TY - JOUR
T1 - Between surveillance and subjectification
T2 - Professionals and the governance of quality and patient safety in English hospitals
AU - Martin, Graham P
AU - Leslie, Myles
AU - Minion, Joel
AU - Willars, Janet
AU - Dixon-Woods, Mary
N1 - Copyright © 2013 Elsevier Ltd. All rights reserved.
PY - 2013/12
Y1 - 2013/12
N2 - 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.
AB - 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.
U2 - 10.1016/j.socscimed.2013.10.018
DO - 10.1016/j.socscimed.2013.10.018
M3 - Article (Academic Journal)
C2 - 24355474
SN - 1873-5347
VL - 99
SP - 80
EP - 88
JO - Social Science and Medicine
JF - Social Science and Medicine
ER -