Combining experiential knowledge with scholarship in charting the decline of the National Health Service in England.

The sustained governmental assault on the National Health Service (NHS) in England during post-1970s financialised or rentier capitalism has received considerable attention by the research community. There is some evidence, however, that many of those members of the public who have not had occasion to use the NHS remain largely ill-informed about the extent of, and reasons for, its present troubles. In this paper I offer an auto/biographic account of my own recent experiences as a patient with type 2 diabetes and subsequent polymyalgia in both primary and secondary care.

Let's Campaign for a Fairer Society in the Aftermath of COVID-19.

In this paper I ground a brief account of the impact of COVID-19 on the United Kingdom in an understanding of a decade of austerity politics from 2010 to 2020, itself a product of the advent and consolidation of post-1970s financialised or rentier capitalism. I argue that such an analysis is essential if realistic plans are to be laid for a "better"-understood here as a more equitable or "fairer"-society. I go on to consider the contributions that sociology can, and arguably should, make to this end.

Covid-19 as a 'breaching experiment': exposing the fractured society.

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.

The symbolic affordances of a video-mediated gaze in emergency psychiatry.

While mental illness is a significant health challenge worldwide, the availability of specialists is limited, especially in rural areas and for psychiatric emergencies. Although tele-psychiatry, via real-time videoconferencing (VC), is used to provide consultative services in areas that lack psychiatrists, there are a paucity of studies on the use of VC for psychiatric emergencies. We examine how VC matters for patient involvement and professional practice in the first Norwegian emergency tele-psychiatric service.

Nurses as Antibiotic Brokers: Institutionalized Praxis in the Hospital.

We are likely moving rapidly toward a post-antibiotic era, as a result of escalating antimicrobial resistance, rapidly declining antibiotic production and profligate overuse. Hitherto research has almost exclusively focused on doctors' prescribing, with nurses' roles in antibiotic use remaining virtually invisible. Drawing on interviews with 30 nurses, we focus on nurses as brokers of doctors' antibiotic decisions, nursing capacity to challenge doctors' decisions, and, "back stage" strategies for circumnavigating organizational constraints.

The path of least resistance? Jurisdictions, responsibility and professional asymmetries in pharmacists' accounts of antibiotic decisions in hospitals.

The misuse of antibiotics has become a major public health problem given the global threat of multi-resistant organisms and an anticipated 'antimicrobial perfect storm' within the next few decades. Despite recent attempts by health service providers to optimise antibiotic usage, widespread inappropriate use of antibiotics continues in hospitals internationally. In this study, drawing on qualitative interviews with Australian pharmacists, we explore how they engage in antibiotic decisions in the hospital environment.

Civil society and the Health and Social Care Act in England and Wales: theory and praxis for the twenty-first century.

In this paper we revisit the notion of civil society in the light of recent attempts to privatize health care in England via the passing of the Health and Social Care Act of 2013. This legislation promises a re-commodification of the National Health Service (NHS) in England. The Bill was bitterly contested during its passage through parliament, most vigorously in 2011.

Resistance in Unjust Times: Archer, Structured Agency and the Sociology of Health Inequalities.

Few sociologists dissent from the notion that the mid- to late 1970s witnessed a shift in capitalism's . Its association with a rapid increase of social and material inequality is beyond dispute. This article opens with a brief summation of contemporary British trends in economic inequalities, and finds an echo of these trends in health inequalities.

The Female Sex Work Industry in a District of India in the Context of HIV Prevention.

HIV prevalence in India remains high among female sex workers. This paper presents the main findings of a qualitative study of the modes of operation of female sex work in Belgaum district, Karnataka, India, incorporating fifty interviews with sex workers. Thirteen sex work settings (distinguished by sex workers' main places of solicitation and sex) are identified.

From fatness to badness: the modern morality of obesity.

Obesity (or being overweight) is now considered a by-product of membership of developed societies. Moreover, it is considered a growing 'global' health problem. This article reports on a small qualitative study of adults who fell into one or other of these categories in Norway in 2010, and who have been faced with decisions about lifestyle versus surgical remedies.

Health inequalities.

