Ruth Mcdonald
Dados Biográficos
| ID | 250528 |
|---|---|
| NOME | Ruth Mcdonald |
| PRENOMES | Ruth |
| SOBRENOME | Mcdonald |
| ASSINATURA | MCDONALD R |
| AFILIAÇÕES | University of Manchester |
| ORCID | 0000-0002-3488-4209 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 36 |
| TOTAL DE CITAÇÕES | 225 |
| TOTAL COMO AUTOR | 36 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2000 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2023 |
| ÍNDICE H | 10 |
Microenterprise and home care for older adults in England and Wales
Paid carers play an important role in helping older adults with care needs to remain living in their own homes. This paper examines changes in the home care field, specifically the emergence of self-employed care entrepreneurs ('microentrepreneurs'). To do this, it employs Bourdieu's concepts of field, capital and habitus. Drawing on 105 semi-structured interviews with stakeholders working in home care, the paper describes how the interaction of …
The Problem of Success and Failure in Public-private Innovation Partnerships
Public-Private Innovation Partnerships (PPIPs) are increasingly used as a tool for addressing 'wicked' public sector challenges. 'Innovation' is, however, frequently treated as a 'magic' concept: used unreflexively, taken to be axiomatically 'good', and left undefined within policy programmes. Using McConnell's framework of policy success and failure and a case study of a multi-level PPIP in the English health service (NHS Test Beds), this paper …
Assembling the Healthopolis
Health and care policy is increasingly promoted within visions of the competitive city-region. This paper examines the importance of policy boosterism within the political construction of city-regions in the context of English devolution. Based on a two-year case study of health and social care devolution in Greater Manchester, England, we trace the relational and territorial geographies of policy across and through new "devolved" city-regional a…
Understanding behaviour change in context
This research examines how midstream social marketing programmes that adopt a relational and community-based approach create opportunities for individuals to make incremental changes to health behaviour. Specifically, it applies Bourdieusian theory to explore how interactions between community healthcare workers (CHWs) and members of the public generate impetus for change and foster individual agency for improved health. Qualitative interviews we…
Regional assemblage and the spatial reorganisation of health and care
In this paper, we examine how space is integral to the practices and politics of restructuring health and care systems and services and specifically how ideas of assemblage can help understand the remaking of a region. We illustrate our arguments by focusing on health and social care devolution in Greater Manchester, England. Emphasising the open-ended political construction of the region, we consider the work of assembling different actors, orga…
Characteristics and Pathways of Long-Stay Patients in High and Medium Secure Settings in England; A Secondary Publication From a Large Mixed-Methods Study
Background: Many patients experience extended stays within forensic care, but the characteristics of long-stay patients are poorly understood. Aims: To describe the characteristics of long-stay patients in high and medium secure settings in England. Method: Detailed file reviews provided clinical, offending and risk data for a large representative sample of 401 forensic patients from 2 of the 3 high secure settings and from 23 of the 57 medium se…
Ethical issues of long-term forensic psychiatric care
Managing madness, murderers and paedophiles
Sensemaking and the co-production of safety
This study explores the ways in which patients make sense of 'safety' in the context of primary medical care. Drawing on qualitative interviews with primary care patients, we reveal patients' conceptualisation of safety as fluid, contingent, multi-dimensional, and negotiated. Participant accounts drew attention to a largely invisible and inaccessible (but taken for granted) architecture of safety, the importance of psycho-social as well as physic…
Beyond Binaries
This article notes the tendency in the sociological literature to frame studies of medical professionals in terms of a series of binaries (e.g. control/resistance, powerful/powerless professionals, medicine/management). It suggests that moving away from this approach to acknowledge a more nuanced perspective would be helpful. The article draws on recent empirical studies to support this view.Keywords: Doctor satisfaction, sociology, control, resi…
Evaluating a handwashing with soap program in Australian remote Aboriginal communities
Cultural, social-economic and physical barriers in remote communities make it challenging to promote adults and children wash their hands with soap and maintain clean faces such that these behaviours become habit. Low levels of access to a television in the home illustrate the extreme level of disadvantage experienced in these communities. Highlighting that social marketing programs have the potential to increase disadvantage if expensive items s…
Bad Doctors, Democracy, and the Public Interest
Bourdieu', medical elites and 'social class
