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Making Wicked Problems Governable? - The Case of Managed Networks in Health Care (Hardcover)
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Making Wicked Problems Governable? - The Case of Managed Networks in Health Care (Hardcover)
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Over the last thirty years, scholars of health care organizations
have been searching for concepts and images to illuminate their
underlying, and shifting, modes of organizing. Nowhere has this
controversy been more intense than in the United Kingdom, given the
long succession of top down reorganizations within the National
Health Service (NHS) over the last thirty years. This book
characterises the nature of key reforms - namely managed networks -
introduced in the UK National Health Service during the New Labour
period (1997-2010), combining rich empirical case material of such
managed networks drawn from different health policy arenas
(clinical genetics, cancer networks, sexual health networks, and
long term care) with a theoretically informed analysis. The book
makes three key contributions. Firstly, it argues that New Labour's
reforms included an important network element consistent with
underlying network governance ideas, specifying conditions of
'success' for these managed networks and exploring how much
progress was empirically evident. Secondly, in order to
conceptualise many of the complex health policy arenas studied, the
book uses the concept of 'wicked problems': problematic situations
with no obvious solutions, whose scope goes beyond any one agency,
often with conflicting stakeholder interests, where there are major
social and behavioural dimensions to be considered alongside
clinical considerations. Thirdly, it makes a contribution to the
expanding Foucauldian and governmentality-based literature on
health care organizations, by retheorising organizational processes
and policy developments which do not fit either professional
dominance or NPM models from a governmentality perspective. From
the empirical evidence gathered, the book argues that managed
networks (as opposed to alternative governance modes of hierarchy
or markets) may well be the most suitable governance mode in those
many and expanding policy arenas characterised by 'wicked
problems', and should be given more time to develop and reach their
potential.
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