204 research outputs found

    Health care needs and health policy : the case of renal services.

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    PhDThis thesis presents a critical ethnography of decision making with respect to the assessment of health care needs in the UK health system. Theories of need, justice and rights are reviewed in relation to structural changes to the National Health Service, together with the different theoretical approaches underpinning health policy based on human needs. The research on which this thesis is based focuses on a case study of an independent review of renal services in London, concentrating on the needs assessment work of the review group set up by the government and the decision making debates this review group engaged in. The methods used are based on a participatory, critical ethnography. The review process is evaluated critically by relating the technical knowledge produced by the group to a theoretical framework for assessing needs and by using a Habermasian perspective to investigate the ways in which the language of need is used to legitimise the agendas of various vested interests. This work is linked with an analysis of quasi-markets in the health service to explore the capacity that the technical discourses of markets and contracting have for reinforcing the ideological distortions identified in the analysis of the group's debates concerning need. Finally, by linking an analysis based on a case study of renal services to theoretical understandings of health care needs and health policy, a general critique of the UK health system is constructed

    Elite city-deals for economic growth? Problematizing the complexities of devolution, city-region building, and the (re)positioning of civil society

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    The concept of localism and spatial delineation of the ‘city region’ have seen a renaissance as the de facto spatial political units of governance for economic development. One articulation of this has seen the creation of Cardiff Capital Region (CCR) to potentially enhance Wales’s poor economic performance and secure democratic forms of social cohesion. City regions have been vaunted as the ‘spatial imaginary’ for engendering economic development, but there are considerable state spatial restructuring tensions. The paper discusses these by following the development of city-regionalism in Wales and specifically the unfolding of the ‘elite-led’ CCR City-Deal

    Social class, dementia and the fourth age

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    Research addressing social class and dementia has largely focused on measures of socioeconomic status as causal risk factors for dementia and in observed differences in diagnosis, treatment and care. This large body of work has produced important insights but also contains numerous problems and weaknesses. Research needs to take account of the ways in which ageing and social class have been transformed in tandem with the economic, social and cultural coordinates of late modernity. These changes have particular consequences for individual identities and social relations. With this in mind this article adopts a critical gaze on research that considers interactions between dementia and social class in three key areas: (i) epidemiological approaches to inequalities in risk (ii) the role of social class in diagnosis and treatment and (iii) class in the framing of care and access to care. Following this, the article considers studies of dementia and social class that focus on lay understandings and biographical accounts. Sociological insights in this field come from the view that dementia and social class are embedded in social relations. Thus, forms of distinction based on class relations may still play an important role in the lived experience of dementia

    Connected Growth: developing a framework to drive inclusive growth across a city-region

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    This ‘in perspective’ piece addresses the (re-)positioning of civil society within new structures of city-region governance within Greater Manchester (GM). This follows on from the processes of devolution, which have given the Greater Manchester City-Region (GMCR) a number of new powers. UK devolution, to date, has been largely focused upon engendering agglomerated economic growth at the city-region scale. Within GMCR, devolution for economic development has sat alongside the devolution of health and social care (unlike any other city-region in the UK) as well. Based on stakeholder mapping and semi-structured interviews with key actors operating across the GMCR, the paper illustrates how this has created a number of significant tensions and opportunities for civil society actors, as they have sought to contest a shifting governance framework. The paper, therefore, calls for future research to carefully consider how civil society groups are grappling with devolution; both contesting and responding to devolution. This is timely given the shifting policy and political discourse towards the need to deliver more socially-inclusive city-regions

    What’s so critical about it? An analysis of critique within different strands of critical gerontology

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    Shortly after emerging in the 1980s, critical gerontology became a recognised part of mainstream gerontology. Under the umbrella of ‘critical gerontology’ sits a number of orientations that draw attention to how ageing is socially located, while foregrounding the importance of values in ageing research. Nevertheless, as critical gerontology is not a clearly defined field or orientation, inconsistencies in the use of ‘critique’ among critical gerontologists has been fermenting internal tensions. In this paper we draw on recent debates on critique as a form of discourse that aims to criticise a deficient social order with the aim of helping to bring about a good society, to identify four discourses of critique. These include the discourses of immanent critique and of transcendent critique, critique that focuses on tensions between these two, and critique that builds on constructive combinations of immanence and transcendence. We add to these an extra level of depth by distinguishing how critical discourse is applied in each case. We use this framework to identify the discourses of critique deployed in variants of critical gerontology. Here, we distinguish political economic, lifecourse, humanistic and culturalist approaches within critical gerontology and assess how each of these applies a discourse of critique. We find that these gerontological perspectives draw on a variety of discourses of critique and make use of varying degrees of engagement with critical discourse. The paper concludes by discussing how critical gerontology may develop as a reflective forum commenting on and integrating insights offered by its own varieties of critique and connecting these with macro-social analyses

