The political economy of co-ordination challenges in the National Health Service: a postpositivist evaluation of diabetes policy and governance

The present PhD thesis develops and applies an evaluative methodology suited to the evaluation of policy and governance in complex policy areas. While extensive literatures exist on the topic of policy evaluation, governance evaluation has received less attention. At the level of governance, policymakers confront choices between different policy tools and governance arrangements in their attempts to solve policy problems, including variants of hierarchy, networks and markets. There is a need for theoretically-informed empirical research to inform decision-making at this level. To that end, the PhD develops an approach to evaluation by combining postpositivist policy analysis with heterodox political economy. Postpositivist policy analysis recognises that policy problems are often contested, that choices between policy options can involve significant trade-offs and that knowledge of policy options is itself dispersed and fragmented. Similarly, heterodox economics combines a concept of incommensurable values with an appreciation of the strengths and weaknesses of different institutional arrangements to realise them. A central concept of the field is coordination, which orientates policy analysis to the interactions of stakeholders in policy processes. The challenge of governance is to select the appropriate policy tools and arrangements which facilitate coordination. Via a postpositivist exploration of stakeholder ‘frames’, it is possible to ascertain whether coordination is occurring and to identify problems if it is not. Evaluative claims of governance can be made where arrangements can be shown to frustrate the realisation of shared values and objectives. The research makes a contribution to knowledge in a number of ways a) a distinctive evaluative approach that could be applied to other areas of health and public policy b) greater appreciation of the strengths and weaknesses of different forms of evidence in public policy and in particular health policy and c) concrete policy proposals for the governance and organisation of diabetes services, with implications for the NHS more broadly.

Theorising and analysing digital labour: from global value chains to modes of production

This paper considers the following question—where do computers, laptops and mobile phones come from and who produced them? Specific cases of digital labour are examined—the extraction of minerals in African mines under slave-like conditions; ICT manufacturing and assemblage in China (Foxconn); software engineering in India; call centre service work; software engineering at Google within Silicon Valley; and the digital labour of internet prosumers/users. Empirical data and empirical studies concerning these cases are systematically analysed and theoretically interpreted. The theoretical interpretations are grounded in Marxist political economy. The term ‘global value chain’ is criticised in favour of a complex and multidimensional understanding of Marx’s ‘mode of production’ for the purposes of conceptualizing digital labour. This kind of labour is transnational and involves various modes of production, relations of production and organisational forms (in the context of the productive forces). There is a complex global division of digital labour that connects and articulates various forms of productive forces, exploitation, modes of production, and variations within the dominant capitalist mode of production.

Against divisiveness: Digital workers of the world unite! A rejoinder to César Bolaño and Eloy Vieira

This piece is a short rejoinder to César Bolaño’s paper The Political Economy of the Internet and related articles (e.g., Comor, Foley, Huws, Reveley, Rigi and Prey, Robinson) that center around the relevance of Marx’s labor theory of value for understanding social media. I argue that Dallas Smythe’s assessment of advertising was made to distinguish his approach from the one by Baran and Sweezy. Smythe developed the idea of capital’s exploitation of the audience at a time when both feminist and anti-imperialist Marxists challenged the orthodox idea that only white factory workers are exploited. The crucial question is how to conceptualize productive labor. This is a theoretical, normative, and political question. A mathematical example shows the importance of the “crowdsourcing” of value-production on Facebook. I also point out parallels of the contemporary debate to the Soviet question of who is a productive or unproductive worker in the Material Product System.