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The purpose of this paper is to explore how the patient comes to be seen as a solution to governance problems.

The paper studies health policy discourse in Denmark from 1970 to 2000. Based on an analysis of national policy documents, the paper traces how the patient is redefined as part of governance problems.

The paper suggests that “the new patient” coincides with changes in healthcare governance and is not just a clinical concern. The persona of the patient has been mobilized in dissimilar ways in addressing specific policy problems, resulting in both a duty-based idea of a socio-economically responsible patient and a rights-based idea of a demanding health-service consumer.

The study is limited to policy documents that address healthcare governance in one country. It does not describe the broader evolution of patient ideas or the practical impact of political discourses.

Practitioners should expect to encounter conflicting views of patient responsibilities, interests and involvement. Such conflicts are not only related to a lack of conceptual clarity but are indicative of how the new, active and responsible patient has become a key clinical concern and a central element of health policy governance.

The paper contributes to the understanding of “the new patient” in discussions on patient-centred healthcare and empowerment by emphasizing the definition of the patient in a political context. The latter has often been ignored in existing research.

Health policies often require individuals to limit behaviours deemed enjoyable or suffer other burdens. This leads to considerable and contested discourse often played out in the popular media. The aim of this study is to determine the effects of such contested media discourse on viewers' perceived attitude change towards the target behaviour.

Combining concepts from discourse analysis and marketing-psychology elaboration models, the authors undertook an online survey in which a large sample of the public (N = 855) watched parts of a real daytime news debate on the UK Sugar Tax. The authors then evaluated the effects of this discourse on the perceived understanding of the tax and perceived attitude change to the consumption of sugary drinks.

Participants differentiated between parts of the discourse related to facts and arguments (termed argument-related discourse devices) and parts related to the format and tone of the debate (termed debate-/speaker-related discourse devices). Contrary to what might be expected, debate-/speaker-related discourse devices, which might be thought of as subjective, appeared to effect positive perceived attitude change through a cognitive processing route that involved perceived improved understanding. The argument-related discourse devices, which may appear objective or rational, were not associated with perceived improved understanding but were directly associated with positive perceived attitude change.

Given the authors' interest in the relationship between discourse and perceived attitude change, the authors take the novel step of linking concepts from discourse analysis with models of attitude change taken from the marketing-psychology domain. Furthermore, the authors' large-scale survey “democratises” discourse analysis, allowing non-expert participants to reflect upon discourse.

This article aims at the sociological inquiry seeking to identify meanings ascribed to the term of vulnerability by official spokespersons, to explore a novel public health policy with reference to vulnerable populations and to trace its enactment with particular attention to vulnerable populations in Greece; finally a case of contest among the state and the civil society over refugees' rights will be located against public health politics and biopolitics in the context of the pandemic Covid-19.

The interpretivist perspective towards analysis of textual data is adopted. Discourse analysis and content analysis are applied to analyze four sets of data.

The main findings show: (1) ambiguity over the terminology, (2) insufficient policy design and policy enactment towards the protection of vulnerable populations' health, (3) an illuminative case of contest among civil society and the state against infringement of refugees' human rights which may interpreted in terms of a tradition of solidarity.

The Foucauldian notion of biopolitics provides the grounds to understanding how market prevails over life at the expense of those in greater need, and how the state, serving homo economicus, intensifies instead of alleviating health vulnerabilities.

The aim of this chapter is to discuss the complexities and ambiguities of health-related citizenship in the neoliberal era. The scholarly discussions investigating the impact of neoliberalism on health and health care have primarily focused on the power of the neoliberal system. At the same time, the capacity of patients and citizens to act against neoliberal principles has been rarely discussed. Against this backdrop, we explore the ways in which civically engaged patients and citizens cope with neoliberal governance. To do so, we focus on the Czech context, as one that is not narrowly dominated by market-driven neoliberal logic but that blurs the distinction between marketisation and social protection. More specifically, we address the following two questions: What are the reactions of citizens and patients to the imperatives of neoliberalism? What are the implications for our understanding of health-related citizenship in the neoliberal era? Our analysis is underpinned by interviews and observations of public and patient involvement in the Czech Republic. Furthermore, the data gathered from interviews were enriched through a review of available documents, including media articles, policy briefs, political statements and websites. We conclude that the neoliberal era is not only connected with the emergence of individualised, conscious citizens whose health is governed at a distance, but also with the occurrence of collectively organised, health-care conscious citizens who problematise the nature of contemporary health-care governance. We thus explain and illustrate how neoliberal ideology is imprinted on the behaviour of patients and citizens, as well as how they resist and strategically appropriate neoliberal imperatives.

Ideas of health-related deservingness in theory and practise have largely been attached to humanitarian notions of compassion and care for vulnerable persons, in contrast to rights-based approaches involving a moral-legal obligation to care based on universal citizenship principles. This paper aims to provide an alternative to these frames, seeking to explore ideas of a human rights-based deservingness framework to understand health care access and entitlement amongst precarious status persons in Canada.

