THE POLITICAL ECONOMY OF MANAGEMENT KNOWLEDGE: MANAGEMENT TEXTS IN ENGLISH HEALTH CARE ORGANIZATIONS (original) (raw)
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The field of public administration and management exhibits a limited number of favoured 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 analysing a long term shift to indirect governance evident in the field? We suggest 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. When compared to the Network Governance narrative, the Anglo-governmentality perspective distinctively highlights: (i) a power knowledge nexus giving strong technical advice; (ii) pervasive grey sciences, which produce such evidence-based guidelines (iii) the ‘subjectification’ of local governing agents, here analysed using Foucauldian concepts of the ‘technology of the self’ and ‘pastoral power’; and (iv) 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 the State and segments of the medical profession form a loose ensemble and that professionals retain scope for colonising these new arenas. We finally suggest that Anglo-governmentality theory warrants further exploration within knowledge based public organizations.
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