Health care and neoliberalism in Ireland: withholding the gift and corrupting the social contract

The health of a nation tells much about the nature of a social contract between citizen and state. The way that health care is organised, and the degree to which it is equitably accessible, constitutes a manifestation of the effects of moments and events in that country's history. Using four case studies, this thesis uses a historical genealogical approach to explain the evolution of Ireland's particular version of health care provision. The total social fact of the gift relationship, central to all human relations, will be used to form a theoretical and conceptual framework on which to build an analysis of Ireland's health and welfare conditions. Additionally, social contract theory will enable an examination of the role of solidarity in relation to social expectations around health care provision. Through the analysis of these cases, the complex matrix of the influential forces that have shaped current conditions are exposed and revealed, enabling a critical understanding of the extent of acquiescence to the inequitable system that arguably exists. The vulnerability of citizens in need of care to the external and global effects of market forces and neoliberalism, therefore, becomes central to any argument for state-provided health and welfare. The hegemony of such forces can be seen to influence the manner in which the idea of individual self-reliance, in place of collective solidarity, is conceptualised and subsequently infiltrated into a range of aspects of the social world. For example, the particular discourse of the market and of economic concerns succeeds in shaping understandings of responsibilities around central areas of health and welfare. Similarly the 'possessor principle' can be seen to be misplaced within the context of health and social care, but yet has become normalised within this discourse. Within this matrix of complex influencing factors, the welfare state struggles to impose a balance between market values and social values. Responsibilities of the state to support and compensate its citizens for the ills of the market have become devalued, as the core values of classical liberalism have become distorted beyond recognition, leaving instead bare neoliberal concerns. This thesis traces the genealogical origins of this transition within the recent history of Irish health care and thereby reveals the embedding of individualism in place of solidarity, the on going reneging of the social contract and the corruption of the gift relationship.

States of play: Irish childhoods, race and belonging

This thesis explores the meaning-making practices of migrant and non-migrant children in relation to identities, race, belonging and childhood itself in their everyday lives and in the context of ‘normalizing’ discourses and spaces in Ireland. The relational, spatial and institutional contexts of children’s worlds are examined in the arenas of school, home, family, peer groups and consumer culture. The research develops a situated account of children’s complex subject positions, belongings and exclusions, as negotiated within discursive constructs, emerging in the ‘in-between’ spaces explored with other children and with adults. As a peripheral EU area both geographically and economically, Ireland has traditionally been a country of net emigration. This situation changed briefly in the late 1990s to early 2000s, sparking broad debate on Ireland’s perceived ‘new’ ethnic, cultural and linguistic diversity arising from the arrival of migrant people both from within and beyond the EU as workers and as asylum seekers, and drawing attention to issues of race, identity, equality and integration in Irish society. Based in a West of Ireland town where migrant children and children of migrants comprise very small minorities in classroom settings, this research engages with a particular demographic of children who have started primary school since these changes have occurred. It seeks to represent the complexities of the processes which constitute children’s subjectivities, and which also produce and reproduce race and childhood itself in this context. The role of local, national and global spaces, relational networks and discursive currents as they are experienced and negotiated by children are explored, and the significance of embodied, sensory and affective processes are integrated into the analysis. Notions of the functions and rhetorics of play and playfulness (Sutton-Smith 1997) form a central thread that runs throughout the thesis, where play is both a feature of children’s cultural worlds and a site of resistance or ‘thinking otherwise’. The study seeks to examine how children actively participate in (re)producing definitions of both childhood and race arising in local, national and global spaces, demonstrating that while contestations of the boundaries of childhood discourses are contingently successful, race tends to be strongly reiterated, clinging to bodies and places and compromising belonging. In addition, it explores how children access belongings through agentic and imaginative practices with regard to peer and family relationships, particularly highlighting constructions of home, while also illustrating practices of excluding children positioned as unintelligible, including the role of silences in such situations. Finally, drawing on teachers’ understandings and on children’s playful micro-level negotiations of race, the study argues that assumptions of childhood innocence contribute to justifying depoliticised discourses of race in the early primary school years, and also tend to silence children’s own dialogues with this issue. Central throughout the thesis is an emphasis on the productive potentials of children’s marginal positioning in processes of transgressing definitional boundaries, including the generation of post-race conceptualisations that revealed the borders of race as performative and fluid. It suggests that interrupting exclusionary raced identities in Irish primary schools requires engagement with children’s world-making practices and the multiple resources that inform their lives.

