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The large number of international medical graduates (IMGs) working in Australia, and many other countries around the world, has received significant attention from the media, governments and academia. These institutions utilise a number of classificatory schemes in order to categorise IMGs. Such classification is often stigmatising, yet goes largely unquestioned. In this paper I show that the 'official naming' of IMGs in Australia, as well as the naming of IMGs by staff in hospitals, is historically, politically and socially produced. Following Bourdieu's call to also study how the classified classify, the paper goes on to examine ways in which IMGs name and categorise each other, drawing on ethnographic research. I argue that IMGs use classification themselves, strategically, in order to modify their marginalised position within the 'social space' of the hospital. The article questions taken-for-granted assumptions about classified groups such as IMGs and leaves an opening for change. [ABSTRACT FROM AUTHOR]

Poor health and disease and the nature of interventions to ameliorate them typically generate opportunities and costs. What diseases are prevalent, which interventions are favoured and what factors fuel the nature of health interventions are recurrent concerns for political economists. This paper examines the prevailing viewpoints about what health policy works and what does not. Drawing on evidence from developing countries, it shows that there are many deficiencies in the prevailing orthodoxy which emphasises state, market, and civil society solutions. The paper suggests that health policy debate must be refrained around poverty and social inequality, constructs which are often subordinated to attaining grand ideological goals. [ABSTRACT FROM AUTHOR]

This paper explores how masculinity may help us understand the varying ways political leaders are responding to the coronavirus crisis. By focusing directly on masculinity as a social process, this analysis contributes to the broader literature on gender and leadership, unpacking the gendered double bind that leaders who identify as men must navigate in acknowledging and responding to risks. I examine the responses of Justin Trudeau and Donald Trump suggesting that their respective struggles to acknowledge and respond to the public health threat were not simply the result of a lack of available information to inform rational policy decisions. Acknowledging risk and taking measures to prevent rather than 'fight' are not culturally neutral, they are coded as feminine and 'weak'. Clearly, the delay in the response and subsequent spread of the virus in North America was not inevitable, other jurisdictions were able to respond more quickly. The masculinity double bind may have been one of the factors that undermined a prompt response in the increasingly macho context of North America. [ABSTRACT FROM AUTHOR]

In this brief paper, I argue that the coronavirus pandemic is functioning like an ethnomethodological 'breaching experiment'. In short, it is putting a gigantic spanner in the works of neoliberal governance, in the process exposing the widening cracks and fissures of what I have called the 'fractured society'. I begin by recalling Garfinkel's notion of the breaching experiment and by listing the principal attributes of the fractured society. I then explore the response to the coronavirus in the UK, from the government's initial commitment to 'herd immunity' to its present policy of 'muddling through'. The bulk of the remainder of this contribution addresses precisely how this global health crisis shines a harsh and unforgiving searchlight on the strategies and policies pursued by governments in the UK since 2010, and most especially after the passing of the Health and Social Care Act of 2012. In the closing paragraphs, I examine possible scenarios for a post-fractured society, making particular use of Fraser's concepts on 'reactionary' versus 'progressive populism', and conclude with a comment on sociology and engagement. [ABSTRACT FROM AUTHOR]

Women are at special risk for HIV/AIDS infection and disease progression due to an inter-related set of biopolitical factors. Biological factors that contribute to women's special vulnerability include hormonal, developmental, and immunological characteristics. Social and political factors such as poverty, gendered power relationships, and violence interact with biological factors to create an HIV risk profile among women. The approach of this paper is to review literatures that describe components of women's risks for HIV in order to create an integrated model of vulnerability. We present a syndemic model that calls attention to the importance of understanding the pathways of adverse interaction among interacting diseases and the social and political environments of sufferers. This paper synthesises known risk factors and analyses them through the lens of syndemics theory in order to demonstrate the biopolitical vulnerability of women to HIV. Applying a syndemic approach offers important implications for prevention and treatment of HIV among women. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative study of the onset of acquired hearing impairment. The focus of attention is why a person seeks treatment. The Danish welfare state serves the population 'in need' such as those with an audiological need and gives them guidance on becoming hearing aid wearers in order to rehabilitate them back to 'normalcy'. However, within audiological research, noncompliance has attracted much attention as investigations have shown that more than 20 percent of hearing aids are very seldom, if ever, in use and 19 percent are used only occasionally. As shown in the paper the form a problem takes is in large part a product of micro-political struggles. Hence, at the onset 'need' is often embedded in social pressure from significant others. The paper examines these two discursive frameworks and their constitution of (hearing) problems and concludes that norms of disease are complex and epistemologically contested and can help explain why noncompliance is dominant when it comes to hearing rehabilitation for hearing impaired adults. [ABSTRACT FROM AUTHOR]

