Between surveillance and subjectification: Professionals and the governance of quality and patient safety in English hospitals

Graham P Martin, Myles Leslie, Joel Minion, Janet Willars, Mary Dixon-Woods

Research output: Contribution to journalArticle (Academic Journal)peer-review

24 Citations (Scopus)

Abstract

Two understandings of the dynamics of power developed by Foucault have been extensively used in analyses of contemporary healthcare: disciplinary power and governmentality. They are sometimes considered alternative or even contradictory conceptual frameworks. Here, we seek to deploy them as complementary ways of making sense of the complexities of healthcare organisation today. We focus on efforts to improve quality and safety in three UK hospitals. We find a prominent role for disciplinary power, including a panoptic gaze that is to some extent internalised by professionals. We suggest, however, that the role of disciplinary power relies for its impact on complementary strategies that are more akin to governmentality. These strategies foster organisational contexts that are receptive to disciplinary work. More fundamentally, we find that both disciplinary power and governmentality work on subjectivities in rather a different manner from that suggested by conventional accounts. We offer an alternative, less individualised and more socialised, understanding of the way in which power acts upon subjectivity and behaviour in professional contexts.
Original languageEnglish
Pages (from-to)80-8
Number of pages9
JournalSocial Science and Medicine
Volume99
DOIs
Publication statusPublished - Dec 2013

Bibliographical note

Copyright © 2013 Elsevier Ltd. All rights reserved.

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