Gerry McGivern

Making Wicked Problems Governable? analyzes managed networks established to enhance service delivery within complex, cross-cutting sectors-a cornerstone of the health management reforms pursued by the UK New Labour governments (1997-2010). Drawing on extensive case study data, the revised second edition features a substantially expanded introduction and updated chapters, underscoring its enduring relevance to contemporary Labour government policies and the persistent challenges in health and social care. The book makes three key contributions. The first relates to Network Governance in Practice: It demonstrates that New Labour's reforms were profoundly influenced by Network Governance principles, fundamentally reshaping the structure and delivery of health care services. The second concerns 'Addressing 'Wicked Problems': By integrating the concept of 'wicked problems,' the work explores policy areas where network-based governance may offer a more effective alternative to traditional market mechanisms or hierarchical models. It compellingly argues that wicked problems are pervasive in health policy and thus merit serious consideration as an analytical framework. The third involves a Governmentality Perspective: Employing a governmentality framework, the book provides a fresh theoretical lens for understanding the indirect modes of public service governance, enriching debates on how best to manage complex policy challenges. Ideal for both policy makers and academic readers, Making Wicked Problems Governable? offers critical insights into the transformation of health care governance and presents robust frameworks for addressing some of today's most intractable public policy issues.'

While the implementation of evidence-based medicine guidelines is well studied, there has been little investigation into the extent to which a parallel evidence-based management movement has been influential within health care organizations. This book explores the various management knowledges and associated texts apparent in English health care organizations, and considers how the local reception of these texts was influenced by the macro level political economy of public services reform evident during the period of the politics of austerity. The research outlined in this volume shows that very few evidence-based management texts are apparent within health care organizations, despite the influence of certain knowledge producers, such as national agencies, think tanks, management consultancies, and business schools in the industry. Bringing together the often disconnected academic literature on management knowledge and public policy, the volume addresses the ways in which preferred management knowledges and texts in these publicly funded settings are sensitive to the macro level political economy of public services reform, offering an empirically grounded critique of the evidence-based management movement.

Over the last thirty years, scholars of health care organizations have been searching for concepts and images to illuminate their underlying, and shifting, modes of organizing. Nowhere has this controversy been more intense than in the United Kingdom, given the long succession of top down reorganizations within the National Health Service (NHS) over the last thirty years. This book characterises the nature of key reforms - namely managed networks - introduced in the UK National Health Service during the New Labour period (1997-2010), combining rich empirical case material of such managed networks drawn from different health policy arenas (clinical genetics, cancer networks, sexual health networks, and long term care) with a theoretically informed analysis. The book makes three key contributions. Firstly, it argues that New Labour's reforms included an important network element consistent with underlying network governance ideas, specifying conditions of 'success' for these managed networks and exploring how much progress was empirically evident. Secondly, in order to conceptualise many of the complex health policy arenas studied, the book uses the concept of 'wicked problems': problematic situations with no obvious solutions, whose scope goes beyond any one agency, often with conflicting stakeholder interests, where there are major social and behavioural dimensions to be considered alongside clinical considerations. Thirdly, it makes a contribution to the expanding Foucauldian and governmentality-based literature on health care organizations, by retheorising organizational processes and policy developments which do not fit either professional dominance or NPM models from a governmentality perspective. From the empirical evidence gathered, the book argues that managed networks (as opposed to alternative governance modes of hierarchy or markets) may well be the most suitable governance mode in those many and expanding policy arenas characterised by 'wicked problems', and should be given more time to develop and reach their potential.