Sociologists of professions draw on Weberian theories of closure. However they have tended to ignore Bourdieu's work, which rejects Weberian notions of class and status groups as distinct ideal types and sees these concepts as inextricably linked. Bourdieu emphasises the importance of a class-based habitus which generates orientations, inclinations and dispositions that organise practices and the perception of practice. For Bourdieu, because indi…
Competing and coexisting logics in the changing field of English general medical practice
Restratification revisited
Restratification, a process which involves medical elites exerting control over members of their profession, was seen by the US sociologist Eliot Freidson as helping to maintain the continued dominance of the medical model and the profession's ability to determine its own fate. Drawing on interviews with primary care doctors in England and California this article reports the emergence of new strata or elites, with groups of doctors involved in bo…
The New Sociology of the Health Service
Professional status in a changing world
Rethinking collegiality
Practice nurses and the effects of the new general practitioner contract in the English National Health Service
Market reforms in English primary medical care
Drawing on interviews with English primary care doctors (GPs), this paper examines GP responses to reforms intended to introduce a market in primary health care. GPs' reactions are conceptualised in terms of a GP habitus, which takes for granted the superiority of 'public' providers (i.e. GP partnerships) in the provision of care. GPs are actively involved in the defence of the public sphere, which is neither a neo-liberal minimalist market state…
The impact of pay-for-performance on professional boundaries in UK general practice
The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact …
Identity, Contract and Enterprise in a Primary Care Setting
This paper examines the responses of primary health care clinicians (doctors and nurses) to an invitation to enterprise contained in a new contract which offers financial rewards for meeting targets. We suggest that far from being swept along by a hegemonic enterprise discourse or having `no choice but to comply' (Cohen and Musson, 2000: 45), the engagement of our study participants in enterprising behaviours can be understood in terms of a more …
Biomedicine, holism and general medical practice
In 2004 a new contract was introduced for General Practitioners in the UK, which introduced a significant element of ‘pay‐for‐performance’, including both clinical and organisational targets. The introduction of this contract has caused interest across the world, particularly amongst those responsible for commissioning primary care services. It can be argued that the clinical targets in the contract (known as the Quality and Outcomes Framework, Q…
Ticking Boxes and Changing the Social World
The new General Medical Services contract was introduced into general practice in the UK in 2004, and it links pay to performance far more than in the past. As a result, accurate data collection about patients and the care that they receive is now not only important for good patient care but also to prove that targets are being met. The use of electronic records and information technology has thus become much more sophisticated. This article repo…
Governing the ethical consumer
Government policy promoting consumerism in healthcare can be seen as offering up certain preferred identities to which its citizens are encouraged to aspire. Whilst many commentators reject the notion that health services users should be conceived of as consumers, this paper outlines the relevance of the concept to our understanding of the ways in which individuals manage their health and service use. The paper examines the identity work undertak…
Governing the ethical consumer
Government policy promoting consumerism in healthcare can be seen as offering up certain preferred identities to which its citizens are encouraged to aspire. Whilst many commentators reject the notion that health services users should be conceived of as consumers, this paper outlines the relevance of the concept to our understanding of the ways in which individuals manage their health and service use. The paper examines the identity work undertak…
Biomedicine, holism and general medical practice
In 2004 a new contract was introduced for General Practitioners in the UK, which introduced a significant element of ‘pay‐for‐performance’, including both clinical and organisational targets. The introduction of this contract has caused interest across the world, particularly amongst those responsible for commissioning primary care services. It can be argued that the clinical targets in the contract (known as the Quality and Outcomes Framework, Q…
Rules, safety and the narrativisation of identity
Patient safety has become a health policy priority around the world. Acknowledging that 'to err is human' has led to attempts to design systems and rules that limit the capacity for individual discretion and thereby reduce clinical errors. In addition, great emphasis is being placed on the need to eradicate cultures of blame, which are assumed to discourage clinicians from reporting errors, and to establish a 'safety culture', which encourages op…
Competing and coexisting logics in the changing field of English general medical practice
Regional assemblage and the spatial reorganisation of health and care
