A governmental analysis

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.

Introducing the governmentality turn

1 Claire Edwards and Eluska Fernández Analysing health and health policy: introducing the governmentality turn Introduction 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 patients

in Reframing health and health policy in Ireland

8 Joanne Wilson and Lindsay Prior Neoliberal governmentality and public health policy in Ireland Introduction 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

in Reframing health and health policy in Ireland
Analysing mental health discourses and practices in Ireland

6 Derek Chambers When health means illness: analysing mental health discourses and practices in Ireland Introduction 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

in Reframing health and health policy in Ireland
The case of Universal Health Insurance – by competition

promise what no government had done before – universal healthcare for all – as well as maintaining and increasing the profits of private health insurance companies’ (Burke, 2015). The General Election in 2016, which removed the Fine Gael / Labour Government, signalled the final death knell for the policy. Whether UHI-C is ultimately implemented or not, the process around the articulation of a new model for the Irish health system is important as it exposes key rationalities of current government thinking about health policy, particularly an increasing reliance on

in Reframing health and health policy in Ireland
Exploring the introduction of the smoking ban in Ireland

-smoking advocates and Irish citizens as one of the biggest success stories in the history of public health policy and tobacco control. However, commentaries and surveys published at the time of the announcement of the ban in January 2003 show that most people thought not only that the ban was too radical a proposal, but that it would be unworkable and difficult to enforce, especially in Ireland, a country often associated with pub culture. Despite vociferous objections to the ban from the hospitality industry and high levels of controversy in the media which followed its

in Reframing health and health policy in Ireland
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Governmentality, health policy and the place of critical politics

12 Eluska Fernández and Claire Edwards Conclusion: governmentality, health policy and the place of critical politics Introduction Our starting point in gathering together this edited collection was a desire to explore the potential of governmentality-inspired ideas to develop a more nuanced and indeed critical understanding of the construction of healthbased policy in Ireland. Health policy analysis in the Irish state, like much social policy research in general, has often taken its starting point from positivist approaches in social science, echoing Osborne

in Reframing health and health policy in Ireland
Children, families and fatness in Ireland

complexity. It blurs and oversimplifies issues and draws conclusions and policy recommendations not founded on the facts reported. Such mismatches between available evidence and consequent policy and practice recommendations are not unusual (see Buckingham, 2011: 108 on similar processes for TV advertising and children) but they can have real negative consequences for health policy and practice and for the ostensible targets (in particular, children) of policy and practice interventions (Evans et al., 2008). A considerable literature has emerged that challenges the

in Reframing health and health policy in Ireland
Children’s health and biosocial power

This chapter examines the writings of Jean Jacques Rousseau. It focuses on how his critical social theory and his normative political theory meet as a conception of childhood that would come into sharper focus during the nineteenth century. The chapter also examines reformatory education and public hygiene, focusing on how the public health strategies were developed and deployed in Ireland. Both in terms of design and strategic objective, the penal reformatory school exemplified biosocial power in that it was deployed as a social technology to refashion life that had been deformed by social circumstances. The chapter looks at how 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'. It also looks at how the prescriptive thrust of Emile was made practical through a pedagogical form of philanthropy.

in Reframing health and health policy in Ireland
A governmental analysis of the Stop the Spread campaign

In a novel departure in Irish public health promotion, 250,000 free measuring tapes were distributed via pharmacies throughout Ireland to encourage people to measure their waists in 2011. This was part of the Stop the Spread (STS) campaign which sought to change people's perception of a healthy and normal waist size. Its central message was that a waist circumference above 32 and 37 inches for women and men, respectively is overweight and an indicator of particular health risks. This chapter suggests that STS campaign illustrates a change in biopedagogical instructions and techniques in health promotion. It focuses on some recent Foucauldian scholarship in order to extend the relevance of such concepts to twenty-first-century movements in biopolitics and neoliberalism, and in order to set out an analytical framework by which STS can be analysed.

in Reframing health and health policy in Ireland