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This chapter explores the Assessment of Need (AoN) process as a governmental technology which literally brings into being a new classification of people with disabilities and their assessed needs as governable entities. Governmentality literature has provided a fruitful hunting ground in terms of finding conceptual tools to analyse the ways in which states problematise and govern 'the wealth, health and happiness of populations'. Ireland has witnessed significant developments in the domain of disability policy and legislation. In a declared commitment to furthering the participation of people with disabilities in society, the government published a National Disability Strategy in 2004, the cornerstone of which was the passing of the Disability Act 2005. The chapter explores the spaces in-between the rationalities of particular policy programmes on the one hand, and the end point of many Foucauldian studies, namely the creation of self-governing subjects, on the other.
Recent years have witnessed a burgeoning international literature which seeks to analyse the construction of health and health policy through an analytical lens drawn from post-Foucauldian ideas of governmentality. This book is the first to apply the theoretical lens of post-Foucauldian governmentality to an analysis of health problems, practices, and policy in Ireland. Drawing on empirical examples related to childhood, obesity, mental health, smoking, ageing and others, it explores how specific health issues have been constructed as problematic and in need of intervention in the Irish State. The book focuses specifically on how Jean Jacques Rousseau's critical social theory and normative political theory meet as a conception of childhood. The 'biosocial' apparatus has recently been reconfigured through a policy framework called Healthy Ireland, the purpose of which is to 'reduce health inequalities' by 'empowering people and communities'. Child fatness continues to be framed as a pervasive and urgent issue in Irish society. In a novel departure in Irish public health promotion, the Stop the Spread (STS) campaign, free measuring tapes were distributed throughout Ireland to encourage people to measure their waists. A number of key characteristics of neoliberal governmentality, including the shift towards a market-based model of health; the distribution of power across a range of agents and agencies; and the increasing individualisation of health are discussed. One of the defining features of the Irish health system is the Universal Health Insurance and the Disability Act 2005.
This chapter establishes some of the conceptual cornerstones associated with governmentality thinking and considers their implications for an analysis of health and health policy in Ireland. It begins by laying out Michel Foucault and others' understandings of governmentality, and follows this by exploring how governmentality literature has been deployed within studies of health and health policy analysis. The chapter provides a context to some of the specificities and contingencies of Irish health policy debates. It also presents some key concepts discussed in this book. The book focuses on the way in which different health issues, through sources including policy documents, television health promotion campaigns and documents from professional bodies, have sought to 'bring into being' particular health problems and construct particular health behaviours as problematic. It deals with the issues of obesity and childhood, albeit in very different ways.
This conclusion presents some closing thoughts on the concepts discussed in the preceding chapters of this book. The book explores the potential of governmentality-inspired ideas to develop a more nuanced and indeed critical understanding of the construction of health-based policy in Ireland. One of the key points underpinning accusations of governmentality's limited critical potential relates to the suggestion that studies often fail to capture the messy actualities of social and political relations. The book provides a clear example of how different and often competing voices, each drawing on different types of knowledge, build into governmental visions and approaches to organ donation. It illustrates how the management of obesity is increasingly being placed in the hands of individuals, by vesting them with a technology designed to monitor their waist circumference.