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 book presents a comprehensive account of a major innovation in hospital funding before the NHS. The voluntary hospitals, which provided the bulk of Britain’s acute hospital services, diversified their financial base by establishing hospital contributory schemes. Through these, working people subscribed small, regular amounts to their local hospitals, in return for which they were eligible for free hospital care. The book evaluates the extent to which the schemes were successful in achieving comprehensive coverage of the population, funding hospital services, and broadening opportunities for participation in the governance of health care and for the expression of consumer views. It then explores why the option of funding the post-war NHS through mass contribution was rejected, and traces the transformation of the surviving schemes into health cash plans. This is a substantial investigation into the attractions and limitations of mutualism in health care. It is relevant to debates about organisational innovations in the delivery of welfare services.
This book seeks to integrate the history of mental health nursing with the wider history of institutional and community care for people experiencing mental illness and/or living with a learning disability. It develops new research questions by drawing together a concern with exploring the class, gender, skills and working conditions of practitioners with an assessment of the care regimes staff helped create and patients’ experiences of them. Contributors from a range of disciplines use a variety of source material to examine both continuity and change in the history of care over two centuries. The book benefits from a foreword by Mick Carpenter and will appeal to researchers and students interested in all aspects of the history of nursing and the history of care. The book is also designed to be accessible to practitioners and the general reader.
The inhabitants of most OECD countries tend to regard state intervention in the everyday lives of individual citizens and in society at large with certain scepticism. Health promotion is really not about curing diseases or even about preventing diseases. The overall aim of this book is to provide a critical understanding of current health promotion ideas and practices unfolding in liberal democracies. It identifies and discusses the merits and the limitations of the most influential political science and sociological analyses seeking to critically address contemporary politics of health. Foucault's analytics of power and government are discussed. The book then seeks to provide a solid understanding of the wider political context of health promotion in England and Denmark, examining obesity control in these regions. It also analyses how and why psychiatric patients, particularly those with chronic mental illness in England and Denmark, are urged to take charge of their mental illness with reference to the notion of rehabilitation. Key shifts in predominant forms of political rationalities and expert knowledge on how best to treat psychiatric patients are also analysed. Finally, the book examines how expert knowledge and political rationalities informed political interventions (policies, programmes, and technologies) in an attempt to promote rehabilitation along with increased implementation of community- based treatment. It summarizes the analytical findings regarding the governing of citizens through lifestyle and rehabilitation respectively. Further research is required on the politics of health promotion.
Claire Edwards and Eluska Fernández
Analysing health and health policy:
introducing the governmentality turn
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
(Petersen and Lupton, 1996; Lupton, 1995, 2003; Joyce, 2001; Petersen
and Bunton, 1997; Lovell, Kearns and Prince, 2014; Ferlie, McGivern and
FitzGerald, 2012). From analyses of constructions of welfare citizens and
Conflict poses considerable challenges for services that support communities, and in particular those affected by violence. This book describes the work undertaken in Omagh against the background of the most recent period of violent conflict in Ireland, and specifically it draws upon the work following the Omagh bombing. The bombing came just four months after the Northern Ireland peace agreement, known formally as the Belfast Agreement of 1998, and more informally as the Good Friday Agreement. The book describes the impact of the bomb and the early responses. Local trade unions, employers and the business community played key roles at times, particularly in underlining the need for solidarity and in identifying themselves with the desire for peace. The book looks at the outcome of needs-assessments undertaken following the Omagh bombing. The efforts to understand the mental health and related impact of the violence associated with the Troubles in Northern Ireland over the period 1969 to 2015 are focused in detail. The later efforts to build services for the benefit of the wider population are described, drawing upon the lessons gained in responding to the Omagh bombing. The developments in therapy, in training and education, and in research and advocacy are described with reference to the work of the Northern Ireland Centre for Trauma and Transformation (NICTT). The book draws together key conclusions about the approaches that could be taken to address mental health and well-being as an essential component of a peace-building project.
Analysing mental health discourses and practices in Ireland
When health means illness: analysing mental
health discourses and practices in Ireland
The last ten years have witnessed significant developments in mental health
policy and practices in Ireland. As Foucault and other authors have noted,
discourses constructing mental health have been strongly tied to biomedical
understandings of mental illness and the medical speciality of psychiatry
(Foucault, 1965; Rogers and Pilgrim, 2005; Middleton, 2007). The recent
questioning of these biomedical discourses in Ireland, as in other countries
This book explores whether early modern people cared about their health, and what
did it mean to lead a healthy life in Italy and England. According to the
Galenic-Hippocratic tradition, 'preservative' medicine was one
of the three central pillars of the physician's art. Through a range of
textual evidence, images and material artefacts, the book documents the profound
impact which ideas about healthy living had on daily practices as well as on
intellectual life and the material world in Italy and England. Staying healthy
and health conservation was understood as depending on the careful management of
the six 'Non-Naturals': the air one breathed, food and drink,
excretions, sleep, exercise and repose, and the 'passions of the
soul'. The book provides fresh evidence about the centrality of the
Non-Naturals in relation to groups whose health has not yet been investigated in
works about prevention: babies, women and convalescents. Pregnancy constituted a
frequent physical state for many women of the early modern European aristocracy.
The emphasis on motion and rest, cleansing the body, and improving the mental
and spiritual states made a difference for the aristocratic woman's
success in the trade of frequent pregnancy and childbirth. Preventive advice was
not undifferentiated, nor simply articulated by individual complexion. Examining
the roles of the Non-Naturals, the book provides a more holistic view of
convalescent care. It also deals with the paradoxical nature of perceptions
about the Neapolitan environment and the way in which its airs were seen to
affect human bodies and health.
Medicine, Health and Irish Experiences of Conflict, 1914-45 is the first exploration of Irish medical and health experiences during the First and Second World Wars, as well as during the Irish revolutionary period. It examines the physical, mental and emotional impact of conflict on Irish political and social life and medical, scientific and official interventions in Irish health matters. The volume asks: What made Irish medical and health experiences unique? Did the financial exigencies of war impact detrimentally on Irish health care provision? How were psychological and emotional responses to war managed in Ireland? Did Ireland witness unique disease trends? And how did Irish medical communities and volunteers partake in international war efforts? The authors suggest that twentieth-century warfare and political unrest profoundly shaped Irish experiences of medicine and health and that Irish political, social and economic contexts added unique contours to those experiences not evident in other countries. In pursuing these themes, Medicine, Health and Irish Experiences of Conflict, 1914-45 offers an original and focused intervention into a central, but so far unexplored, theme in Irish medical history.
Joanne Wilson and Lindsay Prior
Neoliberal governmentality and public
health policy in Ireland
Since 1994 the Irish government has developed policies that set out its
vision, priorities and direction for improving and sustaining the health of
its people. This chapter critically appraises how these strategies have been
configured to structure responsibility for health. Informed by the work of
Rose and colleagues (Rose, 1999, 2000; Rose and Miller, 2010; Rose,
O’Malley and Valverde, 2006), our analysis exposes a number of key characteristics of