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

Glynos, Jason and Speed, Ewen and West, Karen (2015) 'Logics of marginalisation in health and social care reform: Integration, choice, and provider-blind provision.' Critical Social Policy, 35 (1). 45 - 68. ISSN 0261-0183

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Abstract

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.

Item Type: Article
Uncontrolled Keywords: discourse theory, health care integration, logics, marginalisation, nodal analysis
Subjects: H Social Sciences > H Social Sciences (General)
H Social Sciences > HM Sociology
Divisions: Faculty of Science and Health > Health and Social Care, School of
Faculty of Social Sciences > Government, Department of
Depositing User: Ewen Speed
Date Deposited: 27 Oct 2014 09:19
Last Modified: 26 Feb 2019 11:15
URI: http://repository.essex.ac.uk/id/eprint/11193

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