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Bringing Anglo-governmentality into public management scholarship : the case of evidence-based medicine in UK health care
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Ferlie, Ewan and McGivern, Gerry (2014) Bringing Anglo-governmentality into public management scholarship : the case of evidence-based medicine in UK health care. Journal of Public Administration Research and Theory, Volume 24 (Number 1). pp. 59-83. doi:10.1093/jopart/mut002
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Official URL: http://dx.doi.org/10.1093/jopart/mut002
Abstract
The field of public administration and management exhibits a limited number of favored themes and theories, including influential New Public Management and Network Governance accounts of contemporary government. Can additional social science–based perspectives enrich its theoretical base, in particular, analyzing a long-term shift to indirect governance evident in the field? We suggest that a variant of Foucauldian analysis is helpful, namely “Anglo-governmentality.” Having reviewed the literatures, we apply this Anglo-governmentality perspective to two case studies of “post hierarchical” UK health care settings: first, the National Institute for Health and Clinical Excellence (NICE), responsible for producing evidence-based guidelines nationally, and the second, a local network tasked with enacting such guidelines into practice. Compared with the Network Governance narrative, the Anglo-governmentality perspective distinctively highlights (a) a power–knowledge nexus giving strong technical advice; (b) pervasive grey sciences, which produce such evidence-based guidelines; (c) the “subjectification” of local governing agents, herein analyzed using Foucauldian concepts of the “technology of the self” and “pastoral power”; and (d) the continuing indirect steering role of the advanced neoliberal health care State. We add to Anglo-governmentality literature by highlighting hybrid “grey sciences,” which include clinical elements and energetic self-directed clinical–managerial hybrids as local governing agents. These findings suggest that the State and segments of the medical profession form a loose ensemble and that professionals retain scope for colonizing these new arenas. We finally suggest that Anglo-governmentality theory warrants further exploration within knowledge-based public organizations.
| Item Type: | Journal Article | ||||
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| Subjects: | H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management R Medicine > RA Public aspects of medicine |
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| Divisions: | Faculty of Social Sciences > Warwick Business School | ||||
| Library of Congress Subject Headings (LCSH): | Great Britain. National Health Service -- Management, Health services administration -- Great Britain, Public health administration -- Great Britain, Foucault, Michel, 1926-1984, National Institute for Health and Clinical Excellence (Great Britain) | ||||
| Journal or Publication Title: | Journal of Public Administration Research and Theory | ||||
| Publisher: | Oxford University Press | ||||
| ISSN: | 1053-1858 | ||||
| Official Date: | January 2014 | ||||
| Dates: |
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| Volume: | Volume 24 | ||||
| Number: | Number 1 | ||||
| Page Range: | pp. 59-83 | ||||
| DOI: | 10.1093/jopart/mut002 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Open Access | ||||
| Funder: | National Institute for Health Research (Great Britain) (NIHR) | ||||
| Grant number: | 08/1518/102 (NIHR) |
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