Making Wicked Problems Governable?: The Case of Managed Networks in Health Care

Hardcover | April 21, 2013

byEwan Ferlie, Louise Fitzgerald, Gerry McGivern

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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 downreorganizations 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 suchmanaged 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 socialand 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 eitherprofessional 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 timeto develop and reach their potential.

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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 downreorganizations within the National Health Servi...

Ewan Ferlie, AcSS, FRSA, is currently Professor of Public Services Management at Kings College London and previously Head of Department. He has written and published widely on organizational change and restructuring in public services organizations, including health care and also higher education. He is co editor of the Oxford Handbook...
Format:HardcoverDimensions:375 pages, 9.21 × 6.14 × 0.01 inPublished:April 21, 2013Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0199603014

ISBN - 13:9780199603015

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Table of Contents

1. Introduction and Overview2. "Reforming" Health Care Organizations: From New Public Management to Network Governance?3. A Governmentality Based Perspective on UK Health Care Organizations4. Genetics Translation Networks: The Continuing Autonomy of Academic Science5. Managed Cancer Networks: Exemplars of Evidence Based Governmentality?6. Sexual Health Networks: Working With Problematic Human Behaviours7. Networks for Older People's Care: A Really Wicked Problem8. The Limited Role of Information and Communication: Technologies in Managed Networks9. Leadership in Health Care Networks: Small Committed Clinical Managerial Hybrid Teams and Evidence-based Identity Work10. Inter-organizational Learning Within The Networks: A Disappointing Pattern11. Governmentality and Health Care Networks12. New Labour and UK Health Care: Managed Networks, Wicked Problems, and Post NPM Organising13. Concluding Discussion: Overall Contribution and Forward Look