Journal Articles

Logics of marginalisation in health and social care reform: Integration, choice, and provider-blind provision

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The period 2010–2013 was a time of far-reaching structural reforms of the National Health Service in England. Of particular interest in this paper is the way in which radical critiques of the reform process were marginalised by pragmatic concerns about how to maintain the market-competition thrust of the reforms while avoiding potential fragmentation. We draw on the Essex school of political discourse theory and develop a ‘nodal’ analytical framework to argue that widespread and repeated appeals to a narrative of choice-based integrated care served to take the fragmentation ‘sting’ out of radical critiques of the pro-competition reform process. This served to marginalise alternative visions of health and social care, and to pre-empt the contestation of a key norm in the provision of health care that is closely associated with the notions of ‘any willing provider’ and ‘any qualified provider’: provider-blind provision.

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Detail Information

Series Title

Critical Social Policy

Call Number

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Publisher

Thousand Oaks : Sage Publications., 2015

Collation

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Language

English

ISBN/ISSN

2015

Classification

NONE

Content Type

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Media Type

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Carrier Type

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Edition

Volume 35, Issue 1 February 2015, pages 45-68

Subject(s)

Discourse theory
Health care integration
Logics
Marginalisation nodal analysis

Specific Detail Info

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