Barriers to collaboration in health and social care

Paper delivered at Critical Management Studies (CMS) Conference 2017, Liverpool

Stream: An eternal crisis in health and Social Management-Time for a Revolution?

Title: Multi-professional and inter-organizational collaboration: Barriers to collaboration in health and social care

Abstract

Inter-organisational and multi-professional collaboration is widely accepted as an important approach for addressing significant social issues, such as the pressures currently being placed on the health and care system due to an ageing population (Oliver et al., 2014). This paper seeks to identify some of the factors that inhibit collaborative working and thereby develop a better understanding of why ‘the partnership agenda is problematic’ (Pate, 2010, 200). This paper seeks to build on previous work with a particular focus on the structural factors and “the interchange between agents and contexts” (Pettigrew 1997, 339). In the case of health and social care it will be argued that inter-organizational and multi-professional collaboration are inhibited by deeply institutionalised social structures and forces that are essentially anti-collaborative in nature.

Full text

Contact Andy at abrookes@lincoln.uk

Psychological well-being of academics

Paper delivered at EAWOP Small Group Meeting on the Future of Work and Organizational Psychology

16-18 May, 2018. Breda, the Netherlands.

 

Psychological well-being of academics

Andy Brookes

 

I want to talk about a ‘sinister and insidious epidemic’1. This is the epidemic of harm that organisations are inflicting on the mental well-being of their employees. At one level this might simply result in lack of enjoyment or job dissatisfaction. But at another level it might lead to days being lost to sickness and in the UK alone this represents up to 12.5 million working days lost per year. But this harm that is been afflicted by organisations can also be a killer, with workplace stress being thought to contribute to 120,000 deaths in the US each year.

So why is this a pressing concern for us? We are educators in organisations and management, so are we implicated in inflicting this harm? Our mental well-being as academics is also being harmed by our own organisations and if this is occurring it inhibits us from generating the knowledge which is required to address societal issues such as this.

One of the problems from me is that the academic and popular literature on workplace stress is primarily written from within the conventional paradigm. There is an implication that workplace stress is due to a failure of the individual to manage themselves. Or it is implied as the failure of the individual manager to follow ‘best practice’. However, this broad body of knowledge does little to really question the contemporary mode of organisation itself. Of course, there has been plenty of critique of organisations, as long as 50 years ago Eric Fromm was pointing out the limitations of bureaucratic methods of management where people are treated like things. More recently, Martin Parker in his article that suggested ‘we should bulldoze the business school’2 critiqued the role these schools play in perpetuating a single, dominant mode of organising based on market-managerialism. This has resulted in a homogenised way of doing management and explains why we can easily relate to issues we are commonly experiencing.

Another problem for me is that when we talk about ideology it feels very big and ‘out there’. This can make us feel powerless, as if the only thing we can do is wait for the revolution….and that clearly isn’t coming! But we can also think of ideology not as something out there but rather something carried into the organisation inside the heads of ourselves, our managers and our colleagues. In this way these ideologies, I would suggest, contaminate our cognitive structures.

We can also think differently about these unhealthy work environments by considering them as ongoing social constructions which are constructed and reconstructed on an ongoing daily basis, and recognise that we are active participants in their construction. The fundamental building block of these constructed environments is the individual interpersonal relationship that we continually build and sustain. The dominant market-managerial mode of doing organisation tends to produce interpersonal relationships that are hierarchical in nature and based on control. Whereas more collaborative, cooperative and democratic modes of organising are more likely to generate reciprocal relationships which are based on trust. But how does this relate to mental well-being? The basic human need, or yearning, for meaning can only be fulfilled through reciprocal forms of relationship. In such relationships we create shared meaning and understanding through dialogue. But in hierarchical relationships meaning tends to be imposed and dialogue stifled and this results in relationships that are inherently unhealthy. So if in a particular environment the hierarchical relationships significantly outnumber the reciprocal relationships then the likelihood is that environment will be unhealthy.

So to what extent are we agents of our own well-being?

Well we can, and do, construct our own personal organisations or networks and we can actively seek to build these so they consist of primarily reciprocal relationships. We can also continually critically reflect on the types of relationships that we build and sustain. This also might involve political behaviours in terms of a resistance to engage or participate in hierarchical forms of relation. As autonomous professionals therefore we should maintain an expectation of reciprocal relationships – even with those who manage us.

 

Notes

1 ‘How burnout became a sinister and insidious epidemic’, Moya Sarner, The Guardian, 21 Feb 2018.

2 ‘Why we should bulldoze the business school’, Martin Parker, The Guardian, 27 Apr 2018.