A sociology of public responses to hospital change and closure

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Abstract

The "problem" of public resistance to hospital closure is a recurring trope in health policy debates around the world. Recent papers have argued that when it comes to major change to hospitals, "the public" cannot be persuaded by clinical evidence, and that mechanisms of public involvement are ill-equipped to reconcile opposition with management desire for radical change. This paper presents data from in-depth qualitative case studies of three hospital change processes in Scotland's National Health Service, including interviews with 44 members of the public. Informed by sociological accounts of both hospitals and publics as heterogeneous, shifting entities, I explore how hospitals play meaningful roles within their communities. I identify community responses to change proposals which go beyond simple opposition, including evading, engaging with and acquiescing to changes. Explicating both hospitals and the publics they serve as complex social phenomena strengthens the case for policy and practice to prioritise dialogic processes of engagement. It also demonstrates the continuing value of careful, empirical research into public perspectives on contentious healthcare issues in the context of everyday life.
Original languageEnglish
Pages (from-to)1251-1269
Number of pages19
JournalSociology of Health and Illness
Volume41
Issue number7
Early online date8 Apr 2019
DOIs
Publication statusPublished - 30 Sep 2019

Keywords

  • major service change
  • qualitative interviews
  • government/state
  • National Health Service (NHS)
  • patient and public engagement

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