Power is defined by Weber in (Wilson 1999:91) as the ability to get others to do what you want them to do, even if this is against their will. It is also defined specifically by Morgan in (Mullins 2005:843), who sees power as a medium through which conflicts of interest are ultimately resolved. This has led to the struggle, which can be characterised, by competition and challenge. Power and control both play a major part in NHS Trust, the organisation has been driven by what Etzioni describes as coercive power which mean (Mullins 2005:844) “power that relies on the use of threats, or physical sanctions or force” from the foundation, when there was an influence over the decision of multi-skilling in the area of domestics that were divided into teams and how the supervisors designated their area of cleaning and other duties. Luke’s (1974) portrays this as Radical face of power ‘ power reflects a dominant set of interests that is somehow imposed on the majority (Steven Lukes from Fincham & Rhodes 2005,p.561).
Power has been a force in the NHS practices; this is illustrated through the proposals for change put forward by the management as it follows on to an interesting question, which will gain from theses changes? The staffs involved in this changes will gain from participating in different tasks, which enables them to undertake a full range of domestic and pottering role.
The NHS downside that were met amongst the porters and nursing staffs was based on Changes of task, shift and pay rise if their performance at work for this change is accomplished. This enables each individual to keep a record of job success so that the relationship between the organisational goal and actual performance is apparent (Hammer and Hammer, 1976). . These are the ethical issues raised when managers are provided with tools like authority designed to control subordinate (Gill and Anne-Marie, 2000). It also presumes that the controller of behaviour which are the managers at work all have unquestioned control and authority (Gill and Anne-Marie, 2000).
The disadvantage aspect of this improved programme is that, inconsiderable cost savings will occur since it would be difficult to track down porters and also allowing the porters power over nursing staffs come to an end in the NHS. However, the Finance Director, Steve Fountain (NHS Trust), argued that successful implementation would help to provide good value for money and make cost savings. This can be brought about the alteration from the process of staffs working in NHS Trust, while their needs are not met equally even when changes have been made for the workers to be multi-skilled There are different views from the managers such as the shift changes in tasks and pay rise but some are supporting or opposing the facts of the multi-skilled workers taking up the various tasks given. Managers will also try to avoid making decisions with very long-term implications. Therefore, decision-making becomes an activity to solve pressure and not to discuss uncertainty avoidance like the long-term strategies (Cyert and March, 1963).
In addition, this changes led to the management’s decision-making over the employees and how the managers can handle the decision made if any crisis occur. Moreover, crisis can happen even if the managers’ draw out plans to take up the decision for changes in the hospitals based on the departments concerned (Tim, 2003). The managers may look into situations like staffs undertaking a wider array of task as providing opportunities to show exceptional competence in order for the staffs to have flexibility and teamwork.
The classical value of system, traditional organisation theory represents an individualistic, rational approach to life that sets the highest values of achievement (Rokeach, 1972:160). Also, this achievement can be obtained when an employee’s performance is well structured such as attendance of workers for an increase in their pay. These are those behaviours which may take up relatively little effort for an individual or a team, but which are very effective for performance in their organisation (Luthans and Kreitner, 1974; 1975). This in the NHS Trust may be restricted for managers in the extent to which they can alter the level of pay scales and benefits, or decision-making about promotions (David, 1990).
The NHS Trust is a way of culture where anything such as the task given to workers can bring about changes in culture. The changes in culture of the NHS Trust multi-skilled staffs resulted to how some ancillary nurses felt threatened because the Hotel Services believed their staff to be better trained (Fred, 1992, Organisational behaviour). Organisational culture is the collection of traditions, values, policies, beliefs, and attitudes that constitute a persuasive context for everything we do and think in an organisation (Mullins 2005:891). It functions as to provide relatively fixed patterns for handling and solving problem, relating to the organisation’s ability coping with changes (Deode, 1998). In a situation whereby, the change process involved needs reallocation of duties such as the NHS Trust staff moving from nursing to domestic staff and dispensing food to patients.
