The opening sentences of the book invite the reader to the church of San Clemente, near the Colosseum in Rome. The church is unprepossessing from the outside but inside is a beautiful 12^th Century Basilica built upon a 4^th Century church that is itself built upon a Mithraic temple. The theme of the book is that within the everyday practice of management lie hidden religio-ethical assumptions that go largely unnoticed by the casual observer.

Using examples largely from the NHS, Pattison adopts what he calls ‘the view from below’ in examining the nature of management and its theoretical development. He sees management as a religion based upon:

1. the faith assumptions of management
2. the religious style and order of management
3. the faith content and the religious language used

Management is made up of myths and dogmas, pretty much like an ideology but then Pattison’s view is that religion is much like an ideology with a system of symbols, eg strategic planning may be helpful as a tool of social control but the believe that they act as real maps or charts of organisational action is a matter of faith. Thus, he likens the general management reforms introduced into the NHS from 1984 to the religious fundamentalism of the North American evangelicals with much in common including:

• a sense of commitment
• the past is discarded as a time of darkness
• a strong sense of corporate identity
• the individual is important and can be converted to find a sense of purpose and belonging
• perfection to be sought
• leadership is directive and comes from above
• leadership based upon charismatic authority
• managers are required to exhibit inner asceticism and self-control
• a sense of identity and vision

Pattison argues that life is changing so fast that people need to believe in something, to give them a sense of belonging and he explores the reciprocal relationship between business and religion in the USA. He notes, in particular the role of management gurus and the ‘revivalist’ atmosphere of a Tom Peters presentation. Religious metaphors feature prominently as Vision is described and Mission is followed.

Pattison uses the notion of perfection to explore performance measurement and the concept of ideals. He also suggests that increased consumer expectations are part of the search for perfection. However, in the search for perfection, we are doomed to disappointment.

Towards the end of the book, Pattison explores more general ethical issues for managers in the NHS, he examines appraisal and, finally, the nature of change management. Whilst the critique of some of the management practices adopted in the NHS is worthwhile, Pattison has strayed from his major theme of management as religion. This theme allows Pattison to offer us some illuminating insights but is not, ultimately, sustainable as a thoroughgoing critique of modern management practices.

(London, Cassell) pp188 ISBN 0-304-70144-0

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