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Implementing Marketization in Public Healthcare Systems: Performing Reform in the English National Health Service

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Implementing Marketization in Public Healthcare Systems : Performing Reform in the English National Health Service. / Mason, Katy; Araujo, Luis.

In: British Journal of Management, Vol. 32, No. 2, 00, 17.04.2021, p. 473-493.

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Mason, Katy ; Araujo, Luis. / Implementing Marketization in Public Healthcare Systems : Performing Reform in the English National Health Service. In: British Journal of Management. 2021 ; Vol. 32, No. 2. pp. 473-493.

Bibtex

@article{00a96ee70c5d4ef0a84caf974adf2169,
title = "Implementing Marketization in Public Healthcare Systems: Performing Reform in the English National Health Service",
abstract = "To implement marketization in public healthcare systems, policymakers need to situate abstract models of prescriptive practice in complex settings. Using a performativity lens we show how policy processes bring about the changes they presume. Investigating the implementation of the Health and Social Care Act 2012, and the development of a policy instruments and Clinical Commissioning Groups, we explicate the performance of a marketization programme. This longitudinal perspective on the interactions amongst the Act{\textquoteright}s aims, the multiple constituencies the Act attempted to enrol and the existing socio-technical arrangements the Act aimed to change, generates three core contributions. We (1) characterise the performativity of policy instruments as a process of bricolage that incorporates the principled attitude of making do on both sides of the divide – those who design the policy and those who are charged to implement it; (2) identify the mechanisms through which the performativity of an envisioned model of marketization operates at multiple scales within a complex and highly distributed system of provision; and (3) document and explicate why specific performances result in misfires and unintended outcomes. Thus, we conceptualise policy performativity as a non-linear, dynamic process where theories and their effects are constantly being assessed and reconfigured.",
keywords = "Bricolage, Healthcare Systems, Marketization, Performativity, Policy Instruments",
author = "Katy Mason and Luis Araujo",
year = "2021",
month = apr,
day = "17",
doi = "10.1111/1467-8551.12417",
language = "English",
volume = "32",
pages = "473--493",
journal = "British Journal of Management",
issn = "1045-3172",
publisher = "Blackwell Publishing Ltd",
number = "2",

}

RIS

TY - JOUR

T1 - Implementing Marketization in Public Healthcare Systems

T2 - Performing Reform in the English National Health Service

AU - Mason, Katy

AU - Araujo, Luis

PY - 2021/4/17

Y1 - 2021/4/17

N2 - To implement marketization in public healthcare systems, policymakers need to situate abstract models of prescriptive practice in complex settings. Using a performativity lens we show how policy processes bring about the changes they presume. Investigating the implementation of the Health and Social Care Act 2012, and the development of a policy instruments and Clinical Commissioning Groups, we explicate the performance of a marketization programme. This longitudinal perspective on the interactions amongst the Act’s aims, the multiple constituencies the Act attempted to enrol and the existing socio-technical arrangements the Act aimed to change, generates three core contributions. We (1) characterise the performativity of policy instruments as a process of bricolage that incorporates the principled attitude of making do on both sides of the divide – those who design the policy and those who are charged to implement it; (2) identify the mechanisms through which the performativity of an envisioned model of marketization operates at multiple scales within a complex and highly distributed system of provision; and (3) document and explicate why specific performances result in misfires and unintended outcomes. Thus, we conceptualise policy performativity as a non-linear, dynamic process where theories and their effects are constantly being assessed and reconfigured.

AB - To implement marketization in public healthcare systems, policymakers need to situate abstract models of prescriptive practice in complex settings. Using a performativity lens we show how policy processes bring about the changes they presume. Investigating the implementation of the Health and Social Care Act 2012, and the development of a policy instruments and Clinical Commissioning Groups, we explicate the performance of a marketization programme. This longitudinal perspective on the interactions amongst the Act’s aims, the multiple constituencies the Act attempted to enrol and the existing socio-technical arrangements the Act aimed to change, generates three core contributions. We (1) characterise the performativity of policy instruments as a process of bricolage that incorporates the principled attitude of making do on both sides of the divide – those who design the policy and those who are charged to implement it; (2) identify the mechanisms through which the performativity of an envisioned model of marketization operates at multiple scales within a complex and highly distributed system of provision; and (3) document and explicate why specific performances result in misfires and unintended outcomes. Thus, we conceptualise policy performativity as a non-linear, dynamic process where theories and their effects are constantly being assessed and reconfigured.

KW - Bricolage

KW - Healthcare Systems

KW - Marketization

KW - Performativity

KW - Policy Instruments

U2 - 10.1111/1467-8551.12417

DO - 10.1111/1467-8551.12417

M3 - Journal article

VL - 32

SP - 473

EP - 493

JO - British Journal of Management

JF - British Journal of Management

SN - 1045-3172

IS - 2

M1 - 00

ER -