title: Civil society and the Health and Social Care Act in England and Wales: theory and praxis for the twenty-first century.
abstract: In this paper we revisit the notion of civil society in the light of recent attempts to privatize health care in England via the passing of the Health and Social Care Act of 2013. This legislation promises a re-commodification of the National Health Service (NHS) in England. The Bill was bitterly contested during its passage through parliament, most vigorously in 2011. Much of the opposition occurred at a time of widespread, global rebellion, most notably in the 'Arab uprisings' and through the 'occupy movement'. Despite a plethora of protests, we argue, a non-porous boundary between what we call the 'protest sector' of civil society and the wider public sphere of the lifeworld has become apparent in England. A good deal of collective action, whether campaign-focused (like opposition to the Health and Social Care Bill) or more generalized (like rejections of corporate greed), has so far proved ineffective, at least in the short-term; no crisis of legitimation is apparent. We highlight a new 'class/command dynamic', leading to oligarchic rule, in the present era of financial capitalism. We use this health care case-study to re-examine the notion of civil society and its changing properties in what Castells calls a 'networked society'. The contribution ends with a discussion of the role of the sociologist re-civil society and the advocacy of both 'action' and 'foresight sociologies'.
authors.affiliation: Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London, WC1E 6JB, UK. Electronic address: graham.scambler@ucl.ac.uk.
authors.forename: Graham
authors.initials: G
authors.lastname: Scambler
authors.affiliation: Unit of Social and Behavioural Sciences, King's College London, Caldecot Road, London, SE5 9RW, UK. Electronic address: sasha.scambler@kcl.ac.uk.
authors.forename: Sasha
authors.initials: S
authors.lastname: Scambler
authors.affiliation: School of Health and Human Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK. Electronic address: esspeed@essex.ac.uk.
authors.forename: Ewen
authors.initials: E
authors.lastname: Speed
mesh_terms: D003695:Delivery of Health Care / Q000191:economics / Q000331:legislation & jurisprudence; D004739:England; D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D008962:Models, Theoretical; D011050:Policy Making; D017149:Private Sector; D011332:Privatization; D013222:State Medicine / Q000331:legislation & jurisprudence*; D014852:Wales
keywords: Action and foresight sociologies; Class/command dynamic; Health and Social Care Act; NHS; Privatization of health care; Rethinking civil society