Thesis (Ph.D.)--University of Central Florida, 2008. / Adviser: Aaron Liberman. Includes bibliographical references.

Thesis (Ph.D.)--Michigan State University. Rehabilitation Counselor Education , 2008. / Title from PDF t.p. (viewed on July 2, 2009) Includes bibliographical references (p. 128-144). Also issued in print.

Thesis (Ph. D.)--University of Sydney, 2009. / Degree awarded 2009; thesis submitted 2008. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept.of History, Faculty of Arts. Title from title screen (viewed 3 December, 2009). Includes graphs and tables. List of tables: leaf 9. List of illustrations: leaves 10-12. Includes bibliographical references. Also available in print form.

Thesis (Ph.D.)--University of Tennessee Health Science Center, 2009. / Title from title page screen (viewed on March 9, 2010). Research advisor: Robert C. Klesges, PhD. Document formatted into pages (ix, 86 p. : ill.). Vita. Abstract. Includes bibliographical references (p. 74-85).

Thesis (Ph. D.)--UCLA, 2008. / Vita. Description based on print version record. Includes bibliographical references.

Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1995. / Source: Masters Abstracts International, Volume: 45-06, page: 2939. Abstract precedes thesis as [1] preliminary leaf. Typescript. Includes bibliographical references (leaves 91-92).

Thesis (M. A.)--University of British Columbia, 2006. / Includes bibliographical references (leaves 101-104). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

No description available.

This thesis is a critical and post-structural exploration of the discourse of managerialism in the NHS secondary care sector in Wales. Its central intent is to destabilise the dominant thinking about NHS management practice and to evoke intellectual debate about alternative discourses of management that ontologically perceive the organisation as a complex adaptive human system. The emergent theoretical framework conjoins the discipline of Complexity with post-structural conjecture, posing a novel conceptualisation of a fractal self where relations of power are seen as essential for harmonising diverse influences and legitimising a local discourse that informs and regulates practice. Using Foucault’s insights on power and knowledge the thesis critiques the strategic nature of NHS discourse, exposing the discursive dominance of managerialism and its inherent relations of power and debates what this predicates for a local negotiation and a flexible, safe and innovative environment. The methodological approach employs a reflexive and micro-level interpretative strategy to emphasise the singularity of agents and to explore the way in which the discursive constitution of the self influences agent practice. My profound experience of the secondary care system requires I situate my self reflexively within the context where I explore and liberate my own voice in conjunction with my participants. The research adopts a biographical narrative method of data collection and uses Foucauldian discourse analysis as a framework for exploring the underlying discourse in agent stories. The findings demonstrate the polyphonic nature of the secondary care context and reveal the demonstrate the polyphonic nature of the secondary care context and reveal the diverse ways in which agents legitimise, negotiate or resist the conflicting truth claims of various discourse in order to strategically sustain an image of health care historically constituted in their self. The results portray a web of discourses that endorse conformity or complicity through oppressive mechanisms of disciplinary control and surveillance, perpetuating authoritative and dualist structures, dissipating relations of trust and removing intellectual thinking from the front-line. The conclusion asserts that this significantly jeopardises the ability of agents to legitimise local ‘discourse’, severely limiting their capacity for adaptive practice and the generation of new order.

Following in the footsteps of Neitzsche (1968) and Foucault (1980), Clegg et al (2006) and Haugaard and Clegg (2009) have argued that power is the most central concept in the analysis of organization and organizing. The desirability of further developing the theorization of power in health and social care policy in the United Kingdom has been identified in a number of recent publications (Hunter, 2008; Crinson, 2009; Ham, 2009). This critical overview analyzes relative power to connect policy at the macro level (ending the internal market in NHS Wales) with specific policy issues encompassed by the four projects within the portfolio on: • locality commissioning; • delayed transfers of care; • governance, incentives and integration; and • safeguarding adults. The contribution to knowledge that flows from this critical overview: identifies that theorizing power in health and social care policy may help to explain apparent disconnections between policy intent and the effect of policy in practice in the context of post-devolution Wales; • suggests that, at its most extreme, neglecting to take into account the role of power in the design, implementation and review of policy in this particular policy arena becomes a matter of life and death; and • proposes that exploring power in health and social care policy through Foucauldian-informed critical discourse analysis of relative power could to some extent facilitate translation of policy aspirations into practice.