title: Foucault on targets.
abstract: This paper seeks to gain an insight into the behavior of a large NHS trust, in its attempt to meet a 90 percent patient access target, in a week long national audit in March 2003. Why did individuals act in dramatically different ways to their norm over this period. The work of Michel Foucault is used to explore these issues. The discourses of power, knowledge, discipline and governmentality are identified as key foucaudian themes that offer an alternative interpretation of how individuals behave in their place of work. The importance of the historical context of discourse within the NHS cannot be underestimated in shaping the behavior of individuals and groups today. Power and knowledge permeate NHS organizations through disciplinary practices and dressage. Governmentality seeks to maintain the status quo through disciplinary processes such as national healthcare targets. The natural response of NHS organizations is therefore, to seek order and conformity rather than disorder and conflict.
authors.affiliation: Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Leeds, UK.
authors.forename: John
authors.initials: J
authors.lastname: Lynch
mesh_terms: D003299:Cooperative Behavior; D034462:Dissent and Disputes; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000592:standards*; D006779:Hospitals, Public / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007400:Interprofessional Relations; D019359:Knowledge; D008330:Management Audit; D011209:Power, Psychological; D012919:Social Behavior; D013222:State Medicine / Q000458:organization & administration; D006113:United Kingdom; D014600:Utilization Review