In this paper we report on the findings from six focus groups conducted with Australian medical students. The focus groups discussed students' perceptions of conflicts of interest and the influence of commercial values in health care and medical education. Our research revealed that students were aware of a number of structural influences that affected the medical education they received and that had the potential to shape their attitudes and practices as they progressed in becoming a doctor. We found that the pressures of educational workload and anticipated career trajectories tended to have an individualising effect that limited the perceived possibility of collective action and response to structural influences. We interpreted these findings through the lens of neoliberal governmentality to articulate the way commercial interests are negotiated and normalised by medical students. Based on these findings, we suggest that medical education should not only explicitly alert students to effects of political and commercial influences on the healthcare system, but also encourage the collective agency of students and strategies that do not place unrealistic expectations on individuals to effect structural change. [ABSTRACT FROM AUTHOR]

This paper compares the advocacy of mothers and intended mothers in the fields of autism and infertility. Mothers and intended mothers have developed a special competence in dealing with professionals, and in negotiating the delicate balance between expert medical discourses and expertise grounded in their situated knowledge and experiences. Drawing on the social movement and public policy literature, we seek to disrupt taken-for-granted assumptions about the gendered role of women and mothers in these complex and emotionally charged policy fields. We argue that (intended) mothers are far more likely than other women to take on the major advocacy role considering their need to respond to bodily, social, and/or cultural 'failures' imposed on them by the medical establishment. Issues of access to fertility treatments and care for autistic children not only provide a vantage point from which to study their experience in the policy arena, but also to ask broader questions about the role of the welfare state and the shifting authority of experts in policy processes. [ABSTRACT FROM AUTHOR]

New medicines represent exciting possibilities to individual patients for improved futures through reduced morbidity, as well as the potential for disappointment where promised outcomes are not forthcoming. For healthcare systems these technologies can enable enhanced effectiveness as well as spiralling costs, depending on value-for-money offered. Amidst uncertainty over efficacy and pricing, institutions such as the National Institute for Health and Clinical Excellence have been set up to regulate the cost-effectiveness of new products. The increased transparency of this new regulation, combined with inescapable uncertainties, leads to the heightened politicisation of decision-making and an insidious subjectivity beneath a veneer of rational-bureaucracy. This paper develops a theoretical framework for understanding the influence of hope within such contexts. Conceptualised here as ideological, affective and prone to lapsing into trust, hope is considered to shape the lifeworld-background of regulatory decisions and mask uncertainty around effectiveness. These processes challenge regulator legitimacy and effectiveness within polycentric regimes, through the distortion of communication and the manipulation of blame. [ABSTRACT FROM AUTHOR]

In this paper we explore the ways in which corporations have become powerful actors in the political and economic landscapes, and the role the state has played in this development. Focusing on the pharmaceutical industry, we find that revolving door practices have been a key instrument in furthering the growth of corporate power, leading us to a reconsideration of the concepts of class struggle and the role of the state in the maintenance of the dominant class' privileges. We conclude that our findings lend support to Harvey's theory of neoliberalism as a specific project to restore power to the dominant class, and also to Marx's conception of state power subordinated to capitalist economic power. [ABSTRACT FROM AUTHOR]

