IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v342y2024ics0277953623009103.html
   My bibliography  Save this article

A matter of (good) faith? Understanding the interplay of power and the moral agency of managers in healthcare service reconfiguration

Author

Listed:
  • Smith, Chris Q.
  • Williams, Iestyn
  • Leggett, Will

Abstract

Previous studies of service reconfiguration in healthcare have explored the influence of power on processes and outcomes. However, in these accounts the moral agency of managers is often underemphasised. This paper draws on the theoretical tools provided by the sociology of morality to help deepen understanding of the interaction between power and moral agency in service reconfiguration in healthcare. It presents results from a qualitative study of a pan-organisational service reconfiguration in the NHS in England, involving nineteen in-depth interviews with those leading the change and the analysis of twelve programme documents. We combine concepts of the moral background and epistemic governance to interpret participants' conviction that the service change was ‘the right thing to do’. The paper shows how epistemic work carried out by service change regulations shaped the moral background within which participants worked. This, in turn, channelled their moral agency – specifically their commitment to patient care – in a way that also reflected central priorities. The paper adds to sociological understandings of service reconfiguration through considering the interaction of structure, agency and power, while also developing the concept of the moral background to show how power relations can influence moral beliefs.

Suggested Citation

  • Smith, Chris Q. & Williams, Iestyn & Leggett, Will, 2024. "A matter of (good) faith? Understanding the interplay of power and the moral agency of managers in healthcare service reconfiguration," Social Science & Medicine, Elsevier, vol. 342(C).
    • Handle: RePEc:eee:socmed:v:342:y:2024:i:c:s0277953623009103
    DOI: 10.1016/j.socscimed.2023.116553
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953623009103
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2023.116553?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Fraser, Alec & Baeza, Juan & Boaz, Annette & Ferlie, Ewan, 2019. "Biopolitics, space and hospital reconfiguration," Social Science & Medicine, Elsevier, vol. 230(C), pages 111-121.
    2. Jones, Lorelei & Exworthy, Mark, 2015. "Framing in policy processes: A case study from hospital planning in the National Health Service in England," Social Science & Medicine, Elsevier, vol. 124(C), pages 196-204.
    3. Gabriel Abend, 2022. "Making Things Possible," Sociological Methods & Research, , vol. 51(1), pages 68-107, February.
    4. Angelo M. Solarino & Herman Aguinis, 2021. "Challenges and Best‐practice Recommendations for Designing and Conducting Interviews with Elite Informants," Journal of Management Studies, Wiley Blackwell, vol. 58(3), pages 649-672, May.
    5. Gabriel Abend, 2014. "The Moral Background: An Inquiry into the History of Business Ethics," Economics Books, Princeton University Press, edition 1, number 10263.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Andrew Lynn, 2022. "Ethics, Economics, and the Specter of Naturalism: The Enduring Relevance of the Harmony Doctrine School of Economics," Journal of Business Ethics, Springer, vol. 178(3), pages 661-673, July.
    2. Thuy Séran & Anne-Sophie Fernandez & Hervé Chappert, 2024. "Managing coopetition in multi-unit organizations: a management-control perspective," Review of Managerial Science, Springer, vol. 18(10), pages 2889-2924, October.
    3. Masoud Shadnam & Andrey Bykov & Ajnesh Prasad, 2021. "Opening Constructive Dialogues Between Business Ethics Research and the Sociology of Morality: Introduction to the Thematic Symposium," Journal of Business Ethics, Springer, vol. 170(2), pages 201-211, May.
    4. Carly Knight, 2022. "When Corporations Are People: Agent Talk and the Development of Organizational Actorhood, 1890–1934," Sociological Methods & Research, , vol. 51(4), pages 1634-1680, November.
    5. Nannan Wang & Minxun Ma & Yunfei Liu, 2020. "The Whole Lifecycle Management Efficiency of the Public Sector in PPP Infrastructure Projects," Sustainability, MDPI, vol. 12(7), pages 1-17, April.
    6. N. Sharon Hill & Herman Aguinis & Josiah Drewry & Sanjay Patnaik & Jennifer J. Griffin, 2022. "Using Macro Archival Databases to Expand Theory in Micro Research," Journal of Management Studies, Wiley Blackwell, vol. 59(3), pages 627-659, May.
    7. Fraser, Alec & Baeza, Juan & Boaz, Annette & Ferlie, Ewan, 2019. "Biopolitics, space and hospital reconfiguration," Social Science & Medicine, Elsevier, vol. 230(C), pages 111-121.
    8. Jean-Louis Denis & Susan Usher & Johanne Préval, 2023. "Health reforms and policy capacity: the Canadian experience," Policy and Society, Darryl S. Jarvis and M. Ramesh, vol. 42(1), pages 64-89.
    9. Foley, Conor & Droog, Elsa & Healy, Orla & McHugh, Sheena & Buckley, Claire & Browne, John Patrick, 2017. "Understanding perspectives on major system change: A comparative case study of public engagement and the implementation of urgent and emergency care system reconfiguration," Health Policy, Elsevier, vol. 121(7), pages 800-808.
    10. Pitluck, Aaron Z., 2023. "The interpretive and relational work of financial innovation: A resemblance of assurance in Islamic finance," SocArXiv ce7kf, Center for Open Science.
    11. Kvåle, Gro & Torjesen, Dag Olaf, 2021. "Social movements and the contested institutional identity of the hospital," Social Science & Medicine, Elsevier, vol. 269(C).
    12. Jean-Jacques Rosé, 2021. "Dépasser les contradictions inhérentes à l’enseignement et à la recherche en RSE ?," Post-Print hal-03277474, HAL.
    13. Gazi Islam & Michelle Greenwood, 2021. "Reconnecting to the Social in Business Ethics," Journal of Business Ethics, Springer, vol. 170(1), pages 1-4, April.
    14. Geoff Bates & Charles Larkin & Nick Pearce & Laura Smyth, 2023. "Policy ‘R&D’, capacity and advocacy in English Combined Authorities," Local Economy, London South Bank University, vol. 38(3), pages 226-241, May.
    15. Fredriksson, Mio & Gustafsson, Inga-Britt & Winblad, Ulrika, 2019. "Cuts without conflict: The use of political strategy in local health system retrenchment in Sweden," Social Science & Medicine, Elsevier, vol. 237(C), pages 1-1.
    16. Fredriksson, Mio & Moberg, Linda, 2020. "Awareness and opinions on healthcare decommissioning in a Swedish region," Health Policy, Elsevier, vol. 124(9), pages 991-997.
    17. Jones, Lorelei & Fulop, Naomi, 2021. "The role of professional elites in healthcare governance: Exploring the work of the medical director," Social Science & Medicine, Elsevier, vol. 277(C).
    18. Djellouli, Nehla & Jones, Lorelei & Barratt, Helen & Ramsay, Angus I.G. & Towndrow, Steven & Oliver, Sandy, 2019. "Involving the public in decision-making about large-scale changes to health services: A scoping review," Health Policy, Elsevier, vol. 123(7), pages 635-645.
    19. Andrew C. Wicks & Patricia H. Werhane & Heather Elms & John Nolan, 2021. "Spheres of Influence: A Walzerian Approach to Business Ethics," Journal of Business Ethics, Springer, vol. 174(1), pages 1-14, November.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:342:y:2024:i:c:s0277953623009103. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.