Managers have to make moral choices, the NHS's high-flying trainees were told at their conference. Mark Crail reports

Young NHS managers with their careers still ahead of them should set out to 'reclaim' the idea of management from the private sector and instil it with public service values, according to a top public sector management guru.

Speaking at the NHS management training scheme conference in Blackpool last week, Greg Parston, chief executive of the Office for Public Management, said the idea of management had been 'hijacked'.

'Management is not value-free. It is about social choice and social outcomes.

It is about taking moral stances and developing shared purposes, ' he told the conference, which brought together 200 NHS and civil service high-fliers.

'The reason management is not seen as a value-laden exercise is that it has been hijacked. Management is the systematic application of social science to the behaviour of organisations - it is not a private sector monopoly.'

Dr Parston told the conference: 'The ethos of public good has been lost to the language of efficiency and efficacy and the pursuit of financial and not social goals.'

Despite attempts by 'politicians who have never run anything' to put ethics back into the private sector, business leaders such as Sir Stanley Kalms of Dixons continued to insist shareholders' interests were paramount.

'Mainstream managers must reclaim the right to put public purpose back on the bottom line, ' said Dr Parston.

Our NHS is not there to be the most efficient organisation in the world. It is there to improve the health of the people of Britain.'

Speaking on the day NHS managers came under attack for receiving large pay rises, Dr Parston also launched a defence of NHS chief executive Alan Langlands, who was sitting next to him on the conference platform.

'The man on my right runs an organisation that, in terms of staff numbers, is 10 times the size of the largest private sector organisation in Britain - British Telecom. I know his salary is one-tenth the salary of the chief executive of BT, ' he said.

'New Labour had better wake up to the realities of what they call their way.'

Speaking earlier in the conference, Mr Langlands said the NHS would have to be 'much more open' about service reconfiguration and hospital closures, and to go out and explain more clearly what it was doing.

'We have to stop treating people as if we understand these issues and they don't, ' he said.

Mr Langlands said he could understand why people became passionately attached to hospitals. He too felt a pang of regret when change affected hospitals in which he had worked.

'My sister phoned recently to ask me to advise her on how to run a campaign to save their local accident and emergency department. We had to have a very long talk about it.'

But when the trade-off between local accessibility and clinical effectiveness was explained, people would often opt for the latter.

'It is no longer good enough to tell people you are going to change the health service by sending an indecipherable 40-page document to the local advice centre.

'Consultation is something we have to do with people, not to them, ' he concluded.