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地方政府面临的规范性难题:管理英国单人护理服务的引入

Normative puzzles for local government: Managing the introduction of single-handed care in England.

作者信息

Rooney Leigh, Rapley Tim, Whitehead Phillip J

机构信息

Newcastle University, Newcastle upon Tyne, UK.

Northumbria University, Newcastle upon Tyne, UK.

出版信息

Sociol Health Illn. 2023 May;45(4):718-733. doi: 10.1111/1467-9566.13618. Epub 2023 Jan 28.

Abstract

A crisis in social care is apparent across the developed world as ageing populations put unprecedented demand on understaffed social care workforces. A recent popular response to this 'care crisis' within the UK involves the 'innovation' of single-handed care (SHC). SHC involves a care package with two or more homecare workers being reduced to one worker using advanced equipment and new moving and handling techniques. In this article, we explore how SHC is rendered in 245 documents from 52 local authorities in England. Using Actor Network Theory as an interpretative lens, we suggest documents attempt to satisfy three 'duties of care': to the individual wellbeing of citizens, morally and fiscally to the collective and to innovation. Each appeal to different stakeholder groups necessary for SHC to work, but the combination of duties can pose problems in enabling coherent stories of SHC. Duties can be kept apart in different documents, but at times they must be brought together in certain textual spaces to enact SHC as a coherent enterprise. Here, the potential tensions that emerge are routinely orientated to as (merely) problems of process that can and should be managed in and through a more refined approach to change management.

摘要

随着人口老龄化对人手不足的社会护理劳动力提出前所未有的需求,社会护理危机在整个发达国家都很明显。英国最近针对这种“护理危机”的一种普遍应对措施是单人护理(SHC)的“创新”。单人护理涉及将由两名或更多家庭护理人员组成的护理套餐减少为一名使用先进设备和新搬运技术的护理人员。在本文中,我们探讨了英格兰52个地方当局的245份文件中如何呈现单人护理。以行动者网络理论为解释视角,我们认为这些文件试图履行三种“护理职责”:对公民个人福祉的职责、在道德和财政方面对集体的职责以及对创新的职责。每种职责都针对单人护理得以实施所必需的不同利益相关者群体,但这些职责的组合在构建连贯的单人护理故事时可能会引发问题。职责可以在不同文件中分开阐述,但有时必须在某些文本空间中将它们整合在一起,以便将单人护理作为一个连贯的事业来实施。在这里,出现的潜在紧张关系通常被视为(仅仅)是流程问题,可以而且应该通过更精细的变革管理方法来管理和解决。

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