Search

Choice is an imperative for patients in the Australian healthcare system. The complexity of this healthcare ‘maze’, however, means that successfully navigating and making choices depends not only on the decisions of patients, but also other key players in the healthcare sector. Utilising Bourdieu's concepts of capital, habitus and field, we analyse the role of gatekeepers (i.e., those who control access to resources, services and knowledge) in shaping patients' experiences of healthcare, and producing opportunities to enable or constrain their choices. Indepth interviews were conducted with 41 gatekeepers (GPs, specialists, nurses, hospital administrators and policymakers), exploring how they acquire and use knowledge within the healthcare system. Our findings reveal a hierarchy of knowledges and power within the healthcare field which determines the forms of knowledge that are legitimate and can operate as capital within this complex and dynamic arena. As a consequence, forms of knowledge which can operate as capital, are unequally distributed and strategically controlled, ensuring democratic 'reform' remains difficult and 'choices' limited to those beneficial to private medicine. [ABSTRACT FROM AUTHOR]

The paper reports on an empirical study based on qualitative interviews with staff from four Australian universities. These universities are shown to be undergoing significant social change as processes of marketisation impact on the everyday practices of academic workers. The universities are analysed as sites of contestation between the new professional managers and the established academic profession over the control of the conditions of work, the production of expert knowledge and the worksite itself. The theory of academic capitalism is examined, and the relevance of Bourdieu’s work for the analysis of a university sector in a context of marketisation is assessed. Bourdieu’s interlinked concepts of capital, habitus and the field are employed to investigate the nature of the contestation, revealing a dynamic process in which academics innovatively respond to threats to reduce their autonomy, to increased levels of surveillance and other constraints on practice. In addition, the study illustrates the processes through which actors within the sector, through acts of both conformity and resistance, contribute collectively to the growth of academic capitalism in the neoliberal university. [ABSTRACT FROM AUTHOR]

The promotion of choice is a common theme in both policy discourses and commercial marketing claims about healthcare. However, within the multiple potential pathways of the healthcare ‘maze’, how do healthcare ‘consumers’ or patients understand and experience choice? What is meant by ‘choice’ in the policy context, and, importantly from a sociological perspective, how are such choices socially produced and structured? In this theoretical article, the authors consider the interplay of Bourdieu’s three key, interlinked concepts – capital, habitus and field – in the structuring of healthcare choice. These are offered as an alternative to rational choice theory, where ‘choice’ is regarded uncritically as a fundamental ‘good’ and able to provide a solution to the problems of the healthcare system. The authors argue that sociological analyses of healthcare choice must take greater account of the ‘field’ in which choices are made in order to better explain the structuring of choice. [ABSTRACT FROM AUTHOR]