The evidence bearing on the nature and extent of health inequalities documented globally and in the UK is addressed, twin foci within the UK being (a) associations between socioeconomic classification and health and longevity, and (b) the notion of a 'social gradient'. A consideration of the various 'models' that have been developed by sociologists and their allies - most conspicuously social epidemiologists - to account for (a) and (b) is offered, drawing on government-sponsored commissions and reviews as well as the peer-reviewed literature. This is followed by a portrayal of specifically sociological theories of health inequalities, featuring those that hold social structures as well as cultural shifts in convention and behaviour to be causally efficacious for health inequalities.

Health-related stigma.

The concept of stigma, denoting relations of shame, has a long ancestry and has from the earliest times been associated with deviations from the 'normal', including, in various times and places, deviations from normative prescriptions of acceptable states of being for self and others. This paper dwells on modern social formations and offers conceptual and theoretical pointers towards a more convincing contemporary sociology of health-related stigma. It starts with an appreciation and critique of Goffman's benchmark sensitisation and traces his influence on the personal tragedy or deviance paradigm dominant in the medical sociology from the 1970s.

Square pegs in round holes: information systems, hospitals and the significance of contextual awareness.

The considerable emphasis in the development and implementation of clinical information systems in hospitals internationally seems to have had a limited effect. In particular, the implementation of electronic patient record (EPR) systems has been slower and more difficult than anticipated and with little change in efficiency and security. This paper suggests why this might be the case.

Health work, female sex workers and HIV/AIDS: global and local dimensions of stigma and deviance as barriers to effective interventions.

This paper addresses the near global attribution of stigma and deviance to female sex workers, and the salience of this attribution for health interventions in HIV/AIDS. A conceptual frame is developed as a guide to comparative sociological study in this area, and the importance of explanation at the level of social structure emphasized. After a general review of the empirical literature, more sustained attention is paid to specific aspects of female sex work in three contexts or figurations, the cities of London, Bangkok and Kolkarta.

Perceptions of evidence-based medicine: traditional acupuncturists in the UK and resistance to biomedical modes of evaluation.

Acupuncture and other types of 'complementary and alternative medicine' (CAM) are proving increasingly popular in the UK. As attempts to incorporate acupuncture into allopathic medicine have grown in number, the issue of assessing its effectiveness in ways consistent with the concept of evidence-based medicine has become more urgent. The nature, relevance and applicability of such assessments remain controversial however.

Sociology, social structure and health-related stigma.

There is a long and cross-disciplinary tradition of analysing chronic and disabling illness in terms of relations of stigma. The present paper offers a sociological approach which emphasizes: (a) the causal importance of social structures for grasping stigma relations; (b) the importance of understanding stigma relations in the context of wider societal change; and (c) the ways in which relations of stigma typically interact with other relations, such as those of class and command. It is suggested that consideration of specific and often condition-related strategies to reduce stigma might profitably be set in such a context.

Communicative and strategic action in interpreted consultations in primary health care: a Habermasian perspective.

We report a qualitative study of accounts of interpreted consultations in UK primary care. The study sought to explore how three Habermasian tensions between (a) system and lifeworld, (b) communicative and strategic action, and (c) interpersonal and macropolitical spheres played out in the triadic consultation between clinician, interpreter and patient. In a total of 69 individual interviews and two focus groups, we collected narratives from service users (through interpreters or bilingual researchers), interpreters and doctors and other staff in general practice.

Negotiating mothering against the odds: gastrostomy tube feeding, stigma, governmentality and disabled children.

Using the findings of a small-scale qualitative investigation based on in-depth interviews with mothers attending a tertiary paediatric referral centre in London, this paper explores professional and parental discourses in relation to gastrostomy tube feeding and disabled children. Detailed accounts are given of women's struggles to negotiate their identities, and those of their children, within dominant discourses of mothering and child-centredness. Constructions of feeding practices as coercive conflict with normative expectations of 'good mothering' and the 'idealised autonomous' child.

The relationship between medicine and the public: the challenge of concordance.

Concordance is based on the idea that patients and practitioners should work together towards an agreement on treatment choice. This requires a redefinition of the relations and encounters between doctors and their patients. This redefinition emphasizes the need for patient involvement and participation.