Analysing 'Facing the future'.
Article Type: Letter to the editor
Authors: Wigley, Wendy
Greenway, Julie
Roberts, Angela
Pub Date: 02/01/2009
Publication: Name: Community Practitioner Publisher: Ten Alps Publishing Audience: Academic Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2009 Ten Alps Publishing ISSN: 1462-2815
Issue: Date: Feb, 2009 Source Volume: 82 Source Issue: 2
Accession Number: 192802949
Full Text: I write in response to the professional paper by Greenway et al published in November's issue. I am struggling to identify any constructive intentions for its publication at a time when morale within the profession is in desperate need of being raised.

While I consider the use of Foucauldian concepts to analyse the discourse within the Facing the future document interesting, I am reminded of Mills: 'Be sceptical about the value of Foucault; do not accept any of his sometimes bold but often unjustified generalisations' (p125). (1)

I attended one of consultation meetings in the South West and I would argue that statements Greenway et al describe as 'discursive constructions' (p29) were actually commentary made by many of the participants. In addition, my experience of working as a health visitor within public health education is that some of my profession are indeed resistant to change, and as a result become defensive and possessive of their role and status within healthcare provision.

However, we are not fools and most of us recognise that Facing the future is intended to engineer a change in the way service provision to children and families is delivered. Children and families are integral to public health and will continue to be negatively affected by environmental and social determinants--I do not perceive any discourse within the document suggesting that health visitors should no longer be influential in such issues.

Whether we like it or not, change does and will always occur within health and social care provision, and sometimes we need to 'lose the battle to win the war'. We can learn to manage these changes and emerge a powerful profession because of them.

Wendy Wigley

Lecturer in public health, University of Southampton

We thank Wendy Wigley for taking the time to respond to our recent paper and are pleased she found the Foucauldian approach interesting. The paper sought to demonstrate how insights generated by Foucault can be used within a method for examining policy documents to shed light on the strategies that are being used to influence change. The method has several analytic stages and the first of these involves identifying all the different ways in which the discursive object (in this case the role of the health visitor) is constructed in the text. 'Facing the future' was informed in part by consultation meetings with health visitors, and quotations from statements made during these meetings would appropriately be identified as featuring among the discursive constructions of the health visiting role. However, the analysis also considers which of the various constructions are given more or less emphasis and which are presented as more or less desirable. The analysis presented in our paper was intended to show how the discourse of the document serves to promote particular directions of change in practice. We agree that change is necessary and that the health visiting profession itself should be engaged in managing the changes that affect it. We hope that our paper will facilitate that by making explicit the way ideas are being used by government policy-makers. Insightful understanding should help ensure health visitors are able to do more than 'manage' the changes that are imposed on them, but encourage active engagement with current and proposed changes, enabling them to be pro-active 'shapers' of these changes.

Julie Greenway

PhD student, University of Bristol

I read with great interest the paper by Greenway et al in the November issue, which will assist all health visitors to understand why what they do remains disregarded. It helps us as an organisation to understand the government's change machine and its intentions for health visitors in the future.

It is disappointing that the authors of Facing the future have felt unable to state their intentions for changing the health visiting role without denigrating current practice. The article clearly highlights the negative discourses that are used to illustrate the 'vision for the future'.

What I find fascinating is how the intentions proposed in Facing the future are almost diametrically opposed to the views of service users as identified by the Family and Parenting Institute and Social Justice Early Years Commission. (2)

Perhaps it is time for Unite/CPHVA to look toward commissioning well researched and evidence-based documents using Foucauldian principles, to assist the profession of health visiting to re-establish itself as worthwhile and indeed powerful.

Angela Roberts

Unite/CPHVA chair

(1) Mills S. Michael Foucault. Abingdon: Routledge, 2006.

(2) Social Justice Policy Group. Breakdown Britain: interim report on the state of the nation. London: Centre for Social Justice, 2006.
Gale Copyright: Copyright 2009 Gale, Cengage Learning. All rights reserved.