    Elite city-deals for economic growth? Problematizing the complexities of devolution, city-region building, and the (re)positioning of civil society

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    The concept of localism and spatial delineation of the ‘city region’ have seen a renaissance as the de facto spatial political units of governance for economic development. One articulation of this has seen the creation of Cardiff Capital Region (CCR) to potentially enhance Wales’s poor economic performance and secure democratic forms of social cohesion. City regions have been vaunted as the ‘spatial imaginary’ for engendering economic development, but there are considerable state spatial restructuring tensions. The paper discusses these by following the development of city-regionalism in Wales and specifically the unfolding of the ‘elite-led’ CCR City-Deal

    Placing the Foundational Economy: An emerging discourse for post-neoliberal economic development

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    Emerging in the mid-2010s, the Foundational Economy has been heralded as ‘a compelling counter-project against neoliberalism’ and ‘an alternative pathway … [for] progressive political renewal’. Grounded in a review of cross-disciplinary debates, this paper introduces the concept of the Foundational Economy and places it in relation to heterodox geographic theories of socio-economic development such as the ‘social economy’ and ‘diverse economies’ literature. Whilst there are clear overlaps, the concept of the Foundational Economy can be distinguished through its commitment to (a) a zonal perspective; (b) a focus on maximalist social innovations; and (c) the reconstitution of citizenship. In radical combination, it is argued that the lens of the Foundational Economy facilitates ‘a trenchant critique and denaturalization of current conditions, in tandem with creative explorations of the political economy of alternatives’. The paper concludes by reflecting on current oversights and future research trajectories for Foundational Economy research

    Beyond the unitary state: multi-level governance, politics, and cross-cultural perspectives on animal welfare

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    Simple Summary: Existing cross-cultural research on animal welfare often overlooks the way that policy and law are not the exclusive domain of central government. This can result in an over-simplification or misrepresentation of the true situation. The political culture and institutional arrangements for governing the modern state are more complex than a “one-size-fits-all” approach. It is argued that cross-cultural research needs to give greater attention to differences within as well as between unitary states. Specifically, it needs to examine developments in constituent nations and territories. Here we illustrate this by drawing on new research in the United Kingdom, and examine how ‘devolution’—or decentralized government for Wales and Scotland—is providing contrasting opportunities for NGOs, campaigners, and the public to lobby to improve animal welfare policy based on local practices, beliefs, and demands (collectively known as the “political culture”). Our findings show how this is important because it results in contrasting animal welfare policies and laws in the constituent nations of the UK. Abstract: It is argued that extant cross-cultural research on animal welfare often overlooks or gives insufficient attention to new governance theory, civil society, politics, and the realities of devolved or (quasi-)federal, multi-level governance in the modern state. This paper synthesizes relevant social theory and draws on new empirical findings of civil society accounts of campaigning on animal welfare policies and law in the United Kingdom. It is presented as a corrective to arguably reductive, earlier unitary state-based analyses. Our core, evidence-based argument is that cognizance of civil society activism and the contrasting institutional governance structures and political cultures of constituent nations in unitary states—such as the UK—are providing opportunities for the territorialization of legally grounded animal welfare regimes, and culturally distinctive practices

    Sentience and salience – exploring the party politicization of animal welfare in multi-level electoral systems: Analysis of manifesto discourse in UK meso elections 1998–2017

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    This study explores the party politicization of animal welfare in the context of multi-level governance in the UK. It examines over 1300 pledges in party manifestos for Scottish, Welsh and Northern Irish elections 1998–2017. It reveals the nature of party competition, including increasing salience over electoral cycles. This is complemented by examination of the party dynamics in two sub-fields: wildlife protection and farm animal welfare. The wider significance of this study lies in showing how the move to multi-level electoral politics provides new political spaces to advance animal welfare and how meso-ballots are increasingly attuned to the symbiosis of humans and animals. These factors are driving the territorialization of policy and leading to distinctive animal welfare regimes in the different countries of the UK. In addition, partisan theory reveals how the electoral politics of animal welfare varies between sub-fields and is shaped by parties’ relationships with different policy communities

    Exploring the substantive representation of non-humans in UK parliamentary business: a legislative functions perspective of animal welfare petitions, 2010-19

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    This study is concerned with the substantive representation of non-human species in parliamentary business. It applies Leston-Bandeira’s legislative functions perspective (LFP) to a data set of 2500 public petitions on animal welfare, submitted over three terms of the UK parliament. The wider significance of this work lies in: (i) underlining the utility of the LFP to petitions analysis; (ii) showing that, while few directly secure policy change, e-petitions perform valuable legislative functions including campaigning, scrutiny and policy-influencing roles, foremost of which is linkage and fostering citizen engagement in parliamentary business. And (iii) Showing how, over the past decade, public petitions have significantly contributed to the increasing salience of animal welfare in UK politics
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