Raced and risky subjects: The interplay of racial and managerial ideologies as an expression of "colorblind" racism.

Contemporary manifestations of race are dynamic and elusive in the forms and shapes they take. "Colourblind" racism is effective at drawing on seemingly objective and race-neutral discourses to obfuscate racialized forms of structural exclusion. Framed by Critical Race Theory and Critical Narrative Analysis this paper presents an example from the Australian context that examines the relationships between a grassroots initiative developed by creatives from the African diaspora and two not-for-profit human services organizations, to illustrate how ideologies of race are enacted and obscured by managerialist ideologies and discourses of risk. Specifically, it shows how harmful dominant cultural narratives of deficit and danger transforms racialized Africans in Australia into "risky subjects." In a managerialist organization, risk must be controlled, and thus risk becomes the rationality for the control of racialized and risky subjects. Resistance to control by those subjects produces forms of organizational defensiveness that are mobilized through managerialist discourses and practices that work to structurally exclude. These findings illustrate the ways ideologies of race work alongside and through other ideological discourses and practices which render racialized dynamics of oppression race-neutral.

The systemic neoliberal colonisation of higher education: a critical analysis of the obliteration of academic practice.

Within the neoliberal university, scholarship, education, students, academic staff, and practices are subordinated to managerial imperatives. University educators are denigrated and displaced by colonising neoliberal practices that systemically invalidate and invisibilise academic work. The present article provides an example of this by critically analysing the corrosive and Orwellian operations of neoliberal managerialism in higher education through the prism of my own experience of applying for 'recognition of leadership' in relation to teaching. I use a narrative ethnographic approach to generate new insights into the obliteration of academic practice in contemporary university contexts and to produce a counter-hegemonic discourse for understanding these processes. Following Habermas inter alia, it is argued that without radical reform, the uncoupling of the ethical and substantive dimensions of the (educational) lifeworld from systemic (neoliberal managerial) strategising will leave higher education in a state of paralysis. The analysis highlights the urgent need for resistance and provides a critical framework for academics to recognise and contest similar colonising processes occurring in their own experiences and contexts.

Raising the Dead? Limits of CPR and Harms of Defensive Practices.

We describe the case of an eighty-four-year-old man with disseminated lung cancer who had been receiving palliative care in the hospital and was found by nursing staff unresponsive, with clinically obvious signs of death, including rigor mortis. Because there was no documentation to the contrary, the nurses commenced cardiopulmonary resuscitation and called a code blue, resulting in resuscitative efforts that continued for around twenty minutes. In discussion with the hospital ethicist, senior nurses justified these actions, mainly citing disciplinary and medicolegal concerns. We argue that moral harms arise from CPR performed on a corpse and that legal concerns about failing to perform it are unfounded. We contend that such efforts are an unintended consequence of managerialist policies mandating do-not-resuscitate orders and advance care plans and of defensive practices that can value the interests of institutions and practitioners over those of patients. Health management teaching should include managerialism and its pitfalls, while clinician training should prioritize ethical reasoning and legal knowledge over defensive practice.

Managerialism: A workforce health hazard in human service settings.

BACKGROUND: This study assesses the relationship between managerialism and health among human service workers. METHODS: A total of 2154 New York City human service workers participated in an electronic survey that included validated measures of a system of work organization (the Organizational Commitment to Managerialism scale [OCTM]) and a work stressor (the Effort Reward Imbalance scale [ERI]), and single items about physical, mental, and behavioral health. Controlling for demographic variables, logistic regression models were used to predict health outcomes assess the potential role of ERI as a mediator. RESULTS: Managerialism was associated with increased risk of high blood pressure, neck and back pain, gastrointestinal difficulties, sleeping disorders, anxiety, and depression. Mediation analyses suggested that the effects of managerialism on health were partially explained by ERI. CONCLUSIONS: Managerialism in human service agencies significantly increased the risk of adverse physical and mental health. Increased levels of a work stressor helped to explain part of this association.