Leadership in the community sector: promoting collaboration and social change in Belfast

Community development is centrally concerned with people in communities working together to achieve a common goal, that is, to collaborate, whether within local geographical communities, in communities of shared interests or among groups sharing a common identity. Its overarching goal is one of progressive transformational social change. As Belfast transitions from a conflict to a post-conflict society, there is a need for greater, more effective work at local community level in order to address a range of ongoing social and economic issues facing communities, including high levels of disadvantage and division. Given the significance of leadership in building effective collaboration and the centrality of collaboration for community development, it is important to understand how leadership is currently enacted and what kinds of leadership are required to support communities to collaborate effectively to bring about social change. This thesis thus centers on the kind of leadership practised and required to support collaboration for social change within the community sector in Belfast, a city that contains an estimated 28% of the total number of community and voluntary sector (CVS) organisations in Northern Ireland (Northern Ireland Council for Voluntary Action, 2012). Through a series of qualitative, in-depth interviews with people playing leadership roles in local communities, the study critically explores and analyses their experiences and perceptions in relation to leadership and collaboration. Community development in Belfast today is practised within a wider context of neoliberal policies, characterised by austerity and public spending cuts. Whilst not the only influencing factor, this context has had a particular and profound impact on the nature and role of community development practised, and on the kind of leadership enacted within it. The space for reflection and transformative action appears to be shrinking as the contraction of resources to support community development in local communities continues unabated. Those playing leadership roles increasingly find themselves compelled to spend time seeking resources and managing complex funding arrangements rather than focusing on the social change dimensions of their work. Collaboration as promoted by the state seems to have become an instrumental tactic used to implement its austerity measures and curtail the potential of the community sector. Despite this, local leaders are driving initiatives that attempt to push back, helping the sector refocus on its transformational goals of social change. To do this requires support. Those playing leadership roles require resources, including time, to encourage and enable communities to reconnect with the purpose and underpinning values of community development. Leaders also need support to develop and promote new, progressive narratives and visions and pursue these through building collaboration and solidarity.

Issues in the prescribing of psychotropic and psychoactive medication for persons with learning disability: quantitative and qualitative perspectives

The administration of psychotropic and psychoactive medication for persons with learning disability and accompanying mental illness and/or challenging behaviour has undergone much critical review over the past two decades. Assessment and diagnosis of mental illness in this population continues to be psychopharmacological treatment include polypharmacy, irrational prescription procedures and frequent over-prescription. It is clear that all forms of treatment including non-pharmacological interventions need to be driven by accurate and appropriate diagnoses. Where a psychiatric diagnosis has been identified, it greatly aides the selection of appropriate medication, although a specific medication for each diagnosis, as was once hoped, is simply no longer a reality in practice. Part one of the present thesis seeks to address many of the current issues in mental health problems and pharmacological treatment to date. The author undertook a drug prevalence study within both residential and community facilities for persons with learning disability within the Mid-West region of Ireland in order to ascertain the current level of prescribing of psychotropic and psychoactive medications for this population. While many attempts have been made to account for the variation in prescribing, little systematic and empirical research has been undertaken to investigate the factors thought to influence such prescribing. While studies investigating the prescribing behaviours of General Practitioners (GP's) have illustrated the complex nature of the decision making process in the context of general practice, no similar efforts have yet been directed at examining the prescribing behaviours of Consultant Psychiatrists. Using The Critical Incident Technique, the author interviewed Consultant Psychiatrists in the Republic of Ireland to gather information relating not only to their patterns of prescribing for learning disabled populations, but also to examine reasons influencing their prescribing in addition to several related factors. Part two of this thesis presents the findings from this study and a number of issues are raised, not only in relation to attempting to account for the findings from part one of the thesis, but also with respect to implications for improved management and clinical practice.

