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Biopolitics, space and hospital reconfiguration
Alec Fraser1, Juan Baeza2, Annette Boaz3
1Department of Health Services Research & Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom.
Social Science & Medicine (1982)
|April 23, 2019
Summary
Major service change in healthcare, or service reconfiguration, can be understood as a biopolitical intervention. This approach highlights how spatial and population factors shape healthcare delivery, impacting patient outcomes and crisis management.
Area of Science:
- Health Services Research
- Political Science
- Sociology
Background:
- Major healthcare service changes involve complex political and social dynamics.
- Understanding the reconfiguration of health services at local and regional levels is often challenging.
Purpose of the Study:
- To contribute to the theoretical understanding of major service change in healthcare.
- To demonstrate the utility of interpreting health service reconfiguration as a biopolitical intervention.
- To analyze the spatial and population dimensions of healthcare service change.
Main Methods:
- Qualitative study conducted from 2011-2012 in the English National Health Service (NHS).
- Documentary analysis of 125 historical and contemporary policy papers.
- Semi-structured interviews with 20 participants.
Main Results:
- A specific 'geography of stroke' in London was constructed using diverse knowledge types (medical, epidemiological, economic, demographic, managerial, organizational).
- Spatial practices of government legitimized political upheaval by highlighting variations in health outcomes.
- Healthcare reconfiguration was analyzed as a 'practice of security' to manage risks and avert crises.
Conclusions:
- Interpreting health service reconfiguration as a biopolitical intervention offers valuable analytical insights.
- Spatial and population-focused approaches are crucial for understanding major service changes.
- Service reconfiguration can be framed as a security practice aimed at population well-being.
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