Corporatising compassion? A contemporary history study of English NHS Trusts' nursing strategy documents.

The purpose of this contemporary history study is to analyse nursing strategy documents produced by NHS Trusts in England in the period 2009-2013, through a process of discourse analysis. In 2013 the Francis Report on the Mid-Staffordshire NHS Foundation Trust was published. The Report highlighted the full range of organisational failures in a Trust that valued financial efficiency over patient care. The analysis that followed, however, dwelt heavily on the failings of the nurses. Nursing strategy documents at that time served to set the future direction for NHS Trusts, prescribing specific value frameworks for each nursing workforce. However, the values chosen frequently conflicted with each other pitting nursing values against a managerial trope. It is argued that documents provided a response to wider NHS concerns and high-profile failures in care, particularly the Francis Report, paying lip service to staff engagement whilst maintaining a corporate focus. Nursing values were placed firmly within a managerialist discourse, one that has needed to be re-evaluated in the current Covid-19 pandemic. Wider implications of the research suggest discussion of value conflict may be beneficial within nursing education and a truly local approach to strategy creation would potentially promote staff buy-in to strategy documents.

Why do Social Workers Leave? A Moderated Mediation of Professionalism, Job Satisfaction, and Managerialism.

Turnover has been a serious concern to social service organizations. A lack of committed social workers is a risk to organizational performance and service quality. Therefore, it is vital to better understand the leaving process of social work practitioners. The study constructed a moderated mediation model to examine the mediating role of job satisfaction between employees' professionalism and turnover intention and the moderating role of the perceived level of managerialism in the context of social work organizations. A total of 667 participants from Guangzhou, Shenzhen, and Shanghai in China were recruited to complete the survey. Results presented that job satisfaction plays a full mediation role in the relationship between professionalism and turnover intention. In addition, the positive relationship between professionalism and job satisfaction, as well as the negative relationship between professionalism and turnover intention were moderated by managerialism. The findings enrich knowledge about turnover among social workers in the context of China and inspire to foster professionalism among service workers to improve job satisfaction and alleviate turnover intention and actual turnover as well as to apply management techniques and structures properly to strengthen the effect of professionalism on promoting job satisfaction and on preventing turnover intention.

On the Front Lines: The Impact of Managerialism on the New York City Addiction Treatment Workforce.

Since the mid-1970s, neoliberal policies have relied on privatization and other tactics to down-size the state, transforming human service organizations in the process. The impact of this approach, also known as managerialism, has not been examined in addiction treatment, where the opioid epidemic has intensified the need for services. Using qualitative semi-structured interviews, we explore how managerialism has affected the workforce, service delivery, and the quality of care in New York City addiction treatment programs. Front-line and managerial staff identified threats to working conditions, including high caseloads and productivity demands; threats to service quality including standardization of practice, loss of professional discretion and serving only those most likely to succeed; and threats to worker well-being marked by stress, burn-out, and low morale. The contradictions between the goals of managerialism and addiction treatment threaten the ability to meet the needs of people struggling with addiction.

Social movements and the contested institutional identity of the hospital.

Taking popular protest as a common reaction to changes in hospital services as its point of departure, this paper explores how a social movement has taken on the issue of the hospital as an institution. In the wake of the transformation of Norwegian public hospitals into health enterprises (trusts), this paper explores community resistance to the proposals and plans of decision-makers to restructure hospitals. The study is based on a qualitative and quantitative analysis of the website/blog for the local hospital movement's activities from 2007 until 2017 and of its involvement and resistance in respect of three instances of proposed change to the hospital structure during this period. The study reveals that the health enterprises and the managerialism they represent pose a threat to individual safety and sense of belonging, and to the preservation and identity of the local community. Moreover, the framing of the cause of the local hospital movement illuminates how the institutional identity of the hospital is highly contested between the institutional categories of 'public administration' on the one hand, and 'the company' on the other. The impact of the local hospital movement has proven modest in terms of influencing and reversing decisions to restructure hospitals, but it has been considerable in terms of cultural support for its concepts and values, not just concerning hospitals and health care services, but also with regard to democratic governance.