Understanding student stress: a qualitative study of the stress experienced by third level students

Stress can be understood in terms of the meaning of stressful experiences for individuals. The meaning of stressful experiences involves threats to self-adequacy, where self-adequacy is considered a basic human need. Appropriate research methods are required to explore this aspect of stress. The present study is a qualitative exploration of the stress experienced by a group of 27 students at the National Institute of Higher Education, Limerick (since renamed the University of Limerick). The study was carried out by the resident student counsellor at the college. A model of student stress was explored, based on student developmental needs. The data consist of a series of interviews recorded with each of the 27 students over a 3 month period. These interviews were transcribed and the resulting transcripts are the subject of detailed analysis. The analysis of the data is an account of the sense-making process by the student counsellor of the students' reported experiences. The aim of the analysis was to reduce the large amounts of data to their most salient aspects in an ordered fashion, so as to examine the application of a developmental model of stress with this group of students. There were two key elements to the analysis. First, the raw data were edited to identify the key statements contained in the interviews. Second, the statements were categorised, as a means of summarising the data. The results of the qualitative dataanalysis were then applied to the developmental model. The analysis of data revealed a number of patterns of stress amongst the sample of students. Patterns of academic over-identification, parental conflict and social inadequacy were particularly noteworthy. These patterns consisted of an integration of academic, family and social stresses within a developmental framework. Gender differences with regard to the need for separateness and belonging are highlighted. Appropriate student stress intervention strategies are discussed. Based on the present results, the relationship between stress and development has been highlighted and is recommended as a firm basis for future studies of stress in general and student stress in particular.

Victimisation of street children in Addis Ababa: factors of resilience and susceptibility

Cross-cultural variations in conceptions of childhood are discussed, particularly with regard to child abuse and child labour. Regardless of cultural background, a universal minimum standard of child rearing is required. The street child literature is reviewed, culminating in an analysis of Ethiopian street children. Theoretically this work is informed by victimology. Concepts shared by victimology and rational choice perspective are discussed, after Fattah (1993a). Victim surveys are described, highlighting their accuracy of crime estimates. Juvenile prostitution, runaways and rape are examined, particularly with regard to their relevance in Addis Ababa. Fifty five male and 135 female street children were interviewed. Interviews with boys focused on delinquency. An age-related pattern emerged, with younger boys less likely to drink, chew khat, steal or be sexually active. Interviews with street girls focused on the differences between girls living on the streets (girls of the street), girls working on the streets (girls on the street) and a sample of homebased girls. Girls of the street come to the street come to the streets for many reasons. Conflicts with a parent or guardian account for almost 50%. They are highly vulnerable to sexual assaults, particularly those 43% who have worked as prostitutes. Girls on the street experience considerably less victimisation. Urban poor girls live in socio-economic circumstances akin to girls on the street but enjoy almost universal protection from victimisation because they do not spend time on the streets. Unprotected by the stability which a family provides, girls of the street experience high victimisation levels. Such victimisation is often the result of reliance on types of work, such as prostitution, which brings the girls into contact with exploitative adults. Resistance to such victimisation is provided by a secure place to sleep, companions, and relatively safe types of work. Such protective factors are more readily available to family based children as compared to those living independently.

The lived experience of Irish diocesan priests. A qualitative study of clerical identity, obedience and celibacy.

