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Hospital organization
313
Book reviews
system works. The researchers used the technique of working as catalysts with various individuals and groups. and discussed with their subjects how these see their position. funcDERRYANN MORITZOSENTON tion. authority and accountability in the hospital. Department of Nursing Education Part III consists of tentative conclusions. with an Massachusetts General Hospl’tal emphasis on the fact that conclusions can’t really yet be Boston. Massachusetts drawn. Ostensibly. the research aims at preparing the National Health Service for major structural change. Yet the philosophy of the researchers is based on a basic acceptance of the existing system. structure and organization patterns. The Living to be a Hundred-A Study of Old Age, by researchers aim to classify what happens at present. to disIVOR FELSTEIN.David & Charles. Newton Abbot. 1973. cover how the system really works rather than how it is supposed to work. I think this is quite an effective method of This book appears to have been aimed at the lay reader. approach. Nonetheless there is a heavy use of technical terms which It is however. naive to imagine that the process of clarifiremain unexplained, and copious citation of authors in supcation does not. of itself. produce change. An immediate port of statements, for which no references are given. The book has a highly “‘journalistic” tone. and though there is effect of the research is that those people who are in power become more aware of the effect of that power on others. a need for books giving information and guidance on aging Once people know how they affect others. they are highly to the intelligent layman, I do not think this one fulfills that likely to change their behaviour and a new, unresearched need adequately. It has nothing to offer to the professional situation then exists. Hence it seems to me a vain hope to reader. imagine that researchers can in fact fulfil their aim of discoH. M. HODKINS~N vering “what really happens”: this changes all the time. The research instead is likely to clarify roles. to improve comMaudsley Hospital munications among staff, to improve staff morale. within an London, England existing structure and to bring about change as a result of the processes set in motion by the researchers. In general. the book repeats most of what we already know about hospitals; for example. that the clinical Hospital organization, by R. W. ROWBOTTOMet al. Heineautonomy and authority of doctors permeates the whole mann, London, 1973. system and that other groups are still somewhat uncertain of their accountability. The book would be useful, I think. I found this book very hard to review, and while it was lying to change-agents who want to know what the existing sysin my “too hard” basket I came across an article by Rowtem is like. before they introduce change. Chapter 7, which bottom, the major author of the book. Suddenly I realized deals with nursing organization. would also be useful to why the book had been so irritating: it should really have nursing administrators who want to analyse their own nursbeen condensed to the length of perhaps two articles. ing departments. A number of newly coined names are useIn general, the book reads more like a Report to a governful. I think: for example. treatment-prescribing relationment department than like a book on organizational manaships, service relationships, outposting. These definitions gement. It is in fact a preliminary report of the studies unthrow some new light on the complex interrelationships in dertaken by the Health Services Organization Unit at hospitals. Brunei University. In particular the researchers have studA major omission is a discussion of differential pay rates. ied the organization of staff in a number of hospitals of the for different staff categories. Obviously the rate of pay North West Metropolitan Region, and have come to certain affects the status of the group and Jaques demonstrated the conclusions about the way organizational relationships importance of financial rewards in his other studies. I hope work in practice. The immediate need for the research arose this aspect will be examined in the final report. because of the restructuring of the British National Health Lastly. a note of irritation: the style of the book makes Service to begin in 1974. it hard to read. There are long footnotes throughout, and Part I discusses the theoretical assumptions. which were at the end of each chapter there are even longer notes. I based on the model used by Jaques and Brown in the Glahope that in the next edition the notes will either be incorcier Project studies. A number of role-relationships are isoporated in the text. or else deleted. lated, defined and illustrated. This section would have been more useful if it had been written in a problem-oriented Thr UCorrsityqf‘New South Wales ERICABATES way: it is rather heavy reading. For example, page 52, “The School of Health ildministrutio~t most straight-forward (relationships) discussed and identiAustralia fied in the research were those between certain pairs of colleagues where both members of the pair were carrying out operational work, where the work of both interacted, and where both were subject to the authority of some common superior, immediately or at some point organizationallyremoved”. Family Networks, by Ross V. SPECK and CAROLYN ATTPart II deals with the findings in the various hospitals. NEAVE.Pantheon Books, a division of Random House, New The researchers consider the organizational position of docYork. 1973. 160 pp. $6.95. tors. of medical committees. or paramedical staff. nurses and administrators. They discuss, at considerable length. the acIn Family Networks. Speck and Attneave have produced a countability of the various groups for seeing that the whole deceptively simple “how to” guide which takes the reader reader gains no new knowledge in relation to patient care or nursing practice.