Understanding the Microfoundations of Government-Civil Society Relations.

This article adds a much needed microlevel perspective to the literature on interactions between civil society organizations and governments. I argue that a microlevel perspective assists in making connections between two dominant streams in the literature on government-CSO relations: an empirical-analytical stream and a critical stream. It aims to better understand the interactions and relations, by analysing the institutional work done by CSOs' members. Adopting this approach puts CSO members in a more agentic position. Interactional processes are brought to the centre of analysis. The Dutch Community Sport Coach programme was used as a case to illustrate the usefulness of the approach. Through a one-year organizational ethnography, the article scrutinizes the way in which members of one CSO enact the organization's service delivery relationship with a municipality. Through a multidimensional perspective on agency, the analysis shows how individual CSO members act as embedded agents that assimilate a public logic into the dominant community logic. It further shows the CSO's members efforts and struggle to maintain their community logic. The article argues that an analysis of the microfoundations of government-civil society organization relations foregrounds the multivocality of the relationship as foundational.

Corporate Law Versus Social Autonomy: Law as Social Hazard.

This article argues that corporate law has become the legal platform upon which is erected a social process impeding society's capacity to lucidly reflect on its primary ends; in this sense, corporate law is in conflict with social autonomy. This process is described here as a social feedback loop, in the structural centre of which lies the corporation which imposes its own purpose as an irrational social end, i.e. irrespective of its potentially catastrophic social consequences. The article argues that resolving the conflict between corporate law and social autonomy is impossible, because it presupposes a change of social paradigm towards one where corporate law as business organisation law has no obvious fit. This questions the social legitimacy of corporate law, signifies its non-permanence and thus opens up the field for seeking radical alternatives in the future.

Entre managerialismo y nostalgia. El debate por el futuro de la Universidad y el Trabajo Académico / Between managerialism and nostalgia: the dispute for the future of the University and AcademicWork

La universidad y el trabajo académico han sido interpeladas a hacerse más eficientes bajo los criterios del Nuevo Management Público, promoviendo privatización y modelos de gestión y fi-nanciamiento por desempeño. Chile, considerado caso emblemático, ha realizado nuevas re-formas respondiendo a las movilizaciones estudiantiles que han cuestionado dicho modelo des-de 2011. Este artículo aborda el debate en torno a estas reformas, desplegado en columnas de opinión, editoriales y cartas al director en los principales medios. Los resultados evidencian la disputa entre dos versiones de universidad y trabajo académico: la managerialista, orientada a competencia, estándares e indicadores, y la humboldtiana basada en constantes apelaciones a un “pasado mejor” que fue truncado. Entre estas, emergen otras híbridas que dan cuenta de la variabilidad en el uso de estos repertorios. Las versiones desplegadas muestran los límites del debate, y de la posibilidad de imaginar un futuro de la universidad más allá del managerialis-mo.(AU)

The university and academic work have been challenged to become more efficient under the criteria of the New Public Management, promoting privatization and performance manage-ment and financing models. Chile, considered an emblematic case, has carried out new re-forms in response to student mobilizations that have questioned this model since 2011. This article addresses the debate around these reforms, displayed in opinion columns, editorials and letters to the editor in the main media. The results show the dispute between two ver-sions of university and academic work: the managerialist, oriented to competence, standards and indicators, and the Humboldtian based on constant appeals to a “better past” that was truncated. These versions show the limits of the debate and of the possibility of imagining a future of the university beyond managerialism.(AU)

The Perils of Privatization: Bringing the Business Model into Human Services.

