the development of management in medical professionals, the emphasis on standardization and control, and the criticisms and concerns raised about these systems. This book is a valuable resource for scholars, researchers, and policymakers interested in understanding the historical development of healthcare management and its impact on the quality of care.

Weight: 502g
Dimension: 147 x 224 x 21 (mm)
ISBN-13: 9781526113078