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

299 Pages·2013·1.011 MB·English

by  Ewan Ferlie, Louise Fitzgerald, Gerry McGivern, Sue Dopson, Chris Bennett

Making Wicked Problems Governable?
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Making Wicked Problems

Governable?
The Case of Managed Networks
in Health Care
Ewan Ferlie
Louise FitzGerald
Gerry McGivern
Sue Dopson

Chris Bennett
1
3

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© Ewan Ferlie, Louise FitzGerald, Gerry McGivern, Sue Dopson, and Chris Bennett 2013
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First Edition published in 2013
Impression: 1
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Contents
Acknowledgements i x
List of Acronyms x i
1. Introduction and overview 1
2. ‘Reforming’ UK health care organizations—from New Public
Management to network governance? 5
3. A governmentality-based perspective on UK
health care organizations 32
4. Genetics Translation Networks: The continuing
autonomy of academic science 53
5. Managed Cancer Networks: Exemplars of evidence-based
governmentality? 7 3
6. Sexual Health Networks: Working with problematic
human behaviours 9 7
7. Networks for Older People’s Care: A really wicked problem 119
8. T he limited role of Information and Communication
Technologies in managed networks 144
9. L eadership in health care networks: Clinical-managerial
hybrid teams and evidence-based identity work 162
10. I nter-organizational learning in the networks:
A disappointing pattern 189
11. Governmentality and health care networks 2 12
12. New Labour and UK health care: Managed networks,
wicked problems, and post-NPM organizing 2 24
13. Concluding discussion—overall contribution
and forward look 237
vii
Contents
Appendix 1. S tudy design and methods 249
Appendix 2. D eveloping a performance assessment framework 253
Bibliography 257
Index 275

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Acknowledgements
We would like to thank various people who contributed greatly to this study.
Dr Pauline Allen at the London School of Hygiene and Tropical Medicine was
a great supporter of the original idea of commissioning research on health
care networks and of getting the National Institute of Health Research’s
then Service Delivery Organization programme to commission a signifi cant
research programme on the theme of networks in health care. She was ably
assisted by the programme’s administrative team, then also based at the
School.
We would also like to thank members of the project advisory board for their
valuable insight and advice: namely Professor Janet Askham, Dr Jim Elliott,
Dr Mike Kelly, Professor Mark McCarthy, Professor Julienne Meyer, Professor
Adrian Newland, Professor Alison Richardson, and Roger Wilson. We much
benefi ted from advice from Professor Janet Askham from the Picker Institute,
especially on the older people’s cases. Janet tragically died in the course of the
study and was much missed by us all.
We much enjoyed discussions with colleagues working on the other net-
works projects commissioned by the Service Delivery and Organization pro-
gramme, notably at the one day conference held at the School of African
and Oriental Studies which brought all four teams together. We thank all our
respondents for giving up their time to be interviewed and hope they fi nd
this monograph both interesting and useful. We also acknowledge we have
used and extended some work in this book which has been previously pub-
lished in journal form, namely:
Ferlie , E., FitzGerald, L. McGivern, G., Dopson, S., and Bennett, C . ( 2011 )
‘Public Policy Networks and “Wicked Problems”: A Nascent Solution?’,
Public Administration , 89 (2): 3 07–24 .
Ferlie , E., McGivern, G. , and FitzGerald , L. (2 012 ) ‘A New Mode of
Organizing in Health Care? Governmentality and Managed Networks
in Cancer Services in England’ , Social Science and Medicine , 74 :
340–47 .
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