The main aim of this thesis is to document and explore the lived experience of Irish diocesan priests and former priests, in order to explore the reality of diocesan priesthood in contemporary Ireland, and to investigate how, if at all, diocesan priesthood has changed in Ireland during the past fifty years. It sought to do this by interrogating the stories of thirty-three diocesan priests and former priests, and by placing their individual stories within the broader context of Irish society and the Catholic Church, during the fifty-year period, 1962–2012. The research focused on three core areas of priesthood – identity, obedience, and celibacy – and it addressed the following questions. First, how do Irish diocesan priests understand their priesthood and how has this understanding changed over time, if at all? I will argue that three paradigms of priesthood co-exist in the contemporary Irish Church, and that each of these models corresponds with a distinct period in contemporary Irish Church history. I will also demonstrate the existence of underlying similarities in the cultural practice of priesthood that transcend the different generations of priests. Second, how do Irish diocesan priests negotiate their priesthood within a large and complex institution? My study suggests that Irish diocesan priests are typically loyal and obedient. However, they are not necessarily subservient. Third, how do Irish diocesan priests understand and experience celibacy in their day-to-day lives? My study demonstrates that celibacy is typically understood and experienced along a continuum, ranging from total acceptance to total rejection, with most priests somewhere in between. Fourth, I will argue that while priests are experiencing many difficulties in their lives, there is insufficient evidence from the present study to indicate they are experiencing a crisis.

A post-structuralist analysis of Irish youth crime prevention policy with specific emphasis on the Garda youth diversion projects

Garda Youth Diversion Projects (GYDPs) have since their beginnings in the early 1990s gained an increasingly important role and now constitute a central feature of Irish youth justice provision. Managed by the Irish Youth Justice Service and implemented by the Gardai and a variety of youth work organisations as well as independent community organisations, GYDPs are located at the crossroads of welfarist and corporatist approaches to youth justice, combining diversionary and preventative aspects in their work. To date, these projects have been subjected to very little systematic analysis and they have thus largely escaped critical scrutiny. To address this gap, this thesis locates the analysis of GYDP policy and practice within a post-structuralist theoretical framework and deploys discourse analysis primarily based on the work of Michel Foucault. It makes visible the official youth crime prevention and GYDP policy discourses and identifies how official discourses relating to youth crime prevention, young people and their offending behaviour, are drawn upon, negotiated, rejected or re-contextualised by project workers and JLOs. It also lays bare how project workers and JLOs draw upon a variety of other discourses, resulting in multi-layered, complex and sometimes contradictory constructions of young people, their offending behaviour and corresponding interventions. At a time when the projects are undergoing significant changes in terms of their repositioning to operate as the support infrastructure underpinning the statutory Garda Youth Diversion Programme, the thesis traces the discursive shifts and the implications for practice that are occurring as the projects move away from a youth work orientation towards a youth justice orientation. A key contribution of this thesis is the insight it provides into how young people and their families are being constituted in individualising and sometimes pathologising ways in GYDP discourses and practices. It reveals the part played by the GYDP intervention in favouring individual and narrow familial causes of offending behaviour while broader societal contexts are sidelined. By explicating the very assumptions upon which contemporary youth crime prevention policy, as well as GYDP policy and practice are based, this thesis offers a counterpoint to the prevailing evidence-based agenda of much research in the field of Irish youth justice theory and youth studies more generally. Rather, it encourages the reader to take a step back and examine some of the most fundamental and unquestioned assumptions about the construction of young people, their offending behaviour and ways of addressing this, in contemporary Irish youth crime prevention policy and practice.

‘Doing’ separation in contemporary Ireland: the experiences of women who separate in midlife

This study explores the experiences of fourteen Irish women who separated in midlife. The rationale for choosing to study this age group of women is because they are the first generation of Irish women to publically separate in midlife in such large numbers. All of them entered marriage at a time when divorce was not possible in Ireland and as such they are broadly without a cultural ‘script’ for how to ‘do’ separation. An exploratory study was conducted to try to capture the processes and events that are part of the lived experiences of separation for women in midlife. In-depth interviews were conducted with fourteen women who were recruited following their attendance at post-separation courses. The participants came from predominantly middle class backgrounds. Narrative interviews were conducted which covered topics such as the attitudes to separation internalised during childhood, the genesis of the marital problems, the events that triggered the separations, the women’s emotional reactions at the time of separating and their social, housing and financial outcomes of having separated. A theoretical framework using concepts related to connectedness and fragmentation was used to analyse the data. Significant diversity was found in the experiences of the interviewees. Most of the women retained connectedness to their children, to their families of origin and to friends who were not joint friends. Significant fragmentation was found in relationships with ex-husbands, with in-laws and with joint friends. All of the women were worse off financially than if they had remained married. They felt socially isolated in the aftermath of separation. Many of the women were struggling to establish positive identities as separated women. While a few of them were very relieved that their marriages had ended, for most, separation was experienced as a painful episode in their lives.

