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Embedding Economic Relationships through Social Learning? The Limits of Patient and Public Involvement in Healthcare Governance in England
Author(s) -
VincentJones Peter
Publication year - 2011
Publication title -
journal of law and society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.263
H-Index - 48
eISSN - 1467-6478
pISSN - 0263-323X
DOI - 10.1111/j.1467-6478.2011.00541.x
Subject(s) - embeddedness , reflexivity , corporate governance , deliberation , sociology , health care , democracy , public administration , positive economics , public relations , political science , economics , social science , economic growth , law , management , politics
The strategy for NHS modernization in England is privileging individual choice over collective voice in the governance of healthcare. This paper explores the tension between economic and democratic strands in the current reform agenda, drawing on sociological conceptions of embeddedness and on theories of reflexive governance. Building on a Polanyian account of the disembedding effects of the increasing commercialization of health services, we consider the prospects for re‐embedding economic relationships in this field. An analysis is provided of the limits of the present legal and regulatory framework of Patient and Public Involvement (PPI) in establishing the democratic and pragmatist conditions of social learning necessary for effective embedding. We show how the attainment of reflexive governance in the public interest is dependent on such conditions, and on the capacities of patients and the public to contribute to debate and deliberation in decision making, including on fundamental policy questions such as how services are provided and by whom.