Lynch John
Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Leeds, UK.
J Health Organ Manag. 2004;18(2-3):128-35. doi: 10.1108/14777260410538906.
This paper seeks to gain an insight into the behavior of a large NHS trust, in its attempt to meet a 90 percent patient access target, in a week long national audit in March 2003. Why did individuals act in dramatically different ways to their norm over this period. The work of Michel Foucault is used to explore these issues. The discourses of power, knowledge, discipline and governmentality are identified as key foucaudian themes that offer an alternative interpretation of how individuals behave in their place of work. The importance of the historical context of discourse within the NHS cannot be underestimated in shaping the behavior of individuals and groups today. Power and knowledge permeate NHS organizations through disciplinary practices and dressage. Governmentality seeks to maintain the status quo through disciplinary processes such as national healthcare targets. The natural response of NHS organizations is therefore, to seek order and conformity rather than disorder and conflict.
本文旨在深入了解一家大型国民保健服务信托机构的行为,该机构在2003年3月为期一周的全国审计中试图实现90%的患者就诊率目标。为何在此期间,个体的行为与常态大相径庭。本文运用米歇尔·福柯的著作来探讨这些问题。权力、知识、规训和治理术的话语被视为关键的福柯式主题,它们为个体在工作场所的行为方式提供了另一种解读。国民保健服务体系内话语的历史背景在塑造当今个体和群体行为方面的重要性不可低估。权力和知识通过规训实践和训练渗透到国民保健服务机构中。治理术试图通过诸如国家医疗保健目标等规训过程来维持现状。因此,国民保健服务机构的自然反应是寻求秩序与 conformity,而非混乱与冲突。(注:conformity此处可能拼写有误,推测可能是“conformity”,意为“一致、顺从” )