A study of the Zhiqing identity

More than seventeen million Chinese urban youth (Zhiqing in Chinese) went to the countryside, lived and engaged in agricultural work there during the Up to the Mountains and Down to the Countryside (UMDC) Movement (1967-1981). Although this movement was officially terminated in 1981, it has left an imprint on these people – the Zhiqing identity by which they are still characterized as a unique group in Chinese society and a special generation in Chinese history. Historical and sociological perspectives are combined in this study. By applying Glen H. Elder’s life course approach, the study reveals how Zhiqing’s life trajectories are embedded in the social history and identifies a series of interrelated factors that made Zhiqing into a unique generation. With the guidance of Henri Tajfel’s social identity theory, the study uncovers the emergence of the Zhiqing group and the Zhiqing identity, explains individuals’ acquisitions of the Zhiqing identity and analyzes how it has kept influencing individuals’ lives during and after the UMDC Movement. Using Zhiqing’s life stories allowed the researcher to combine the historical and sociological aspects in her examination of Zhiqing’s identity issues. In each life story, the narrator reviewed his/her life experience, reflected on socio-historical changes and expressed his/her emotions and ideas about identity issues. Utilizing methods of in-depth interview and thematic analysis, the researcher completed the study and presents this thesis as one interpretation on the Zhiqing identity, which, as according the researcher’s hermeneutic stance, is open to further discussion and future research.

Place, teenagers and urban identities: Growing up in the revanchist city

The recreational lives of teenagers in Ireland has been the subject of much debate in recent years. The subject has received much attention from academics, particularly in the UK and the US. In Ireland there is a dearth of research on, and a poor understanding of teenagers recreational lives. Additionally much of the research from the UK and the US to date has been focused on teenagers’ use of the street for recreation, arguing that teenagers are increasingly pushed out of public space. The research frequently emphasises teenagers’ resistance against adult hegemony. This thesis explores the recreational geographies of teenagers living in two socially and economically distinct neighbourhoods in Cork. It seeks to fill in gaps in knowledge of teenagers recreational lives in Ireland and contribute to geographical wisdom on teenagers’ geographies. Using a mixed method approach and a variety of thinking tools this research shows that teenagers living in Cork are growing up in a revanchist society. The thesis demonstrates how teenagers’ recreational practices are currently being configured in Irish society, unfolding strategies of dominance and affection which construct and regulate the recreational lives of teenagers. The effects of revanchism on teenagers’ experiences of outdoor space for recreation are also pursued. Furthermore the socio-spatial contingencies of teenagers’ recreational lives and revanchism are probed throughout the thesis, but in greater depth in the final chapters. The work also addresses an under-researched aspect of young people’s recreational - relationships with pets. Lastly, the subject of teenagers’ right to urban space is critically analysed.

The multiple reality: A critical study on Alfred Schutz’s sociology of the finite provinces of meaning

This work is a critical introduction to Alfred Schutz’s sociology of the multiple reality and an enterprise that seeks to reassess and reconstruct the Schutzian project. In the first part of the study, I inquire into Schutz’s biographical context that surrounds the germination of this conception and I analyse the main texts of Schutz where he has dealt directly with ‘finite provinces of meaning.’ On the basis of this analysis, I suggest and discuss, in Part II, several solutions to the shortcomings of the theoretical system that Schutz drew upon the sociological problem of multiple reality. Specifically, I discuss problems related to the structure, the dynamics, and the interrelationing of finite provinces of meaning as well as the way they relate to the questions of narrativity, experience, space, time, and identity.

