Qualitative management research in the NHS. A classic case of counting to one?

This paper examines research that has been undertaken to investigate management in health care and argues that there is no firm "evidence base" to demonstrate its effectiveness. However there is an emerging tradition of qualitative work, which has developed in response to the pace of organisational and structural change in health care, which reveals that the prevalent "ideal type" of rational management is inaccurate. One of the avowed strengths of qualitative research is that it uncovers what the nature of a particular phenomenon is, in essence it aims to "count to one". This need to understand and define health care management, forms the rationale for the studies reviewed and has influenced the research agenda in this area. Evidence is being demanded to demonstrate the efficacy of all clinical procedures, yet in researching managerial practice we are still counting to one.