Dr Kathryn Oliver says it’s not academics, Directors of Public Health, politicians or big business who are the most influential, but those without any public health background –managers in the health service and local government.
And it’s the middle managers, she says, who have successfully brought issues such as minimum unit price for alcohol to the forefront of the policy agenda.
Her findings provide some rare comfort to middle-managers under fire by some media commentators and politicians, who claim there are too many.
Health Secretary Jeremy Hunt and his predecessor Andrew Lansley have highlighted the “pen-pushing culture” in the NHS, promising to reduce bureaucracy.
For her research she asked 152 policy leaders across local government and the NHS in an English conurbation to nominate the most powerful and influential people in public health policy across the city.
A small minority of the ten or so Directors of Public health were singled out as not having any influence at all – whereas middle managers were seen as being among the most influential.
The researcher, who carried out the work from the University’s Centre for Epidemiology and the School of Social Sciences, said: “Despite the extraordinary pressures on local government and NHS caused by funding cuts and reorganisations, my research shows middle managers have worked wonders.
“But though they are highly influential through all stages of the policy process, this is a group that is much maligned by politicians and journalists.
“My research shows that expertise in public health or research doesn’t necessarily help people to be influential.
“Instead, skills which aren’t necessarily headline grabbing but nevertheless crucial seem to be more important in getting things done.
“These include persuading and influencing people, running meetings and being able to bring people and organisations together.
“Managers are also able to provide policy content, and manage selected experts and executives to act as ‘champions’ on policies.”
Greater Manchester, says Dr Oliver, is an example of a region where managers punch above their weight.
The impetus for minimum unit alcohol pricing, she says, was created by local NHS managers and council officers who provoked Westminster into a response by declaring that Manchester was considering the policy.
And the region’s managers – not health bosses – were also responsible for transforming stroke services from having the worst survival rates in England to amongst the best.
She added: “My research shows public health professionals and academics are indirectly connected to policy – but only via managers.
“They are in a position to control how information is passed between different groups, and become the ‘go-to’ people from research and policy alike.
“So I hope this research injects some balance into the way we think about these incredibly important public servants.”
Notes for editors
Image courtesy Ambro and freedigitalphotos.net
Dr Kathryn Oliver is available for interview
She is due to publish a forthcoming paper on her research – though previous analysis are available
For media enquiries contact:
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The University of Manchester
0161 275 0790