ABSTRACT
Early attempts at control, from the creation of a moral machinery, through the development of piece-work, to the introduction of scientific management and human relations, although they all have implications for the structure of organizations, were oriented to individuals and groups within organizations, rather than to organizations per se. Although they were developed initially in the sphere of productive enterprise as means of controlling the capitalist labour process, they are capable of extension both beyond productive organizations and capitalist societies. While the example cited in Chapter 3 of Lenin's use of Taylorism justifies the correctness of the first assertion, changes in the structure of nursing in the British Health Service demonstrate the latter. In the late 1960s the whole structure of nursing in Britain was transformed by the implementation of the Salmon Report. This recommended that a hierarchical structure of nursing grades be established as part of the management of a modern hospital, to be implemented through the process of writing job descriptions for the new grades in the hierarchy. The job descriptions re-defined the nurse's role at the various levels, and removed many elements of both mental (ward supervision) and manual (physically moving patients, emptying bed-pans) labour from the nurse's role, removing them either to a superordinate or subordinate, such as a higher-graded nursing post, or to porters or auxiliary staff. The process whereby this re-design was achieved was one of individual jobs being re-designed on criteria of efficiency not too far removed from those which can be found in scientific management's re-design of jobs. The objective consequences are exactly the same: the hyper-qualification of mental labour, the hiving off of mental from manual labour and the down-grading of manual labour to a less professional auxiliary status.
