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The Risks of Managing Uncertainty: The Limitations of Governance and Choice, and the Potential for Trust

Published online by Cambridge University Press:  09 December 2009

Patrick Brown  and
Michael Calnan
Patrick Brown
Affiliation:
Research Associate, School of Social Policy, Sociology and Social ResearchUniversity of Kent E-mail: p.r.brown@kent.ac.uk
Michael Calnan
Affiliation:
Professor of Medical Sociology, School of Social Policy, University of Kent
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Abstract

The inherent problems and limitations of managing risk and uncertainty are examined in a salient case setting – the English NHS. The ‘dark-side’ of simply trusting professionals to pursue their own craft, as acknowledged by Sennett, has been politicised to under-gird an increased use of quasi-markets, via the choice agenda, and governance. It is argued that these alternatives to trust – price and control – are further dysfunctional still. The innate tendencies of governance, and therefore choice, to lose sight of patient care are even more pronounced than the fallibility of professionals. A new, qualified form of trust is proposed in resolution.

Type
Articles
Information
Social Policy and Society , Volume 9 , Issue 1 , January 2010 , pp. 13 - 24
Copyright
Copyright © Cambridge University Press 2009

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