In this paper, we examine how space is integral to the practices and politics of restructuring health and care systems and services and specifically how ideas of assemblage can help understand the remaking of a region. We illustrate our arguments by focusing on health and social care devolution in Greater Manchester, England. Emphasising the open-ended political construction of the region, we consider the work of assembling different actors, orga…
The micropolitics of clinical guidelines
English This article analyses data from a participant observation study of decision making in local National Health Service institutions, focusing on the construction of local clinical guidelines. We found that guideline construction departed significantly from the ‘bureaucratic-scientific’ model. Although clinical guidelines are often seen as constraining the practice of medicine, our study suggests that there is nothing intrinsically corrosive …
Rethinking collegiality
Market reforms in English primary medical care
Drawing on interviews with English primary care doctors (GPs), this paper examines GP responses to reforms intended to introduce a market in primary health care. GPs' reactions are conceptualised in terms of a GP habitus, which takes for granted the superiority of 'public' providers (i.e. GP partnerships) in the provision of care. GPs are actively involved in the defence of the public sphere, which is neither a neo-liberal minimalist market state…
Ticking Boxes and Changing the Social World
The new General Medical Services contract was introduced into general practice in the UK in 2004, and it links pay to performance far more than in the past. As a result, accurate data collection about patients and the care that they receive is now not only important for good patient care but also to prove that targets are being met. The use of electronic records and information technology has thus become much more sophisticated. This article repo…
The impact of pay-for-performance on professional boundaries in UK general practice
The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact …
Practice nurses and the effects of the new general practitioner contract in the English National Health Service
At the Cutting Edge? Modernization and Nostalgia in a Hospital Operating Theatre Department
Attempts by government to 'modernize' the British National Health Service involve constructing previous working practices and forms of organization as dys-functional, whilst at the same time selectively drawing on nostalgic images of the NHS in an attempt to win public support for and employee commitment to modernization. The use of nostalgic and nostophobic discourses by government can be interpreted as an attempt not merely to adjust working pa…
Individual identity and organisational control
The notion of empowerment has been increasingly used within management discourses in recent years. Alternatively, more critical commentators have interpreted it as another means of exercising control over employees and their identities. Although various commentators have speculated on the management of identity as a means of organizational control, there is very little empirical work from which to draw conclusions. This paper, using participant o…
Street-level bureaucrats? Heart disease, health economics and policy in a primary care group
Assembling the Healthopolis
Health and care policy is increasingly promoted within visions of the competitive city-region. This paper examines the importance of policy boosterism within the political construction of city-regions in the context of English devolution. Based on a two-year case study of health and social care devolution in Greater Manchester, England, we trace the relational and territorial geographies of policy across and through new "devolved" city-regional a…
Sensemaking and the co-production of safety
This study explores the ways in which patients make sense of 'safety' in the context of primary medical care. Drawing on qualitative interviews with primary care patients, we reveal patients' conceptualisation of safety as fluid, contingent, multi-dimensional, and negotiated. Participant accounts drew attention to a largely invisible and inaccessible (but taken for granted) architecture of safety, the importance of psycho-social as well as physic…
Bourdieu', medical elites and 'social class
Sociologists of professions draw on Weberian theories of closure. However they have tended to ignore Bourdieu's work, which rejects Weberian notions of class and status groups as distinct ideal types and sees these concepts as inextricably linked. Bourdieu emphasises the importance of a class-based habitus which generates orientations, inclinations and dispositions that organise practices and the perception of practice. For Bourdieu, because indi…
Restratification revisited
Restratification, a process which involves medical elites exerting control over members of their profession, was seen by the US sociologist Eliot Freidson as helping to maintain the continued dominance of the medical model and the profession's ability to determine its own fate. Drawing on interviews with primary care doctors in England and California this article reports the emergence of new strata or elites, with groups of doctors involved in bo…
Professional status in a changing world
Autonomy and modernisation
Recent New Labour policy for the 'modernisation' of Government places a good deal of emphasis on decentralisation. This emphasis is particularly marked in relation to the organisation of primary care. However, like hospitals and other National Health Service institutions, primary care trusts (PCTs) are subject to a substantial raft of centrally established performance targets and indicators, including those which contribute to the public award of…
