The art and science of non-evaluation evaluation
Abstract: There is growing recognition of the limitations of realist evaluation, and other theory driven approaches, in the context of healthcare policies. These approaches, which seek to surface ‘programme theories’ or construct ‘logic models’, are often unable to account for empirical observations of policy implementation in real-life situations. This paper argues that this failure stems from insufficient theoretical elaboration of the social, cultural, and political dimensions of healthcare policies. Drawing from institutional theory, critical theory and discourse theory, and from organizational ethnography, an alternative approach to research on healthcare policies is set out, illustrating with examples from Lorelei’s own experience of research on acute care ‘reconfiguration’, integrated health and social care, and other forms of major system change in the NHS in England.
Biography: Lorelei is an anthropologist in the UCL Department of Applied Health Research. Her research looks at the changing social organization of healthcare services and professional work in the context of contemporary policy reforms. Her doctoral research was an ethnographic study of the politically contested issue of hospital planning. She is currently interested in the role of expertise in governing, using policies for ‘major system change’, self-care and policy evaluation as particular cases. She is a member of the Sociology of Health and Illness editorial board and an executive member of the Society for Studies in Organizing Healthcare. With Oliver Bonnington, she convenes the London Medical Sociology Group where they explore the links between social theory, philosophy and medical sociology.
The Faculty of Public Health and Policy Seminar Series provide a forum for presenting current research on health systems and policy in low-, middle- and high-income countries. The series cover empirical research, theoretical and methodological issues, and gives an opportunity for staff and students to participate in debate and learn about new developments in health systems and policy research.
Series organized by: Dina Balabanova and Alec Fraser