During the last three decades in both the United States and Europe, neoliberal policies, especially privatization, have restructured services in ways that dramatically affect the capacity of human services workers and agencies to serve all clients. Privatization means not only transforming public programs such as Social Security, but also managerialism-the incorporation of business principles, methods, and goals into public and nonprofit human services organizations. Few researchers have looked at the impact of market-based managerialism (focused on productivity, accountability, efficiency, and standardization) on social work's mission and the effectiveness of human services workers and organizations. Using an anonymous survey of 3,000 New York City human services workers, authors examined the impact of managerialist practices including performance measures, quantifiable short-term outcomes, and routinized practices on frontline workers and service provision. A troubling trend emerged. Workers in agencies with a high commitment to managerialism found it considerably more difficult to adhere to social work's mission and fundamental values. This conflict between the "logic of the market" and the "logic of social work" subsided dramatically in agencies with a low commitment to managerialism, indicating that even in today's competitive environment, agencies can protect the social work mission.

Therapeutic relationships: Making space to practice in chaotic institutional environments.

WHAT IS KNOWN ABOUT THE SUBJECT?: While therapeutic relationships remain core to mental health nursing practice and patient recovery, increased managerialism and focus on risk has impacted nurses' therapeutic practice with patients. While there is anecdotal evidence of the impact there has been little research that demonstrates nurses experience of therapeutic engagement within the current context. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The paper reports on qualitative research that highlights nurses' strong attempts to create the space for therapeutic engagement with clients. This research provides evidence of the constraints on practice imposed by new managerial processes and suggests potential means of responding to them. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses are committed to working therapeutically but struggle to balance this against new managerial demands imposed across many OECD countries. The New Zealand government has recently reported on positive changes to mental health provision but does not suggest changes to the structures that impede good practice. This research indicates that structural change is essential to therapeutic engagement. ABSTRACT: Introduction Increasing managerialism, driven in part by notions of risk, compromises the mental health nurses therapeutic engagement with clients potentially impacting their recovery. While the importance of therapeutic relationships in mental health recovery is acknowledged, there is little evidence about how managerial processes encroach on this relationship. Aim To explore mental health nurses experience of engaging in therapeutic relationships within the current practice environment. Method This paper utilized an interpretive phenomenological approach, using interviews with mental health nurses. Results Managerial processes significantly impacted the practice of nurses who struggled to make space for therapeutic relationships within a chaotic milieu. The chaos is associated with increasing austerity within the health system; this has resulted in high staff turnover and staff shortages. Discussion Managerial demands dominate the practice field at the expense of therapeutic engagement between nurses and clients ultimately affecting client recovery. While nurses' integrity means they desperately try to make space for the therapeutic work, they often become burnt out and disheartened. Implications for practice While nurses are often blamed for failures in the system, the structures that disable nurses in their attempts to practice therapeutically require urgent responses, strengthening professional organizations and engaging in democratic partnerships with consumer groups.

Benefits and risks of standardization, harmonization and conformity to opinion in clinical laboratories.

Large laboratory systems that include facilities with a range of capabilities and capacity are being created within consolidated healthcare systems. This paradigm shift is being driven by administrators and payers seeking to achieve resource efficiencies and to conform practice to the requirements of computerization as well as the adoption of electronic medical records. Although standardization and harmonization of practice improves patient care outcomes and operational efficiencies, administratively driven practice conformity (conformity to opinion) also has serious drawbacks and may lead to significant system failure. Juxtaposition of the distinct philosophical approaches of physicians and scientists (i.e. "professionalism") versus administrators and managers (i.e. "managerialism") towards bringing about conformity of the laboratory system inherently creates conflict. Despite an administrative edict to "perform all tests using the same methods" regardless of available "best practice" evidence to do so, medical/scientific input on these decisions is critical to ensure quality and safety of patient care. Innovation within the laboratory system, including the adoption of advanced technologies, practices, and personalized medicine initiatives, will be enabled by balancing the relentless drive by non-medical administration to meet "business" requirements, the medical responsibility to provide the best care possible, and customizing practice to meet individual patient care needs.

