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This paper welcomes Bevir’s Democratic Governance, applauding especially its theoretical coherence and sophistication, and its conclusion that we need a more dialogic, diverse notion of democracy. However, it also raises concerns regarding Bevir’s decentred approach to the state and his non-foundationalism. In the former case it suggests that the demise of the role of the state has been over-estimated, especially in the wake of the financial crisis. In the latter case, it claims that to understand the problems public services face, it is often necessary to embrace a materiality that non-foundationalism finds it hard to accommodate. The paper illustrates concerns by showing how these combined in the development of Labour policy in the UK between 1997 and 2010 o produce an account that has a very different emphasis to Bevir’s.

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.

Contends that path‐dependency provides an accurate, but under‐theorised description of organisational behaviour. By incorporating insights from actor‐network theory, we can better understand the processes by which organisations become “locked‐in” to behaviour patterns, but also how we might begin to break free from them. It seems that we must pay greater attention to the role of durable materials in networks, and to the strategies of simplification employed within organisations to deal with the complexity that surrounds them. In order to understand path‐dependency we must also look wider than traditional management theory towards a more semiotic understanding of organisational communication. All of these findings point to managers having to reconsider their role, especially with regard to the power that they may or may not hold, and to move towards an approach based more on the governance of their organisations than attempting to control every aspect under their jurisdiction. Concludes by providing some appropriate strategies through which this might be achieved.

This article explores issues of trust in narratives of interpreted consultations in primary health care.

The paper is based on empirical data from a qualitative study of accounts of interpreted consultations in UK primary care, undertaken in three north London boroughs. In a total of 69 individual interviews and two focus groups, narratives of interpreted consultations were sought from 18 service users, 17 professional interpreters, nine family member interpreters, 13 general practitioners, 15 nurses, eight receptionists, and three practice managers. The study collected and analysed these using a grounded theory approach and taking the story as the main unit of analysis. It applies a theoretical model that draws on three key concepts: Greener's taxonomy of trust based on the different “faces” of power in medical consultations; Weber's notion of bureaucratic vs traditional social roles; and Habermas' distinction between communicative and strategic action.

Trust was a prominent theme in almost all the narratives. The triadic nature of interpreted consultations creates six linked trust relationships (patient‐interpreter, patient‐clinician, interpreter‐patient, interpreter‐clinician, clinician‐patient and clinician‐interpreter). Three different types of trust are evident in these different relationships – voluntary trust (based on either kinship‐like bonds and continuity of the interpersonal relationship over time, or on confidence in the institution and professional role that the individual represents), coercive trust (where one person effectively has no choice but to trust the other, as when a health problem requires expert knowledge that the patient does not have and cannot get) and hegemonic trust (where a person's propensity to trust, and awareness of alternatives, is shaped and constrained by the system so that people trust without knowing there is an alternative). These different types of trust had important implications for the nature of communication in the consultation and on patients' subsequent action.

The methodological and analytic approach, potentially, has wider applications in the study of other trust relationships in health and social care.

Quality in the interpreted consultation cannot be judged purely in terms of accuracy of translation. The critical importance of voluntary trust for open and effective communication, and the dependence of the latter on a positive interpersonal relationship and continuity of care, should be acknowledged in the design and funding of interpreting services and in the training of both clinicians, interpreters and administrative staff.

This is the first study in which interpreted consultations have been analysed from a perspective of critical sociology with a particular focus on trust and power relations.

One of the major developments of the post‐War years has been the rise of consumer protection ‘watchdog’ committees galore, a flood of legislation and completely changed enforcement methods by existing local authority officers who to all and intents have become a completely new service. Voluntary agencies, national and local, based on the local High Street, have appointed themselves the watchdogs of the retail trade; legislation and central departments, the larger scene. The new service has proved of inestimable value in the changed conditions; it continues to develop. When shopping was a personal transaction, with the housewife making her purchases from the shopkeeper or his staff on the opposite side of the counter; when each was well known to the other and the relationship had usually lasted for many years, often from one generation to the next, things were very different, complaints few, unsatisfactory items instantly replaced, usually without question. This continuing state of equanimity was destroyed by the retail revolution and new methods of advertising and marketing. Now, the numbers of complaints dealt with by consumer protection and environmental health departments of local authorities are truly enormous. We have become a nation of “complainers,” although in all conscience, we have much to complain about. Complaints cover the widest possible range of products and services, of which food and drink form an integral component. The complaints to enforcement authorities include many said to be unjustified, but from the reports of legal proceedings under relevant enactments, it is obvious that the bulk of them now originate from consumer complaints. Not all complainants, however, relish the thought of the case going before the courts. Less is heard publicly of complaints to the numerous voluntary bodies. Enforcement authorities see complaints in terms of infringements of the law, although their role as honest broker, securing recompense to the aggreived customer, has become important; a few departments being able to claim that they secured reimbursements and replacements of value totalling upwards of amounts which annually run into six figures. The broker role is also that adopted by voluntary bodies but with much less success since they lack the supporting authority of legal sanction.

New Chief Executive for Aslib. Roger Bowes, the successor to Dennis Lewis at Aslib, is a former Chief Executive of Express Group Newspapers and of Mirror Group Newspapers. He comes to Aslib from the Chairmanship of Citybridge Ltd, a management consultancy.

New Chief Executive for Aslib Roger Bowes, the successor to Dennis Lewis at Aslib, is a former Chief Executive of Express Group Newspapers and of Mirror Group Newspapers. He comes to Aslib from the Chairmanship of Citybridge Ltd, a management consultancy.

I summarize my views on democratic governance before responding to critics. Governance arose partly from the impact of modernist social science on public policy and it limits the space for democratic action. My preferred alternative is an interpretive social science inspiring more participatory and dialogic democratic practices. In defending these arguments, I concentrate on the nature of interpretive social science and its relation to democratic theory. I define interpretive social science in theoretical terms as based on recognition of the role of meanings in human life and the holistic and historical nature of meanings. This interpretive social science does not lead to any particular methods or topics, but it does rule out reified and deterministic appeals to structures. Democratic renewal depends on promoting interpretive social science, not institutional blueprints.