Separately, but to some extent integrated, is a third ideological strand, that of paternalism. Male domination in health care is of long standing and it was of interest how the female managers attempted to undermine this through the use of gender games. However, such games were not actually going to lead to any major threat to senior male managers and male medical staff. On the whole, as Anyon (1983) explained, such activities are likely to be low profile and individual. Generally, the behaviour of the two professional groups tended to follow a gendered path. As highlighted in a range of literature, gender underpins most of our activities and the different professions have built on this with the incorporation of certain stereotypes that are still strong in spite of legal and other measures to change them (see Hugman (1991) for a comprehensive summary of gender and the caring professions). However, some women managers were able to dip in and out of using the conventional stereotypes. It was interesting that several female managers made the point that they were not 'gentle, loving sorts of people'.
With this somewhat complex matrix of ideological influences, further development of an ideological explanation of managerial behaviour needs to move from an interpretation of ideologies as discrete entities to one that can explore the inter-relations between them. I suggest that the concept of ideological articulations as proposed by Gramsci (1971) and developed by Mouffe (1979) might be particularly useful in progressing the analysis I have initiated here