Harm reduction: Philosophical drivers of conceptual tensions and ways forward.

Of the various debates surrounding harm reduction, a conceptual tension that perhaps has the most relevance for the provision of services is that of harm reduction as a technical solution versus a contextualized social practice. The aim of this paper was to examine this conceptual tension. First, the two perspectives will be presented through the use of examples. Second, philosophical drivers that serve to underpin and justify each perspective will be explicated at the level of the knowledge that we privilege; the ideologies that we subscribe to; and the interests that we stand to serve. In this paper, I argue that the existing tension between technical and social approaches to harm reduction is embedded within discord pertaining to ways of knowing, paradigms of inquiry, prevailing ideologies, and notions of harm and risk. Building on these sources of tension, I suggest a means of philosophical reconciliation between the two approaches and ways forward, namely through acknowledging multiple sources of knowledge, through embracing paradigmatic incommensurability, through considering alternative conceptions of people who use drugs as political subjects, through involving service providers and end-users in shared decision-making, and lastly through reaffirming people who use drugs as the intended beneficiaries of services.

Capitalismo contemporâneo em crise e sua forma política: o subfinanciamento e o gerencialismo na saúde pública brasileira / Contemporary capitalism in crisis and its political form: underfunding and managerialism in Brazilian public health

Resumo O artigo tem como objetivo analisar a problemática do subfinanciamento da saúde no Brasil e a expansão de mecanismos gerenciais de mercado no interior da política pública de saúde no contexto do capitalismo contemporâneo sob a dominância do capital portador de juros, sua crise e sua forma política específica materializada no Estado. A primeira parte analisa a crise capitalista numa perspectiva teórica marxista, ressaltando a tendência de queda da taxa de lucro e a expansão da dominância do capital portador de juros no centro das relações econômicas e sociais. A segunda parte evidencia a forma política específica do capitalismo, em que o Estado se constitui no elemento essencial das relações capitalistas de produção, contribuindo para a compreensão do perfil de atuação do Estado brasileiro na contemporaneidade. A terceira parte aborda os efeitos da crise capitalista na problemática do subfinanciamento da saúde, enquanto a última discute o fenômeno da apropriação privada das políticas públicas de saúde por meio do gerencialismo, com foco na adoção de instrumentos de gestão no interior da administração pública direta baseados na lógica do desempenho.

Abstract The article aims at analyzing the underfunding of health in Brazil and the expansion of market management mechanisms within the public health policy in the context of contemporary capitalism under the dominance of interest-bearing capital, its crisis and its political form specified in the State. The first part analyzes the capitalism crisis in a theoretical Marxist perspective, emphasizing the tendency of decreasing rate of profit and the expansion of the dominance of interest-bearing capital at the center of economic and social relations. The second part shows the specific political form of capitalism, in which the State constitutes the essential element of the capitalist relations of production, contributing to the understanding of the profile of the Brazilian state in the contemporary world. The third part deals with the effects of the capitalism crisis on the health underfunding matter, while the last part discusses the phenomenon of private appropriation of public health policies through managerialism, focusing on the adoption of management tools within the direct public administration based on the logic of performance.

Contrarreforma do Estado e gerencialismo: novo fetiche, velha proposta / State counter-reformation and managerialism: new fetish, old proposition

Resumo: Este artigo debate as transformações do mundo do trabalho sob a égide dos organismos multilaterais, dando ênfase à disseminação do ideário gerencial no setor público, espaço privilegiado de atuação do assistente social. Realizamos um levantamento bibliográfico do pensamento social crítico, bem como documental do Judiciário trabalhista carioca enquanto espaço sócio-ocupacional reestruturado. Conclui-se que essa conjuntura inflexiona a tradição progressista do Serviço Social brasileiro.