Drawing from theoretical conceptualizations of deservingness, this paper aims to bring deservingness frameworks into the language of human rights discourses as these ideas relate to inequalities based on noncitizenship.

Deservingness frameworks have been used in public discourses to both perpetuate and diminish health-related inequalities around access and entitlement. Although, movements based on human rights have the potential to be co-opted and used to re-frame precarious status migrants as “undeserving”, movements driven by frames of human rights-based deservingness can subvert these dominant, negative discourses.

To date, deservingness theory has primarily been used to speak to issues relating to deservingness to welfare services. In relation to deservingness and precarious status migrants, much of the literature focuses on humanitarian notions of the “deserving” migrant. Health-related deservingness based on human rights has been under-theorized in the literature and the authors can learn from activist movements, precarious status migrants and health care providers that have taken on this approach to mobilize for rights based on being “human”.

In the UK the concept of social exclusion came into widespread use in mental health following the publication of an influential Social Exclusion Unit report in 2004. Based on a comparison of ways of defining social exclusion with the mental health literature, this article begins by outlining a social systems approach to understanding social exclusion. The approach is later used to examine the position of people with mental health needs in the UK. First, however, a common assumption that social inclusion constitutes the opposite of social exclusion is addressed and an alternative way of thinking about the two concepts is put forward. A further assumption that social inclusion is self‐evidently desirable is also critiqued from political and service user perspectives before drawing conclusions from the evidence reviewed. These concern a need for policy initiatives to focus on tackling the structural barriers that work to exclude people with mental health needs, as well as on challenging the deep‐rooted prejudice and stigmatisation that reinforce those barriers; and a need to be mindful of the context in which inclusion policies are implemented, the assumptions that become implicit within these policies, and the possible consequences of their adoption as a moral imperative.

This paper aims to bring greater clarity to the debate on the merits (or demerits) of relative performance evaluation through a broad assessment of current UK National Health Service (NHS) benchmarking. It seeks to examine whether benchmarking is being used dynamically to disseminate best practice in healthcare, or whether it is primarily a government tool to enforce static competitive performance standards.

Draws on recent literature and government pronouncements. It charts the development of the health care policy discourse that articulated a move from the internal market of the early 1990s to the metrics approach of New Labour.

Benchmarking is one of the private sector‐grown “managerialist” tools whose application and significance is rapidly increasing in the UK public sector. Despite its prevalence, the nature (competitive or comparative), the process (based on indicators or ideas) and the outcomes (standards or “best practice”) of benchmarking in public services remain unclear. The findings reveal that benchmarking requirements, imposed by government policy, are articulated in terms of comparative ideas – benchmarking with the stated objective of “sharing best practice”, but are operationalised and disseminated in the form of indicator league tables with standardised benchmarks for performance. Hence, there is an apparent “articulated policy – implemented practice gap”. Concludes that, whilst benchmarking is a highly desirable policy instrument, its practical relevance to health care improvement is still in doubt.

The findings are relevant to both NHS policy‐makers and to NHS actors who must engage with the processes and outcomes of benchmarking practices.

Using Dean's (2010) analytics of government, this research explores how regimes of governing practices are linked to the underlying policy rationalities in dealing with the UK government's COVID-19 testing policies as a strategy for governing at a distance, including how targets were set and operationalized.

This paper draws on the UK government's policy documents, other official publications (plans) and parliamentary discourse, together with publicly available media information related to its COVID-19 policies.

This research reveals that, with respect to the governance of COVID-19 in the UK, testing has the dual role of inscription for the government's performance and classification for the pandemic risks. The analysis illustrates that the central role of testing is as a technology for classification for identifying and monitoring the virus-related risks. Moreover, our discourse analysis suggests that initially COVID-19 testing was used by the UK government more for performance communication, with the classificatory role of testing and its performativity as a strategic device evolving and only being acknowledged by government gradually as the underlying testing infrastructure was developed.

This paper is based upon publicly available reports and other information of a single country's attempts to control COVID-19 over a relatively short period of time.

This paper provides a critical understanding of the role of (accounting) numbers in developing an effective government policy for governing COVID-19.

Since the 1980s UK government enthusiasm for market reforms has reconfigured the nature and scope of public services. Initially the marketisation of public services changed how public services were provided, increasingly market reforms and pro business policies have also modified the formation and understanding of public policy problematics and how they ought to be resolved. This is particularly noticeable when markets work imperfectly or even fail. UK governments have shown their reluctance to employ regulatory instruments to change the behaviour of companies preferring instead to make use of softer interventions, by focusing on providing advice for consumers and urging individuals to act responsibly. The dilemmas of this approach are explored by discussing the UK's former Labour government's (1997–2010) response to the increase in the incidence of obesity and related health complications.

This paper presents contextual and empirical analyses of the pressures on senior health managers in the NHS through an examination of the documents produced by the NHS National Co‐ordinating Centre for Service Delivery and Organisation on “Managing change”. The result is a discussion and advocacy of the means through which “knowledge” with “knowing” might be brought together in the NHS to move it more towards an evidence‐based approach to management.