The role of the NHS in the development of Revans' action learning: correspondence and contradiction in action learning development and practice

Abstract

In adapting Bowles' and Gintis's correspondence principle of education, this paper suggests that there are ways in which the theory and practice of action learning developed in correspondence with the NHS. In doing so, the paper draws, in part, upon an historical assessment of Revans' Hospital Internal Communications Project of the 1960s, treated here as a special case, together with evidence drawn from a survey of current NHS action learning practice. It is suggested that the correspondence principle provides an explanation for some of the vertical development of action learning (over time) and its horizontal development (across situations). In setting out my argument I draw on the work of Foucault to inform a discussion on self-discipline and the internalisation of control via action learning and the developing role of critical action learning.

Keywords:

• correspondence principle
• action learning
• critical action learning
• NHS

Notes

For an account of the HIC project, the reader may turn to Revans (1972) Hospitals: Communication, choice and change: The Hospital Internal Communications Project seen from within.

Standards for Morale is reproduced in Revans (1976) Action learning in hospitals: Diagnosis and therapy.

Several equally blunt examples of dissent expressed by participants in HIC can be found in Revans (1972).

I was able to interview two HIC participants – Jonathan Holland, who was a student at the King's Fund at the time of HIC, and Professor Tom Arie, who was a psychiatrist and lecturer in social medicine.

This study followed on from a research project led by Burgoyne and Pedler and substantiated the findings of that earlier project but in the context of the NHS, see Pedler, Burgoyne and Brook (2005) What has action learning learned to become? My (NHS-based) study found that 84% of those questioned felt that action learning was concerned with bringing about personal change and development, as against 64% who felt it was concerned with achieving organisational change (based on the views of 95 respondents).

Having said this, self-managed action learning in the NHS was also in evidence in the survey, especially that developed by the University of Brighton.

As Klein (1995, 57) acknowledges, these dates are to an extent arbitrary, but they do fit with the generally held view of a broadly held political consensus in matters of social policy during that period, which only became frayed toward the end of the 1970s. The period included the era of Butskellism (derived from the names of RA Butler of the Conservatives and Hugh Gaitskell of the Labour Party), which suggested that there was no huge gap separating the political policy makers.

Bentham's model of the panopticon was a tower placed at the centre of a prison to afford effective surveillance of all prisoners. Foucault (2003, 53) draws on the idea in his work on discipline. Foucault coins the term panopticism to describe a form of power that relies not upon overt repression but on the constant surveillance of a population and ‘discipline’ or the regimentation of the population (Macey 2000).

See Learmonth and Pedler (2004) Auto action learning: A tool for policy change? Building capacity across the developing regional system to improve health in the North East of England Health Policy, 169–81.

Revans describes examples of participants ‘trying out new methods’, for example, establishing a weekly clinic with the attachment of a social worker to look at the growth and development of children (Revans 1975b, 210).

Written in 1995, Disclosing doubts devotes considerable space to Belgium's positive economic development (including tables showing, inter alia, output growth and productivity rates), which Revans (1995, 43–95) apparently links with ‘modern Belgian action learning’.

Revans (1971, 6–10, italics in original) writes: ‘Each fellow … was assigned to a full-time field study, lasting eight months, of a policy problem in an enterprise other than his own. … Each enterprise thus proposed and helped to design, with the university staff and the visiting participant himself, a project’.

My NHS survey found that 64% of those surveyed aimed to make more use of action learning in the future.

Williams and Burgoyne (2003) The vessel or the fire: How managers learn through knowledge, action and social practice (unpublished manuscript).

Taylor (2000, 18) was able to report in a millennium survey of the world of work that ‘we have also seen a significant advance in the proportion of employees who have a direct say on any decision that changes the way they work, up from 52 per cent ten years ago to 60 per cent in 2000. Nearly three quarters of these said they had a great deal or quite a lot to say or influence that decision. This compared with 64% who thought this in 1992', but Taylor (2000, 18) also found that ‘this change has not led automatically to a greater readiness by companies to allow their employees more autonomy in their jobs’.