The authors describe the incremental approach to the marketisation of the English National Health Service (NHS) since the introduction of an 'internal market' in 1990 until the 2010 White Paper, 'Equity and Excellence: Liberating the NHS', and the subsequent Health and Social Care Bill published in January 2011. The introduction of a competitive market for a universal, tax-financed health system requires fundamental changes in regulation in order that market bureaucracy can be substituted for direct management. The components of reform are insufficiently captured by the framework of hierarchies and networks in new public management theories of decentralisation. [ABSTRACT FROM AUTHOR]

Public--private partnerships (P3s) with the for-profit private sector are increasingly used in Canada to deliver public infrastructure and support services within the health care sector (e.g., hospitals, clinics, community health centres). This paper examines the emergence and legacy of P3s in the Canadian health care sector, classifying them as a form of neoliberal accumulation by dispossession and discussing their inability to live up to proponents' promises. Economic and social costs are examined, and examples are drawn from operational P3 hospitals in Canada. The article also briefly examines how P3s have been affected by the recent global financial crisis, arguing that despite serious problems with the private finance component of these projects, ultimately the policy is poised to weather the storm. [ABSTRACT FROM AUTHOR]

Despite recent critiques of contemporary obesity discourses that link 'modern Western lifestyles' to an 'obesity epidemic', the population's weight remains a central concern of current dietary guidelines. Food choices that are considered beneficial to maintaining a certain weight are understood to play a key role in one's health. This concern reflects medico-moral assumptions about the properties of food and what people should eat. However, the impact of obesity discourses on different individuals and social groups is rarely considered, although there is some evidence that people do generate, reflect and resist the norms and standards set for them, including those that relate to food/weight. In this paper, we will examine the perspectives on fatness and food choice amongst Black and White women and men living in Vancouver and Halifax, Canada. With this examination, we will challenge conventional assumptions about the singular 'modern Western lifestyle' that leads to obesity concerns by teasing out some of the social, cultural and political contexts within which people conceptualise issues regarding weight and make their food choices. By examining the experiences of both women and men we will also provide important insights into the gendered ways in which people engage with obesity discourses and the injunction to 'eat healthily' as a form of weight management. [ABSTRACT FROM AUTHOR]

Yi Nao describes a type of violence displayed in Chinese hospitals which involves organised disturbances led by patients' relatives and/or Yi Nao gangs. Drawing on media reports of Yi Nao, we argue that the phenomenon of Yi Nao transforms hospitals into 'power arenas' in which a struggle over moral and political resources (capital) takes place between patients, Yi Nao gangs, doctors, government agencies, and hospital management. Two interrelated rules that are crucial to understanding the ad hoc local strategies of the actors involved in Yi Nao are examined: the 'publicity rule', and the 'rule of risk-avoidance'. We also argue that the political discourse of 'stability' has been internalised by the officials in the Chinese government and public hospitals in mediating social disputes. At the same time, Yi Nao actors use this discourse to creatively adapt to social resistance, as reflected in the disposition to use performative disturbance in pursuit of material or symbolic compensation. [ABSTRACT FROM AUTHOR]

South Africa's long and arduous journey from colonial and apartheid-era care for people with mental illness to more comprehensive, equitable mental health care is well-described. Deeper engagement with the structural power dynamics involved in providing collaborative mental health services are less-well described, especially in its post-apartheid era. This conceptual article positions state and non-state mental health service providers - along with their relationships and conflicts - within Bourdieu's bureaucratic field. It is suggested that key internecine struggles in South Africa's post-apartheid socio-political arena have influenced the ways in which collaborative mental health care is provided. Drawing from two recent examples of conflict within the bureaucratic field, the article illustrates the ways in which neoliberal forces play out in contemporary South Africa's mental health service delivery. Struggles between the state and private healthcare in the Life Esidimeni tragedy receive focus, as well as the shifting of responsibility onto civil society. A court case between the state and a coalition of non-profit organisations provides further evidence that neoliberal rationalities significantly influences the position and power of non-state service providers. Unless serious consideration is given to these dynamics, collaborative mental health care in South Africa will remain out of reach. [ABSTRACT FROM AUTHOR]

