Neoliberalism and the contract state: exploring innovation and resistance among New Zealand Health Promoters

Abstract

Concern for the creep of surveillance and control into the everyday lives of citizens has revived contemporary debates over the politics of health promotion. We examined how political changes have impacted on the work of health promoters through qualitative research with individuals working in the health promotion sector. Interviews and focus groups were undertaken between January 2008 and March 2009. Caught in a neoliberally influenced drive to increase the efficiency of the health sector, health promotion in New Zealand has been subject to considerable changes in the funding and provision of services. Characterised by a growth in limited-term contracts with constrained budgets, health promoters have responded to fiscal limitations by pooling resources. We find that rather than being uncritical agents of the government’s health promotion agenda, health promoters often became advocates of the community’s agenda, occupying a ‘grey space’ where the demands of contracts create tension with their commitments to communities. Any portrayal of health promotion must acknowledge the contested nature of the spaces of governance health promoters occupy and resist reducing them to uncritical agents of the state.

Keywords:

• health promotion
• neoliberalism
• new public health
• New Zealand
• workforce
• healthism

Acknowledgements

The authors would like to acknowledge the Canadian Commonwealth Postdoctoral Research Fellowship Program and New Zealand’s Building Research Capacity for the Social Sciences postdoctoral funding for the support which made this research possible.

Notes

1. All names and locations have been anonymised