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Liisa Kurunmäki, Andrea Mennicken and Peter Miller

Much has been made of economizing. Yet, social scientists have paid little attention to the moment of economic failure, the moments that precede it, and the calculative…

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Much has been made of economizing. Yet, social scientists have paid little attention to the moment of economic failure, the moments that precede it, and the calculative infrastructures and related processes through which both failing and failure are made operable. This chapter examines the shift from the economizing of the market economy, which took place across much of the nineteenth century, to the economizing and marketizing of the social sphere, which is still ongoing. The authors consider a specific case of the economizing of failure, namely the repeated attempts over more than a decade to create a failure regime for National Health Service (NHS) hospitals. These attempts commenced with the Health and Social Care Act 2003, which drew explicitly on the Insolvency Act 1986. This promised a “failure regime” for NHS Foundation Trusts modeled on the corporate sector. Shortly after the financial crash, and in the middle of one of the biggest scandals to face NHS hospitals, these proposals were abandoned in favor of a regime based initially on the notion of “de-authorization.” The notion of de-authorization was then itself abandoned, in favor of the notion of “unsustainable provider,” most recently also called the Trust Special Administrators regime. The authors suggest that these repeated attempts to devise a failure regime for NHS hospitals have lessons that go beyond the domain of health care, and that they highlight important issues concerning the role that “exit” models and associated calculative infrastructures may play in the economizing and regulating of public services and the social sphere more broadly.

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Thinking Infrastructures
Type: Book
ISBN: 978-1-78769-558-0

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Abstract

Details

Thinking Infrastructures
Type: Book
ISBN: 978-1-78769-558-0

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Book part

Jacob Reilley and Tobias Scheytt

This study sets out to shed light on those infrastructures underlying the ubiquitous, yet contested nature of governing by numbers. Investigating the 30-year long…

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This study sets out to shed light on those infrastructures underlying the ubiquitous, yet contested nature of governing by numbers. Investigating the 30-year long emergence of Germany’s “external quality assurance system” for hospitals, the authors show how methods for quantifying quality align with broader institutional and ideational shifts to form a calculative infrastructure for governance. Our study focuses on three phases of infrastructural development wherein methods for calculating quality, institutions for coordinating data and reform ideals converge with one another. The authors argue that the succession of these phases represents a gradual layering process, whereby old ways of enacting quality governance are not replaced, but augmented by new sets of calculative practices, institutions and ideas. Thinking about infrastructures as multi-layered complexes allows us to explore how they construct possibilities for control, remain stable over time and transform the fields in which they are embedded. Rather than governance being enacted according to a singular goal or value, we see an infrastructure that is flexible enough to support multiple modalities of control, including selective intervention, quality-based competition and automatized budgeting. Infrastructural change, instead of revolving around crises in measurement, is shaped by incubation periods – times of relative calm when political actors, medical practitioners, mathematicians, and many others explore and reflect past experiences, rather than follow erratic reforms fads. Finally, analysing infrastructures as multi-layered constructs underlines how they produce multiple images of care quality, which not only shift existing power relations, but also change the ways we understand and make sense of public services.

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Thinking Infrastructures
Type: Book
ISBN: 978-1-78769-558-0

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Michael Power

The notion, technologies and organizational elaboration of traceability have become more prominent and more systematic in recent years in many different fields, notably…

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The notion, technologies and organizational elaboration of traceability have become more prominent and more systematic in recent years in many different fields, notably food. This chapter argues that traceability has many faces: it is a programmatic value embedded in norms and regulations; it is a frontier of technology development such as blockchain, and it is a continuous processual and political dynamic of organizational connectedness, leading also to resistance. These different aspects make up “traceability infrastructures,” which embody a number of tensions and dynamics. Three such dynamics are explored in this chapter: the tension between organizational entities and meta-entities, problems of agency and the distribution of responsibility, and dialectics of connectivity and disconnectivity. These three dynamics generate three testable propositions, which define a prolegomena for a new subject of “traceability studies.” Overall, traceability is argued to be an ongoing process of connecting discrete agencies – a process of “chainmaking” – and is formative of more or less stable forms of distributed agency and responsibility.

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Afshin Mehrpouya and Rita Samiolo

Through the example of a “regulatory ranking” – an index produced with the aim to regulate the pharmaceutical market by pushing companies in the direction of providing…

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Through the example of a “regulatory ranking” – an index produced with the aim to regulate the pharmaceutical market by pushing companies in the direction of providing greater access to medicine in developing countries – this chapter focuses on indexing and ranking as infrastructural processes which inscribe global problem spaces as unfolding actionable territories for market intervention. It foregrounds the “Indexal thinking” which structures and informs regulatory rankings – their aspiration to align the interests of different stakeholders and to entice competition among the ranked companies. The authors detail the infrastructural work through which such ambitions are enacted, detailing processes of infrastructural layering/collage and patchwork through which analysts naturalize/denaturalize various contested categories in the ranking’s territory. They reflect on the consequences of such attempts at reconfiguring global topologies for the problems these governance initiatives seek to address.

