ABSTRACT
This chapter explores the unusual nature of healthcare organisations, noting that they provide public services for human beings; are staffed by clinical professionals who operate as street-level bureaucrats and experience emotional labour. Conventional wisdom tends to treat healthcare organisations in exactly the same way as all other kinds of organisation. Yet there is a powerful case to be made that healthcare organisations are very different from most industrial, commercial and financial enterprises, while having some parallels with other public sector organisations. Healthcare organisations are also primarily professional organisations where the front-line clinical professionals possess a high degree of day-to-day control over their practice. Clinical professionals form what Mintzberg has called the “operating core” of healthcare organisations. Keith Grint has identified three kinds of problems which all organisations face and the “ideal types” associated with addressing them. Increased bureaucratisation of professional work has served to increase prescription and to decrease discretion.
