ABSTRACT
This chapter explores several ideas about organisational culture, including the important roles that structure and power play. Within the context of health and social care, it is perhaps worth pausing to look at a term that is often associated with large public sector organisations – bureaucracy. Max Weber was not a fan of bureaucracies as he believed they could not deal with power or change effectively but instead deadened innovation. It helped, however, that he identified several characteristics of bureaucracies which are still useful today in making sense of organisations in health and social care. Gerry Johnson and his colleagues, in developing work dating from 1992, proposed a ‘cultural web’ as a relatively straightforward approach to analysing organisational culture. A critical view of culture sees it as reflecting power relationships within a group, a community or an organisation, an approach influenced by the idea of ‘hegemony’.
