Professional discourse and service cultures: an organisational typology developed from health and welfare services for people with learning disabilities

Int J Nurs Stud. 2003 Sep;40(7):781-93. doi: 10.1016/s0020-7489(03)00115-9.

Abstract

This study focuses upon the effect of social policy upon a particular area of service provision. It is influenced by the Foucauldian concept of governmentality and the proposition by Lewis et al. that social policy needs to be understood in local contexts. Only through understanding the partial and fragmented impact of policy can we gain a clear insight into the outcomes for users. The study is undertaken through an exploration of the micro politics of organisations providing health and welfare services for people with learning disabilities. It involves an approach to discourse analysis that focuses upon text developed from interviews with service providers, which is brought into contact with published literature in an iterative process. The interpretation of the text produces four themes: power, trust, citizenship and managerialism. The development of these themes and a further holistic interpretation of the text suggest an emerging organisational typology. A typology based upon different articulations of the themes noted that work to produce particular outcomes for service users.

MeSH terms

  • Community Health Services / organization & administration*
  • Culture
  • Government
  • Health Policy*
  • Humans
  • Learning Disabilities / psychology*
  • Learning Disabilities / therapy
  • Power, Psychological
  • Social Support
  • Social Welfare / psychology
  • Topography, Medical
  • Trust