Management of a pandemic engages multiple sites where previously settled or uncontroversial understandings may be transformed by global and domestic forces. This article examines the iconography of social distancing implicated in the discourses of 'quarantine' and 'risk control' in public health, and the tension between scientific and popular media readings of the contours of acceptable public health models for managing particular pandemics. The role of culture in shaping and reshaping borders at an operational level is explored as a basis for explaining the apparent paradoxes in the way historic and contemporary pandemics are actually managed, and the different ways particular pandemics are framed. The article argues that a rational-scientific approach to pandemic management is insufficient and that a more nuanced socio-political blend of science, culture and public perceptions offers a more substantial basis for public health policy. [ABSTRACT FROM AUTHOR]

This study explored Aboriginal perspectives of child health and wellbeing in an urban area in partnership with Aboriginal people and organisations. In depth interviews were conducted with 25 grandparents, parents, aunties or uncles of Aboriginal children. Interviews were transcribed and thematically analysed. A major conceptual theme was related to social, historical, and political factors seen by participants as influencing urban Aboriginal child health and wellbeing. This theme was called 'Strengths and Challenges: Harder for Koori Kids/Koori Kids Doing Well'. Increased challenges to achieving good health and wellbeing faced by Aboriginal children due to factors in their social, historical and political environment were emphasised. Many of these factors can be related back to historical and contemporary forms of racism. On the other hand, there was also a clear call to recognise and celebrate that many Aboriginal children were doing well in the context of these added challenges. [ABSTRACT FROM AUTHOR]

Explaining the trajectory of Australian health policies over the last century requires an analysis of different political regimes and their dreams of order for managing risk. Crook reverses the Beckian axiom that risk is the unintended outcome of the failure of industrial societies, arguing for an understanding of risk within a Foucauldian and Actor Network Theory of governmentality. Risk becomes a mechanism for the realisation of different dreams of order. The welfare state was the risk management mechanism of organised capitalism. Individual aspirations of reflexive individuals form the risk management mechanism of neo-liberal regimes. As competing risk discourses destabilise the field of maternity care, key actors (including doctors, midwives, women and policymakers) form themselves into neo-traditional communities in ongoing struggles to have their risk claims institutionalised within policies and protocols that further legitimise their interests. These struggles around risk and power are evident in recent debates over maternity policy in the context of the 2009 Maternity Services Review and the policy aftermath. [ABSTRACT FROM AUTHOR]

Having a difficulty with reading, or being unable to read, has not always been a medical problem. In the late nineteenth century, physicians such as (Broadbent 1872; Hinshelwood 1895) became interested in identifying particular bodies with reading difficulties. This article is focused around the question of 'how' reading difficulties were formed as a concern for medical researchers. It shall be suggested that the existence of acquired word-blindness as a legitimate medical diagnosis had established the inability to read or difficulty with reading as a medical concern, albeit with a different aetiology. This constituted the practical conditions and established a vocabulary that made congenital word-blindness a technically feasible diagnosis. The medical concern for a difficulty with reading was in most cases a concern with how this difficulty could be overcome. The clinical criteria that were negotiated for congenital word-blindness seem to have been negotiated in relation to rationalities of government concerned with capitalising the population. This article forms part of part a wider project to use analytical concepts drawn from Michel Foucault to help map a genealogy of dyslexia. [ABSTRACT FROM AUTHOR]

Peer support is a fast growing type of service provision within the mental health sector. This study draws on interviews with peer supporters and peer support managers to explore the ways that risks of violence, suicide and self-harm are managed within peer support settings in Aotearoa New Zealand. Drawing on Nikolas Rose and other theorists, who define risk thinking as an attempt to 'discipline uncertainty', we argue that the philosophy of peer support is in tension with a 'risk consciousness' because it sees crisis as a learning opportunity. We contend that peer supporters are pulled towards the 'risk consciousness', which pervades the mental health sector, and that they address this by managing risk in various ways. Finally, we show that peer supporters challenge this risk consciousness by working with risk through a philosophy of engagement and relationship. As peer support becomes more integrated into the wider health system, the challenge will be to continue the development of risk practices which work within a strong peer support philosophy. [ABSTRACT FROM AUTHOR]