The legitimation of risk and democracy: A case study of Bt cotton in Andhra Pradesh, India

This thesis explores the inter-related attempts to secure the legitimation of risk and democracy with regard to Bt cotton, a genetically modified crop, in the state of Andhra Pradesh in India. The research included nine months of ethnographic fieldwork, extensive library and newspaper research, as well as university attendance in India, undertaken between June, 2010 and March, 2011. This comparative study (involving organic, NPM and Bt cotton cultivation) was conducted in three villages in Telangana, a region which was granted secession from Andhra Pradesh in July, 2013, and in Hyderabad, the state capital. Andhra Pradesh is renowned for its agrarian crisis and farmer suicides, as well as for the conflict which Bt cotton represents. This study adopts the categories of legitimation developed by Van Leeuwen (2007; 2008) in order to explore the theory of risk society (Beck, 1992; 1994; 1999; 2009), and the Habermasian (1996: 356-366) core-periphery model as means of theoretically analysing democratic legitimacy. The legitimation of risk and democracy in relation to Bt cotton refers to normative views on the way in which power should be exercised with regard to risk differentiation, construction and definition. The analysis finds that the more legitimate the exercise of power, the lower the exposure to risk as a concern for the collective. This also has consequences for the way in which resources are distributed, knowledge constructed, and democratic praxis institutionalised as a concern for social and epistemic justice. The thesis argues that the struggle to legitimate risk and democracy has implications not only for the constitution of the new state of Telangana and the region’s development, but also for the emergence of global society and the future development of humanity as a whole.

A cultural study on communication and technology with specific reference to media in China

This dissertation examines the role of communications technology in social change. It examines secondary data on contemporary China arguing that many interpretations of events in China are unsuitable at best and at worst conceptually damages our understanding of social change in China. This is especially the case in media studies under the ‘democratic framework’. It proposes that there is an alternative framework in studying the media and social change. This alternative conceptual framework is termed a zone of interpretative development offering a means by which to discuss events that take place in a mediated environment. Taking a theoretical foundation using the philosophy of Mikhail Bakhtin this dissertation develops a platform with which to understand communication technology from an anthropological perspective. Three media events from contemporary China are examined. The first examines the Democracy Wall event and the implications of using a public sphere framework. The second case examines the phenomenon of the Grass Mud Horse, a symbol that has gained popular purchase as a humorous expression of political dissatisfaction and develops the problems seen in the first case but with some solutions. Using a modification of Lev Vygotskiĭ’s zone of proximal development this symbol is understood as an expression of the collective recognition of a shared experience. In the second example from the popular TV talent show contests in China further expressions of collective experience are introduced. With the evidence from these media events in contemporary China this dissertation proposes that we can understand certain modes of communication as occurring in a zone of interpretative development. This proposed anthropological feature of social change via communication and technology can fruitfully describe meaning-formation in society via the expression and recognition of shared experiences.

Community workers' understandings and practices of resistance

This research is focused on Community Workers located in Southern Ireland, and their understandings and practices of resistance. It is an attempt to explore the ways in which community workers’ understandings and practices of resistance are formed and, in turn, inform their sense of identity and their responses to the wider context of community development work in Ireland today. This study is specifically located but also has wider application and relevance because of the extended international reach of neo-liberal and managerial rationalities, and their implications for politics, policy and practice. The study considers resistance in a number of inter-related ways: as a collective oppositional position (with negative and positive dimensions); a personal and/or professional value (associated with the ‘expansion of contention’); a strategy for negotiating unequal power relations (in a range of levels and spaces of power); an identity (in relation to the sustaining of ‘reflexive subjectivities’); a set of practices, (which take into account the interplay between economic, political and cultural influences); and an educational process through which practitioners assess and enact personal and professional agency. Critical theorisations of community development and of the Irish state over time, trace the ways in which neo-liberalism and managerialism has inflected community development practice and the positions of community workers and communities in that process. The study draws on James C. Scott, Gramsci, Barnes and Prior, among others, which enabled the interrogation of resistance in relation to everyday practices through engaging with ‘hidden transcripts’ and spaces. The method chosen was focus group discussions with three groups of community workers located in different counties in Southern Ireland. This method facilitated a deep discourse analysis of practitioners’ encounters with resistance in the field of community work. Key findings relate to the various interpretations of the role of resistance, practices of resistance (including current restrictions), the value of resistance work and the conditions that may be conducive to practising resistance.