Abstract: This article discusses the transformation of the workers world under the influence of multilateral organizations, emphasizing the dissemination of managerial ideas in the public sector - a privileged space for social worker performance. Was performed a bibliographysurvey of the critical social thinking, as well as a documentary of the Rio labor court as a restructured socio-occupational space. We conclude that this situation shrugs the progressive tradition of Brazilian Social Service.

Indo além do gerencial: a agenda da governança democrática e a mudança silenciada no Brasil / Yendo más allá del gerencial: la agenda de la gobernanza democrática y el cambio silenciado en Brasil / Going beyond management: the agenda of democratic governance and the silenced change in Brazil

Resumo O objetivo deste artigo é discutir a agenda de reforma do Estado brasileiro em uma perspectiva exploratória e normativa, observando os modelos de gestão pública decorrentes da experiência histórica brasileira. Observar essa experiência histórica possibilita pensar a trajetória institucional de construção da administração pública no Brasil, com destaque para os processos de mudança e para os desafios impostos ao processo de construção do Estado. Além disso, o artigo discute a relação entre administração pública e democracia, tendo em vista o conceito de governança democrática. Por fim, analisamos o que nomeamos de mudança silenciosa no Brasil, destacando a forma de acordo com a qual o processo de mudança ocorre de forma incremental, mas descoordenado, impondo desafios ao processo de construção da governança no setor público brasileiro e à atualização da agenda de reformas.

Resumen El objetivo de este artículo es discutir la agenda de reforma del Estado brasileño en una perspectiva exploratoria y normativa, observando los modelos de gestión pública resultantes de la experiencia histórica brasileña. Observar esta experiencia histórica posibilita pensar la trayectoria institucional de construcción de la administración pública en Brasil, con destaque para los procesos de cambio y para los desafíos impuestos al proceso de construcción del Estado. Además, el artículo discute la relación entre administración pública y democracia, teniendo en cuenta el concepto de gobernanza democrática. Por último, analizamos lo que denominamos de cambio silencioso en Brasil, destacando la forma de acuerdo con la cual el proceso de cambio ocurre de forma incremental, pero descoordinado, imponiendo desafíos al proceso de construcción de la gobernanza en el sector público brasileño y a la actualización de la agenda de reformas.

Abstract This article aims to analyze the agenda of the reform of the Brazilian State adopting an exploratory and normative perspective, observing the models of public management arising from the Brazilian historical experience. The country's experience enables thinking about the institutional history of construction of public administration, highlighting the changes and the challenges posed in state-building processes. In addition, the article discusses the relationship between public administration and democracy, in view of the concept of democratic governance. Finally, the article analyze what we name "silent change in Brazil", highlighting the uncoordinated way the process of change incrementally takes place, imposing challenges to the governance of the construction process in the Brazilian public sector and challenges in updating the agenda of reform.

Assistência social em risco: conservadorismo e luta social por direitos / Brazilian Social Assistance at risk: conservateurism and social struggle for rights

Resumo: Este artigo aborda as tendências regressivas na política de assistência social no Brasil, a partir da análise dos constrangimentos institucionais típicos do pacto federativo e das evidências de retrocessos que colocam em risco as bases do Sistema Único de Assistência Social, com flagrante aprofundamento da programática neoliberal, numa conjunta de avanço das contrarreformas, ameaça à democracia e de redução dos direitos. A partir da análise das evidências de retrocessos, reafirma-se o necessário fortalecimento das formas de resistência e lutas sociais pela dignidade humana.

Abstract: This article deals with regressive trends in social assistance policy in Brazil, based on the institutional constraints typical of the federative pact and the evidence of setbacks that put the foundations of the Unified Social Assistance System at risk, with a flagrant deepening of the neoliberal program, A joint advance of counter-reforms, a threat to democracy and a reduction of rights. From the analysis of the evidence of setbacks, the necessary strengthening of forms of resistance and social struggles for human dignity is reaffirmed.