Cultural change will be necessary in this aspect, if change is very vital and may even be a condition, which will enable strategic renewal to take place and will allow the organisational structure to function properly in a different way like involving in various tasks (Oswick et al. 1996). Furthermore, this cultural change may be seen as the performance on mainly tasks and jobs in organisations and how it is strongly affected by the job relevant knowledge and skills of the individuals who do the work (Porter et. al). The pilot scheme managed by Dougie McEwen (NHS Trust) was effective and they were enthusiastic and dedicated. Likewise, some of the staffs involved in the pilot scheme did not work towards the changes but thought such process that proves difficult. In the NHS Trust, several departments had an awareness workshop for senior managers, who would then take the initiative down to lower levels (Andrew, 2004).
The management team was structured from the Director of Site Services, deputy and the managers of domestic and porter’s staff for their decision-making. With this, organisational decision-making model can be used for the ideal stages, which management teams go through in solving their problems or in creating new opportunities. The Kurt Lewin’s model can be used to portray a target of change and such as a measure of change that has two forces (Hatch, 1997:353). They are the driving forces and restraining forces which is a merit and demerit for the task given to perform (Hatch, 1997:353).
The changes in NHS way of life is that the organisation allows changes in order to adapt, which started in the form of fordism structure involving strong power and a pyramid structure to a post fordism structure with a flatter structure, self regulating units and horizontal communication. There was resistance of change from staffs due to no approval of team working, from staffs even if they contributed to productivity and workers, which became more flexible in the organisation. It meant the change was basically effective and ineffectual. NHS is an organisation that truly needs a change and in order for this change to be completely effective, the organisation as a whole would have to hold unto the culture change and let go of traditions. Also, this can be said to be a form to fix power and control as it is an evident through out the case study, every member of staff was to be multi-tasking from one department to another. The group leaders for example where bitter over their status and authority being worn. To add, this can be seen as an issue of power and control effectiveness used and not used to a specific group or individuals. This may be an advantage with time but the whole organisation will slowly embrace the change and then the NHS can modify it self as an organisation with successful transformational change.
However, the system of NHS is letting people down in the aspect of dentistry crisis, in a documentary which featured, the fact people have resorted to pulling their teeth out with pliers or fixing broken crowns with glue some of which are old people. Dentists also have their issues due to clinical problems such as recruiting or retaining dentists who no longer accept the NHS patients. This changes appears to having many patients being forced to go private because they do not want to loose their current trusted and respected dentist.
REFRENCES
Andrew K. and John B. (2004), Working in Organisations. Second edition. England
David C, Robert H (1990), Managing Organizations. England
Gill Kirton and Anne-Marie (2000), The Dynamics of Managing Diversity; a crucial approach. Oxford
Hatch,M.J.,(1997) Organization Theory. United States of America:Oxford
Jerald and Robert A. Baron (2003), Behaviour in Organisation. Eight edition. New Jersey.
Michael A. and Angela B. (2005), Managing Performance, Performance Management in Action. London
Mullins. L (2005), Management and Organisational Behaviour. Seventh edition. Essex: Pitman
Oswick,C.,&Grant D,(1996) Organization Development: Metaphorical Explorations London: Pitman
Porter. W, Bigley A and Steer M (2003), Motivation and Work Behaviour. Seventh edition. New York
Rollinson. D (2005), Organisational Behaviour and Analysis: An Integrated Approach. 3rd ed. England: Prentice Hall
Wilson. F (1999), Organizational Behaviour. New York: Oxford
BIBILIOGRAPHY
Bloisi. W, Cook, C. and Hunsaker. P (2003), Management and Organisational Behaviour. London: McGraw-Hill
Cole. G.A (1996), Management Theory and Practice. London: Letts
Fred L (1992), Organisational behaviour. Sixth edition. Singapore
Hales C. (1994), Managing Through Organisation. London: Rout ledge
Hales C. (2001), Managing Through Organisation. Second edition. London: Business Press
Mescon. M, Albert. M and Khedouri. F (1988), Management. Third edition. New York: Harper & Row
R. Wayne and Shane R. (1995), Management, Concepts, Practices and Skills. Seventh edition. New Jersey
Susan and Jean B. (2003), Managing Across Cultures. England
Tim Hannagan (2002), Management, Concepts and Practices. Third edition. England