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Thinking Infrastructures
Type: Book
ISBN: 978-1-78769-558-0

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Andreas Folkers

The chapter analyses the role of smart grid technology in the German energy transition. Information technologies promise to help integrate volatile renewable energies…

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The chapter analyses the role of smart grid technology in the German energy transition. Information technologies promise to help integrate volatile renewable energies (wind and solar power) into the grid. Yet, the promise of intelligent infrastructures does not only extend to technological infrastructures, but also to market infrastructures. Smart grid technologies underpin and foster the design of a “smart” electricity market, where dispersed energy prosumers can adapt, in real time, to fluctuating price signals that register changes in electricity generation. This could neutralize fluctuations resulting from the increased share of renewables. To critically “think” the promise of smart infrastructure, it is not enough to just focus on digital devices. Rather, it becomes necessary to scrutinize economic assumptions about the “intelligence” of markets and the technopolitics of electricity market design. This chapter will first show the historical trajectory of the technopolitical promise of renewable energy as not only a more sustainable, but also a more democratic alternative to fossil and nuclear power, by looking at the affinities between market liberal and ecological critiques of centralized fossil and nuclear based energy systems. It will then elucidate the co-construction of smart grids and smart markets in the governmental plans for an “electricity market 2.0.” Finally, the chapter will show how smart grid and smart metering technology fosters new forms of economic agency like the domo oeconomicus. Such an economic formatting of smart grid technology, however, forecloses other ecologically prudent and politically progressive ways of constructing and engaging with intelligent infrastructures.

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Marian Konstantin Gatzweiler and Matteo Ronzani

This study explores how thinking infrastructures can orchestrate collective sensemaking in unstable and socially contested environments, such as large-scale humanitarian…

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This study explores how thinking infrastructures can orchestrate collective sensemaking in unstable and socially contested environments, such as large-scale humanitarian crises. In particular, drawing from recent interest in the role of artifacts and infrastructures in sensemaking processes, the study examines the evaluative underpinnings of prospective sensemaking as groups attempt to develop novel understandings about a desired but ambiguous set of future conditions. To explore these theoretical concerns, a detailed case study of the unfolding challenges of managing a large-scale humanitarian crisis response was conducted. This study offers two contributions. Firstly, it develops a theorization of the process through which performance evaluation systems can serve as thinking infrastructures in the collaborative development of new understandings in unstable environments. Secondly, this study sheds light on the practices that support prospective sensemaking through specific features of thinking infrastructures, and unpacks how prospective and retrospective forms of sensemaking may interact in such processes.

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Pierre-André Juven

Whereas many researchers have examined the way in which health institutions have been transformed through funding modalities, and particularly through prospective payment…

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Whereas many researchers have examined the way in which health institutions have been transformed through funding modalities, and particularly through prospective payment systems (PPS), few have investigated the architecture of these systems, that is, costs and cost variance. Focusing on the study of costs and on the production of hospital rates, this chapter shows that the French PPS, called “rate per activity” made possible what we call a policy of variance. For health policymakers, the aim was to make the different accounting figures between hospitals, and between ways of practising healthcare, visible, in order to reduce these variances. This policy was attended by uncertainty in the processes of quantification, which led to metrological controversies. As a consequence of the issues around the way of calculating costs, some accounts and calculations were redone. In this chapter, we consider the case of metrological controversy over the remuneration of costs for cystic fibrosis patients’ hospital stays, and over the action of a patient organization that criticized the costs calculated officially. It leads to the analysis of the way calculative infrastructures, as cost accounting and rates, are challenged, and how some actors try to stabilize them.

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Hans Kjellberg, Johan Hagberg and Franck Cochoy

This chapter explores the concept of market infrastructure, which is tentatively defined as a materially heterogeneous arrangement that silently supports and structures…

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This chapter explores the concept of market infrastructure, which is tentatively defined as a materially heterogeneous arrangement that silently supports and structures the consummation of market exchanges. Specifically, the authors investigate the enactment of market infrastructure in the US grocery retail sector by exploring how barcodes and related devices contributed to modify its market infrastructure during the period 1967–2010. Combining this empirical case with insights from previous research, the authors propose that market infrastructures are relational, available for use, modular, actively maintained, interdependent, commercial, emergent and political. The authors argue that this conception of market infrastructure provides a powerful tool for unveiling the complex agencements and engineering efforts that underpin seemingly superficial, individual and isolated market exchanges.

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