Consider social anthropology

doi:10.1136/bmj.39283.413148.1F

BMJ 2007;335:172 (28 July), doi:10.1136/bmj.39283.413148.1F

Letters

NHS restructuring

Consider social anthropology

The first 150 words of the full text of this article appear below.

Braithwaite provides a practical strategy for coping with therestructuring of the NHS.¹ NHS organisations are distinguishedonly by their instability, and the costs of this are high.²So why do we do it?

It is a symbolic act for politicians, so what is also of interestnow is the symbolism of who is appointed to lead this—and,whatever the personal characteristics of the individual, thesymbolism of a surgeon sends out specific messages about doctorled action. From a social anthropological perspective it mayalso represent the reaffirmation of the order of tribes in healthcare,³ ⁴ which increases in importance in forming and maintainingidentity for individuals as the organisational identities failyet again.

But the continual costly and often ineffective process of mergerand acquisition in private industry is predicated on similartribalism and results in similar costs, so the lessons fromany sector that can be learnt . . . [Full text of this article]

Annabelle L Mark, professor of healthcare organisation

Middlesex University Business School, London NW4 4BT

a.mark@mdx.ac.uk