Brian Howieson

Mutuality in Scottish healthcare: Leading for public good

This paper offers an alternative paradigm to healthcare, and its delivery, by introducing the concepts of mutuality and empowerment into the existing NHS model of a public health system. In this paper, we will: revisit what is meant by mutuality; advance the meaning of the ‘public interest’ in this context; explore empowerment and community empowerment and their relationship to health; and introduce leading for the public good, which links these concepts and terms together via a dual development approach. It is suggested that this dual development approach will enable policy makers, practitioners in the NHS, and citizens to explore and evolve ways of leading and managing a mutual NHS, with public interest fora becoming the engines that will lead the development of mutuality. Our approach has not been taken from an observation of practice as such; rather, we suggest it as something to pursue as a consequence of theoretical reasoning applied to observations of practice in terms of policy ideas and outcomes of varied healthcare models that suggest inadequacies with existing approaches. It is hoped that this analysis will help researchers and practitioners alike to appreciate further the important concept of mutuality, and to suggest the importance of empowerment and leadership into the existing public health system paradigm.

A mutual health service in Scotland

Purpose – The purpose of this paper is to explore the leadership implications of a mutual health service in National Health Service (NHS) Scotland. Design/methodology/approach – Analysis of extant government policy and suggestions of leadership considerations for practice. Findings – Moving towards a mutual health system will require new ways of thinking about health care and existing leadership practices in NHS Scotland. The leadership implications at the strategic, operational and tactical levels of delivery in NHS Scotland will need to be thought through. At present, it is not clear how this will be done, either from the available health-related literature or from policy. “Mutuality” will require a complex and multi-layered effort to embed it within the culture of the organisation, which will require inspirational leadership and sustained management from the government, the NHS and the wider public to make the change happen. Research limitations/implications – This paper suggests that more leadership r...

Eroding ‘respectability’: Deprofessionalization through organizational spaces

This article addresses the question – can a deterioration in organizational spaces erode a profession’s status? It draws on the organizational spaces literature to analyse the relationship between design of the physical work setting and senior doctors’ experiences of deprofessionalization. Analysis of qualitative data from a study of senior hospital doctors identifies two main themes that link the experience of spaces with perceptions of the erosion of professional status and reduced knowledge sharing. These two themes are: emplacement, which is the application of coercive power both in and through spatial arrangements; and isolation, which refers to physical alienation in the workplace leading to disconnection and a perceived loss of power. Observing the changes in the physical environment over time and mapping them against these processes of deprofessionalization offers interesting new insights into the sociology of professions.

Learning to be a professional football manager: a Bourdieusian perspective

ABSTRACT This paper draws on the theoretical concepts of Pierre Bourdieu to provide an insight into aspirant football managers’ perceptions of what is required and valued at different stages of their desired managerial career journey. Drawing on interviews with candidates from one cohort of the Scottish Football Association Professional Licence (n = 19), our evidence suggests that aspirant managers have responded to changes in field logic by adopting strategies which place increased emphasis on cultural capital in the form of engagement with educational discourse. While we find evidence of instrumentality in attitudes to education, we also find evidence which emphasises the importance of habitus as an unconscious process. Educational culture is absorbed and embodied by some aspirant managers, which enlightens their actions and encourages them to adopt empowering strategies through which they seek to transform their place in the field. The paper concludes by considering potential implications for governing bodies and clubs.

Mutuality in the provision of Scottish healthcare.

The backdrop to this article is provided by the Better Health, Better Care Action Plan (Scottish Government, 2007), Section 1 of which is entitled ‘Towards a Mutual NHS’. According to Better Health, Better Care (Scottish Government, 2007: 5): ‘Mutual organisations are designed to serve their members. They are designed to gather people around a common sense of purpose. They are designed to bring the organisation together in what people often call “co-production.”’ The aim of this article is to précis the current knowledge of mutuality in the provision of Scottish healthcare. In detail, it will: introduce the ‘mutual’ organisation; offer a historical perspective of mutuality; suggest why healthcare mutuality is important; and briefly, detail the differences in mutual health-care policy in England and Scotland. It is hoped that this analysis will help researchers and practitioners alike appreciate further the philosophy of mutuality in the provision of Scottish healthcare.