Machinic Operations. Data structuring, healthcare and governmentality

Goffey, Andrew

Abstract

The National Programme for IT, or NPfIT for short, was a flagship IT project of the first Labour administration initiated by Tony Blair in 2002. Headed by Richard Grainger and costing an alleged £18.7bn, it was widely billed as the ‘biggest IT project in the world’, and while it would be unfair to say that it failed spectacularly, it was indeed one of the biggest and most expensive of a rapidly growing number of public sector IT fiascos. In the historical context of proclamations on information superhighways (especially in the US) and a proliferation of high-level public administration announcements about the virtues of ‘interoperability’, the project was billed as a comprehensive endeavour to bring the National Health Service in Britain into the present, unifying disparate local IT systems that numbered in their thousands, employing widely differing standards and practices of data gathering. NPfIT would ensure citizens could continue to have access to high standards of free healthcare without fear that a system that was already exhibiting distinct signs of creakiness might become ever more backwards and idiosyncratic in an era of rapid technological shift. NPfITwas finally dismantled in 2011 by the Conservative-Lib Dem coalition government, with widely varying estimates of the overall costs of the project to the public purse. Yet the failure of NPfIT did not prevent the Coalition administration from promising in its wake an ‘Information Revolution in the NHS’. This revolution would fulfil many of the promises made by the original project, without the administrative overheads and inefficiency of the suspiciously centralised original model. Nor, indeed, did the publicly touted failure of NPfIT prevent subsequent administrations from putting to use the infrastructural changes that the project did achieve. Subsequent events give good reason not to take the rhetoric of the infor-

mation revolution at face value. Given the current situation of healthcare provision in the United Kingdom (to say nothing of the broader attacks on public healthcare provision), we are forced to consider a little more directly some of the dynamics at play – between public administration and private contractor, state health professional and citizen – and, more broadly to address the question of what we can learn from this case study about the changing forms of governmentality associated with national healthcare provision in a problematically globalising world. What can an exploration of the accelerating

trend towards digitisation and technical mediation through digital infrastructures tell us about the changing organisation and deployment of power relations in contemporary societies of the Global North? More specifically, through a discussion of some aspects of the ongoing infrastructural transformation of the National Health Service in the United Kingdom, this chapter asks what light an exploration of such infrastructures casts on the shifting practices of governmentality in contemporary societies.

Citation

Goffey, A. (2016). Machinic Operations. Data structuring, healthcare and governmentality. In P. Harvey, C. Bruun Jensen, & A. Morita (Eds.), Infrastructures and Social Complexity: A Companion. Routledge. https://doi.org/10.4324/9781315622880-45

• Online Publication Date: Oct 4, 2016
• Publication Date: 2016
• Deposit Date: Sep 7, 2016
• Publisher: Routledge
• Book Title: Infrastructures and Social Complexity: A Companion
• Chapter Number: 27
• ISBN: 9781138654945
• DOI: https://doi.org/10.4324/9781315622880-45
• Public URL: https://nottingham-repository.worktribe.com/output/1116535
• Publisher URL: https://www.taylorfrancis.com/books/e/9781315622880/chapters/10.4324/9781315622880-45