Understanding behaviour change in context
This research examines how midstream social marketing programmes that adopt a relational and community-based approach create opportunities for individuals to make incremental changes to health behaviour. Specifically, it applies Bourdieusian theory to explore how interactions between community healthcare workers (CHWs) and members of the public generate impetus for change and foster individual agency for improved health. Qualitative interviews we…
Managing madness, murderers and paedophiles
The New Sociology of the Health Service
Just say no? Drugs, politics and the UK National Health Service
English Over recent decades, UK government attitudes towards the pharmaceutical industry have been ambivalent, reflecting the conflicting aims of controlling drug expenditure and maintaining a strong pharmaceutical industry. Policy can best be characterised as a careful balancing act, with indirect regulation leaving drug producers free to set prices. However, recent policy developments suggest a shift towards a more directly interventionist appr…
Just say no? Drugs, politics and the UK National Health Service
English Over recent decades, UK government attitudes towards the pharmaceutical industry have been ambivalent, reflecting the conflicting aims of controlling drug expenditure and maintaining a strong pharmaceutical industry. Policy can best be characterised as a careful balancing act, with indirect regulation leaving drug producers free to set prices. However, recent policy developments suggest a shift towards a more directly interventionist appr…
Rationality and reality
The number of health economists in the UK has grown rapidly over the last 25 years. Little is known about the impact of health economics on local resource allocation decisions although academic health economists assert the superiority of 'rational' and systematic approaches to priority setting. However, recently, there have been suggestions that health economics has 'lost its way' by failing to provide practical advice to guide decision makers. I…
Managing the entry of new medicines in the National Health Service
For the most part, the management of new medicines in the NHS has hitherto been a matter for local discretion. The result is that access to medicines is often determined by where a patient lives, as opposed to some nationally agreed clinical criteria. This "postcode prescribing" has led to widespread variations in access to medicines and concerns about the resulting inequalities. Primary care groups and trusts are expected to reduce variations in…
Street-level bureaucrats? Heart disease, health economics and policy in a primary care group
Autonomy and modernisation
Recent New Labour policy for the 'modernisation' of Government places a good deal of emphasis on decentralisation. This emphasis is particularly marked in relation to the organisation of primary care. However, like hospitals and other National Health Service institutions, primary care trusts (PCTs) are subject to a substantial raft of centrally established performance targets and indicators, including those which contribute to the public award of…
The micropolitics of clinical guidelines
English This article analyses data from a participant observation study of decision making in local National Health Service institutions, focusing on the construction of local clinical guidelines. We found that guideline construction departed significantly from the ‘bureaucratic-scientific’ model. Although clinical guidelines are often seen as constraining the practice of medicine, our study suggests that there is nothing intrinsically corrosive …
Individual identity and organisational control
The notion of empowerment has been increasingly used within management discourses in recent years. Alternatively, more critical commentators have interpreted it as another means of exercising control over employees and their identities. Although various commentators have speculated on the management of identity as a means of organizational control, there is very little empirical work from which to draw conclusions. This paper, using participant o…
‘Balancing risk, that is my life’
The management of risk has become a policy priority in health systems around the world. Current orthodoxy within patient safety policy circles stresses the need to identify and manage risk to reduce harm to patients. However, this rests on an assumption that there is common agreement that risk can be managed, together with a shared set of beliefs about what constitutes risk and the methods for managing risk. The framing of particular issues as ri…
What are the key attributes of primary care for patients? Building a conceptual ‘map’ of patient preferences
Background Responding to the preferences of patients is a key focus of current health policy and is especially important in primary care. Responding effectively to patient preferences requires a clear understanding of the way in which patients assess primary care services. Objective This study was designed to provide a ‘map’ of the content and structure of the key attributes of patient preferences concerning primary care. Design The development o…
At the Cutting Edge? Modernization and Nostalgia in a Hospital Operating Theatre Department
