What B Would Otherwise Do: A Critique of Conceptualizations of                 ‘Power’ in Organizational Theory

Ailon, Galit

doi:10.1177/1350508406068504

Cited by 31 publications

(27 citation statements)

References 90 publications

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“…Both of these strands of thinking (we could call them "pessimistic" and "optimistic", respectively), as well as Lukes's concept, presuppose a counterfactual identification of the "real" wants and interests of those subject to domination, which they could pursue or realize in the absence of power (Ailon, 2006;Knights & Willmott, 1989: 539-41). From a Foucauldian perspective, this appears a contradiction in terms, as power is ubiquitous and fundamentally pervades all social practice (Knights et al, 1993).…”

Section: Trust Power and Subjectivitymentioning

confidence: 99%

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Trusting organizations: The institutionalization of trust in interorganizational relationships

Kroeger

2011

Organization

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Recent research on interorganizational trust has stressed the need to develop a deeper understanding of the multi-level nature of this construct. This article focuses on trust on different analytical levels in an interorganizational context, and on the hitherto underspecified connections between these. Based on an institutionalization approach, it revisits the classic question: (how) can organizations trust each other? To do so, we consider organizations as objects of trust and reappraise the transferral from interpersonal to interorganizational trust in "facework" (Giddens, 1990). We also examine the conflicts and struggles of trust and power that can arise from this process between boundary spanners and their organizational constituents. Next, we consider organizations as subjects of trust in interorganizational relationships. We detail the institutionalization of trust and its reproduction on an organizational level, and how it can be transmitted to new generations of organizational actors, creating path-dependent histories of trust which are truly interorganizational. Taking up the theme of trust and power, we analyze ways in which the institutionalization of trust can entail that of power, too, and examine the implications of this from a critical point of view.We conclude that in interorganizational trust, both the subject and object of trust move across analytical levels, and further, that this movement demonstrates the significance of the organization as a distinct entity that can be both trusted and trusting.

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Section: Trust Power and Subjectivitymentioning

confidence: 99%

“…Who determines how it is built and what it is used for? It is thus obvious that conscious attempts at manipulating institutional patterns can be to the detriment of the organization (and/or groups within it) if they aim at intraorganizational political advantage rather than organizational effectiveness (Farrell & Petersen, 1982;Ailon, 2006).…”

mentioning

confidence: 99%

Trusting organizations: The institutionalization of trust in interorganizational relationships

Kroeger

2011

Organization

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“…Power relations, often implying conflict and dissensus, are well conceptualized in organizational literature (see, for example, Ailon, 2006;Reuver, 2006), sometimes with respect to organizational politics (cf. Fleming and Spicer, 2008).…”

Section: Introductionmentioning

confidence: 99%

Ethical Considerations in Organizational Politics: Expanding the Perspective

Gotsis

Kortezi

2009

J Bus Ethics

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“…The concept of power implies a counterfactual account of what providers would otherwise do 206 if commissioners were less powerful (and vice versa), which we obtained empirically from informants' accounts of commissioners' attempts to change provider practice, of providers' response(s) and of what happened when providers proposed changes that the commissioners contested.…”

Section: Data Collectionmentioning

confidence: 99%

NHS commissioning practice and health system governance: a mixed-methods realistic evaluation

Sheaff

Charles

Mahon

et al. 2015

Health Services and Delivery Research

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BackgroundBy 2010 English health policy-makers had concluded that the main NHS commissioners [primary care trusts (PCTs)] did not sufficiently control provider costs and performance. After the 2010 general election, they decided to replace PCTs with general practitioner (GP)-controlled Clinical Commissioning Groups (CCGs). Health-care commissioners have six main media of power for exercising control over providers, which can be used in different combinations (‘modes of commissioning’).ObjectivesTo: elicit the programme theory of NHS commissioning policy and empirically test its assumptions; explain what shaped NHS commissioning structures; examine how far current commissioning practice allowed commissioners to exercise governance over providers; examine how commissioning practices differ in different types of commissioning organisation and for specific care groups; and explain what factors influenced commissioning practice and the relationships between commissioners and providers.DesignMixed-methods realistic evaluation, comprising: Leximancer and cognitive frame analyses of policy statements to elicit the programme theory of NHS commissioning policy; exploratory cross-sectional analysis of publicly available managerial data about PCTs; systematic comparison of case studies of commissioning in four English sites – including commissioning for older people at risk of unplanned hospital admission; mental health; public health; and planned orthopaedic surgery – and of English NHS commissioning practice with that of a German sick-fund and an Italian region (Lombardy); action learning sets, to validate the findings and draw out practical implications; and two framework analyses synthesising the findings and testing the programme theory empirically.ResultsIn the four English case study sites, CCGs were formed by recycling former commissioning structures, relying on and maintaining the existing GP commissioning leaderships. The stability of distributed commissioning depended on the convergence of commissioners’ interests. Joint NHS and local government commissioning was more co-ordinated at strategic than operational level. NHS providers’ responsiveness to commissioners reflected how far their interests converged, but also providers’ own internal ability to implement agreements. Commissioning for mental health services and to prevent recurrent unplanned hospital readmissions relied more on local ‘micro-commissioning’ (collaborative care pathway design) than on competition. Service commissioning was irrelevant to intersectoral health promotion, but not clinical prevention work. On balance, the possibility of competition did not affect service outcomes in the ways that English NHS commissioning policies assumed. ‘Commodified’ planned orthopaedic surgery most lent itself to provider competition. In all three countries, tariff payments increased provider activity and commissioners’ costs. To contain costs, commissioners bundled tariff payments into blocks, agreed prospective case loads with providers and paid below-tariff rates for additional cases. Managerial performance, negotiated order and discursive control were the predominant media of power used by English, German and Italian commissioners.ConclusionsCommissioning practice worked in certain respects differently from what NHS commissioning policy assumed. It was often laborious and uncertain. In the four English case study sites financial and ‘real-side’ contract negotiations were partly decoupled, clinician involvement being least on the financial side. Tariff systems weakened commissioners’ capacity to choose providers and control costs. Commissioners adapted the systems to solve this problem. Our findings suggest a need for further research into whether or not differently owned providers (corporate, third sector, public, professional partnership, etc.) respond differently to health-care commissioners and, if so, what specific implications for commissioning practice follow. They also suggest that further work is needed to assess how commissioning practices impact on health system integration when care pathways have to be constructed across multiple providers that must tender competitively for work, perhaps against each other.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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What B Would Otherwise Do: A Critique of Conceptualizations of ‘Power’ in Organizational Theory

Cited by 31 publications

References 90 publications

Trusting organizations: The institutionalization of trust in interorganizational relationships

Trusting organizations: The institutionalization of trust in interorganizational relationships

Ethical Considerations in Organizational Politics: Expanding the Perspective

NHS commissioning practice and health system governance: a mixed-methods realistic evaluation

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