Many years ago, a doctor friend who had been working in the NHS for decades shared his frustration about the growing managerialism in his workplace. He said that “the NHS is hiring highly paid managers who have nothing to do with either health systems or medical science. These over-glorified managers have been brought in to run the health service despite having not an iota of knowledge or training in healthcare or human welfare. Ironically, they have joined to make the NHS more efficient in its structure and functioning.” My friend said this after a long pause.
The same friend retired last week, and I was speaking with him about his post-retirement plans for life after leaving the NHS. During our conversation, I asked if he was considering returning part-time as a consultant. He replied, “I am glad to be out of the NHS, where managers have replaced the medical and health fraternity and relegated them to a small common room. Managers have taken over the space that was once used by doctors to learn and practise patient care. Doctors are now squeezed into a tiny room like sardines in a tin, while managers occupy entire floors and office spaces that were previously used by doctors, nurses, and other healthcare workers. These managers have ruined the NHS and its purpose. They squeeze every penny from the system to increase their own salaries.” My friend had always loved the NHS and his work treating patients, so hearing such disappointment from him not only surprised me but also highlighted the deeply entrenched perils of managerialism in healthcare.
The privatisation of healthcare has turned illness into a business; business of sickness. While it generates massive profits for private medical corporations, pharmaceutical companies, and health insurance providers, it does so at the expense of people’s health and well-being. Managerialism in healthcare has not improved the efficiency of medical care delivery for those in need; instead, it has bureaucratised patient care and delayed treatment under the guise of creating multiple layers of appointments, investigations, reporting, and treatment processes. Moreover, the privatisation of healthcare has expanded the profit empires of pharmaceutical and insurance companies. In essence, privatisation serves corporate interests while endangering human health by delaying timely health care and treatment.
In the same way, the privatisation of education — much like healthcare — has opened the doors for managerialism in universities and higher education institutions. Under the banner of industry–academia collaboration, a class of individuals has entered universities who have little or nothing to contribute to the growth of the teaching and learning environment. These individuals become managers of teaching and learning without any experience or training in knowledge production or dissemination. Many of them have never taught a class or written a single page of research, yet they shape policies on the quality of teaching and research. This managerial disaster is often justified in the name of efficiency and austerity, allowing managers to profit at the expense of teaching and learning — and at the cost of precarious students and staff.
University managers have begun awarding themselves professorial titles without making any meaningful contribution to the production or dissemination of knowledge, either within or beyond university structures. A colleague — a teacher and researcher who has worked in higher education for a long time — shared her frustration with the increasingly managerial nature of universities and the rise of a clientelist culture, where managers not only receive undeserved academic promotions but also grant promotions based on personal networks and client relationships. She expressed deep disappointment with a system that is dismantling the ideals of higher education in pursuit of profit-driven managerial practices. In such an environment, she feels unproductive as a researcher and disheartened as a teacher. As she put it, “The idealism, hope, optimism, and creative desires that drew me into academia no longer exist within these manager-led universities in the UK.”
Such trends of managerial overreach are not confined to universities in the UK. The profit-driven dominance of managerial culture across universities and institutions of higher learning represents one of the greatest threats to knowledge production and the learning environment necessary for skill development and knowledge transfer. This managerialist approach undermines the essential conditions for the growth of critical scholarship — scholarship that is vital for the social, political, and economic transformation of society. Managers increasingly view the curriculum as a product, teachers as sellers, and students as consumers, a perspective that fundamentally erodes the very idea and purpose of higher education.
Managerial bureaucracy — with its hierarchical mechanisms of control and its compliance culture in the name of efficiency and masquerading as “quality control” — is a myth. In reality, it serves to undermine the role of higher education as a tool for the radical transformation of society. It is time to rid our universities and institutions of higher learning of this managerial virus and reclaim them as spaces where students and staff are accountable only to one another, collaborating to develop and share knowledge freely without external control. Academic freedom for both students and staff is central to promoting creative teaching and learning environments within universities. The current perils and precarious conditions of higher education starkly reveal the extent of the managerial assault on education.
The managerial assault on health and education is deliberately designed to produce weak and compliant bodies and minds — individuals who cannot question the powers that domesticate their lives, dominate their labour, and control their creativity to sustain an unjust and exploitative rent-seeking system known as capitalism. This system, often embodied by markets, states, and governments, thrives on such managerial control. Therefore, the managerial assault is, at its core, a capitalist assault on health and education — one that seeks profit and perpetuates a rent-seeking culture devoid of the collective foundations of knowledge, consciousness, and skill.