Attempts by government to 'modernize' the British National Health Service involve constructing previous working practices and forms of organization as dys-functional, whilst at the same time selectively drawing on nostalgic images of the NHS in an attempt to win public support for and employee commitment to modernization. The use of nostalgic and nostophobic discourses by government can be interpreted as an attempt not merely to adjust working pa…
Rules, safety and the narrativisation of identity
Patient safety has become a health policy priority around the world. Acknowledging that 'to err is human' has led to attempts to design systems and rules that limit the capacity for individual discretion and thereby reduce clinical errors. In addition, great emphasis is being placed on the need to eradicate cultures of blame, which are assumed to discourage clinicians from reporting errors, and to establish a 'safety culture', which encourages op…
Ticking Boxes and Changing the Social World
The new General Medical Services contract was introduced into general practice in the UK in 2004, and it links pay to performance far more than in the past. As a result, accurate data collection about patients and the care that they receive is now not only important for good patient care but also to prove that targets are being met. The use of electronic records and information technology has thus become much more sophisticated. This article repo…
Governing the ethical consumer
Government policy promoting consumerism in healthcare can be seen as offering up certain preferred identities to which its citizens are encouraged to aspire. Whilst many commentators reject the notion that health services users should be conceived of as consumers, this paper outlines the relevance of the concept to our understanding of the ways in which individuals manage their health and service use. The paper examines the identity work undertak…
Identity, Contract and Enterprise in a Primary Care Setting
This paper examines the responses of primary health care clinicians (doctors and nurses) to an invitation to enterprise contained in a new contract which offers financial rewards for meeting targets. We suggest that far from being swept along by a hegemonic enterprise discourse or having `no choice but to comply' (Cohen and Musson, 2000: 45), the engagement of our study participants in enterprising behaviours can be understood in terms of a more …
Biomedicine, holism and general medical practice
In 2004 a new contract was introduced for General Practitioners in the UK, which introduced a significant element of ‘pay‐for‐performance’, including both clinical and organisational targets. The introduction of this contract has caused interest across the world, particularly amongst those responsible for commissioning primary care services. It can be argued that the clinical targets in the contract (known as the Quality and Outcomes Framework, Q…
Rethinking collegiality
Practice nurses and the effects of the new general practitioner contract in the English National Health Service
Market reforms in English primary medical care
Drawing on interviews with English primary care doctors (GPs), this paper examines GP responses to reforms intended to introduce a market in primary health care. GPs' reactions are conceptualised in terms of a GP habitus, which takes for granted the superiority of 'public' providers (i.e. GP partnerships) in the provision of care. GPs are actively involved in the defence of the public sphere, which is neither a neo-liberal minimalist market state…
The impact of pay-for-performance on professional boundaries in UK general practice
The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact …
The New Sociology of the Health Service
Professional status in a changing world
Restratification revisited
Restratification, a process which involves medical elites exerting control over members of their profession, was seen by the US sociologist Eliot Freidson as helping to maintain the continued dominance of the medical model and the profession's ability to determine its own fate. Drawing on interviews with primary care doctors in England and California this article reports the emergence of new strata or elites, with groups of doctors involved in bo…
Competing and coexisting logics in the changing field of English general medical practice
Bourdieu', medical elites and 'social class
Sociologists of professions draw on Weberian theories of closure. However they have tended to ignore Bourdieu's work, which rejects Weberian notions of class and status groups as distinct ideal types and sees these concepts as inextricably linked. Bourdieu emphasises the importance of a class-based habitus which generates orientations, inclinations and dispositions that organise practices and the perception of practice. For Bourdieu, because indi…
Beyond Binaries
This article notes the tendency in the sociological literature to frame studies of medical professionals in terms of a series of binaries (e.g. control/resistance, powerful/powerless professionals, medicine/management). It suggests that moving away from this approach to acknowledge a more nuanced perspective would be helpful. The article draws on recent empirical studies to support this view.Keywords: Doctor satisfaction, sociology, control, resi…
Political science (28 obras) · Sociology (27 obras) · Law (22 obras) · Medicine (21 obras) · Public relations (21 obras) · Psychology (16 obras) · Law (14 obras) · Business (13 obras) · Primary Care and Health Outcomes (13 obras) · Nursing (12 obras)