Book reviews
system works. The researchers used the technique of working as catalysts with various individuals and groups. and discussed with their subjects how these see their position. funcDERRYANN MORITZOSENTON tion. authority and accountability in the hospital. Department of Nursing Education Part III consists of tentative conclusions. with an Massachusetts General Hospl’tal emphasis on the fact that conclusions can’t really yet be Boston. Massachusetts drawn. Ostensibly. the research aims at preparing the National Health Service for major structural change. Yet the philosophy of the researchers is based on a basic acceptance of the existing system. structure and organization patterns. The Living to be a Hundred-A Study of Old Age, by researchers aim to classify what happens at present. to disIVOR FELSTEIN.David & Charles. Newton Abbot. 1973. cover how the system really works rather than how it is supposed to work. I think this is quite an effective method of This book appears to have been aimed at the lay reader. approach. Nonetheless there is a heavy use of technical terms which It is however. naive to imagine that the process of clarifiremain unexplained, and copious citation of authors in supcation does not. of itself. produce change. An immediate port of statements, for which no references are given. The book has a highly “‘journalistic” tone. and though there is effect of the research is that those people who are in power become more aware of the effect of that power on others. a need for books giving information and guidance on aging Once people know how they affect others. they are highly to the intelligent layman, I do not think this one fulfills that likely to change their behaviour and a new, unresearched need adequately. It has nothing to offer to the professional situation then exists. Hence it seems to me a vain hope to reader. imagine that researchers can in fact fulfil their aim of discoH. M. HODKINS~N vering “what really happens”: this changes all the time. The research instead is likely to clarify roles. to improve comMaudsley Hospital munications among staff, to improve staff morale. within an London, England existing structure and to bring about change as a result of the processes set in motion by the researchers. In general. the book repeats most of what we already know about hospitals; for example. that the clinical Hospital organization, by R. W. ROWBOTTOMet al. Heineautonomy and authority of doctors permeates the whole mann, London, 1973. system and that other groups are still somewhat uncertain of their accountability. The book would be useful, I think. I found this book very hard to review, and while it was lying to change-agents who want to know what the existing sysin my “too hard” basket I came across an article by Rowtem is like. before they introduce change. Chapter 7, which bottom, the major author of the book. Suddenly I realized deals with nursing organization. would also be useful to why the book had been so irritating: it should really have nursing administrators who want to analyse their own nursbeen condensed to the length of perhaps two articles. ing departments. A number of newly coined names are useIn general, the book reads more like a Report to a governful. I think: for example. treatment-prescribing relationment department than like a book on organizational manaships, service relationships, outposting. These definitions gement. It is in fact a preliminary report of the studies unthrow some new light on the complex interrelationships in dertaken by the Health Services Organization Unit at hospitals. Brunei University. In particular the researchers have studA major omission is a discussion of differential pay rates. ied the organization of staff in a number of hospitals of the for different staff categories. Obviously the rate of pay North West Metropolitan Region, and have come to certain affects the status of the group and Jaques demonstrated the conclusions about the way organizational relationships importance of financial rewards in his other studies. I hope work in practice. The immediate need for the research arose this aspect will be examined in the final report. because of the restructuring of the British National Health Lastly. a note of irritation: the style of the book makes Service to begin in 1974. it hard to read. There are long footnotes throughout, and Part I discusses the theoretical assumptions. which were at the end of each chapter there are even longer notes. I based on the model used by Jaques and Brown in the Glahope that in the next edition the notes will either be incorcier Project studies. A number of role-relationships are isoporated in the text. or else deleted. lated, defined and illustrated. This section would have been more useful if it had been written in a problem-oriented Thr UCorrsityqf‘New South Wales ERICABATES way: it is rather heavy reading. For example, page 52, “The School of Health ildministrutio~t most straight-forward (relationships) discussed and identiAustralia fied in the research were those between certain pairs of colleagues where both members of the pair were carrying out operational work, where the work of both interacted, and where both were subject to the authority of some common superior, immediately or at some point organizationallyremoved”. Family Networks, by Ross V. SPECK and CAROLYN ATTPart II deals with the findings in the various hospitals. NEAVE.Pantheon Books, a division of Random House, New The researchers consider the organizational position of docYork. 1973. 160 pp. $6.95. tors. of medical committees. or paramedical staff. nurses and administrators. They discuss, at considerable length. the acIn Family Networks. Speck and Attneave have produced a countability of the various groups for seeing that the whole deceptively simple “how to” guide which takes the reader reader gains no new knowledge in relation to patient care or nursing practice.