Value Critical Analysis and Actor Network Theory: two perspectives on collaboration in the name of health

Abstract

Ferlie and Pettigrew (1996) report that, after nearly a decade of policy promoting market-like competition in the UK NHS, there was also a wealth of evidence of co-operative (net)working. The new forms of interorganisational working which they catalogue should not be read necessarily as a fundamental shift in organising principle: indeed, Ferlie and Pettigrew (1996) suggest that the diversification may only represent a temporary, ‘unresolved excursion’ from the principal organisational form of an integrated hierarchy. A second interpretation suggests that, although there are strong institutional pressures on the selection of organisational form in the NHS, they are unlikely to lead in one direction only: variety is to be expected. A third view is that pure organisational form should not be expected at all. Thus Lowndes and Skelcher (1997) suggest that collaborative partnerships (as one pure form) pass through a natural life cycle in which different modes of governance [hierarchy, market and network] assume a particular importance at different points in time, and in relation to particular partnership tasks.