This paper explores the professionalization project of paramedics, based on an ethnographic study of UK National Health Service (NHS) ambulance personnel. Drawing on concepts derived from institutional theory and the sociology of professions, we argue that the project is enacted at two levels, namely a formal, structural and senior level reflecting changing legitimation demands made on NHS practitioners and pursued through institutional entrepreneurship, and an informal, agentic, ‘street level’ enacted by the practitioners themselves via ‘institutional work’. Focusing on this latter, front‐line level, our ethnographic data demonstrate that the overall impact of the senior level professionalization project on the working lives of paramedics has been somewhat muted, mostly because it has had limited power over the organizations that employ paramedics. Given the slow progress of the senior level professionalization project, paramedics at street level continue to enact subtle forms of institutional work which serve to maintain ‘blue‐collar professionalism’ – a form originally identified in Donald Metz's ethnography of ambulance work. Our analysis draws attention to the complex and contested nature of professionalization projects, in that their enactment at senior and street levels can be somewhat misaligned and possibly contradictory.

Based on qualitative interviews (n = 64) within five UK organizations that have embarked on large-scale restructuring (including delayering, downsizing, culture change, role redesign, lean production) we argue that middle managers are currently experiencing significant and progressive work and personal pressures. Performance is monitored more closely, hours and intensity of work are increasing, roles and tasks are changing frequently, and prospects for promotion are downscaled within flattened hierarchies. Whereas middle managers report increased levels of autonomy and skill, are often well remunerated, and frequently appear motivated (at least in the private sector), we suggest their burgeoning grievances over working hours, role pressures and promotion prospects have worrying implications for the future performance of UK industry. We argue further that the motivation for corporations to embark on such large-scale restructuring is best understood with reference to the incessant demands of international capitalism. We conclude that such restructuring, and the personal managerial experiences that result from it, is in keeping with many, but crucially not all, of the trends predicted by Bravermanian labour process theory. Copyright Blackwell Publishing Ltd 2008.

Lean thinking has recently re-emerged as a fashionable management philosophy, especially in public services. A prescriptive or mainstream literature suggests that lean is rapidly diffusing into public sector environments, providing a much-needed rethink of traditional ways of working and stimulating performance improvements. Our study of the introduction of lean in a large UK public sector hospital challenges this argument. Based on a three-year ethnographic study of how employees make sense of lean ‘adoption’, we describe a process in which lean ideas were initially championed, later diluted and ultimately eroded. While initially functioning as a ‘mechanism of hope’ (Brunsson, 2006) around which legitimacy could be generated for tackling longstanding work problems, over time both ‘sellers’ and ‘buyers’ of the concept mobilized lean in ambiguous ways, to the extent that the notion was rendered somewhat meaningless. Ultimately, our analysis rejects current prescriptive or managerialist discourses on lean while offering support for prior positions that would explain such management fashions in terms of the ‘life cycle of a fad’.

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University governance is becoming increasingly autocratic as marketization intensifies. Far from the classical ideal of a professional collegium run according to academic norms, today’s universities feature corporate cultures and senior leadership teams disconnected from both staff and students, and intolerant of dissenting views. This is not a completely new phenomenon. In 1960s America, senior leaders developed a technocratic and managerialist model of the university, in keeping with theories around the ‘convergence’ of socio-economic systems towards a pluralist ‘industrial society’. This administrative-managerial vision was opposed by radical students, triggering punitive responses that reflected how universities’ control measures were at the time mostly aimed at students. Today, their primary target is academics. Informed by Critical Theory and based on an autoethnographic account of a university restructuring programme, we argue that the direction of convergence in universities has not been towards liberal, pluralist, democracy but towards neo-Stalinist organizing principles. Performance measurements – ‘targets and terror’ – are powerful mechanisms for the expansion of managerial power or, in Marcuse’s words, ‘total administration’. Total administration in the contemporary university damages teaching, learning, workplace democracy and freedom of speech on campus, suggesting that the critique of university autocracy by 1960s students and scholars remains highly relevant.