Problematizing the role of lay-workers: lessons from a clinical setting

This paper seeks to problematize the role(s) that lay-workers can play and the nature of their relationship with other, well-established professional groups. Views are extracted from the literature on how best to manage the introduction of lay-workers into professional settings and the paper examines the experience of attempting this in national health demonstration project funded by the Scottish Executive Health Department. Whilst the literature argues that the use of lay-workers will enhance flexibility and challenge some of the bureaucratic/hierarchical problems of traditional organizations, the empirical evidence presented here suggests that phenomena such as hierarchy are persistent and that individual and collective identities are constantly renegotiated in a complex and dynamic process which recreates hierarchy albeit in an unintentional way. This paper offers a series of observations from the project study then generalise in terms of implications for management practice and management theory.