What is the Meaning of Public Sector Health? Translating Discourse into New Organizational Practices

Abstract

This study explores the dynamics involved in establishing discourses necessary for constructing organizational change within the public sector. Drawing upon critical discourse analysis, the study identifies two competing discourses – a ‘patient’ and a ‘healthy citizen’ discourse, which exist as strategic resources in health care. The case study focuses on a municipality in Denmark and the way the organizational actors translated meaning into the development of a new healthcare centre. The analysis contributes to our understandings of translation by focusing on discursive legitimizing strategies in the context of public sector change. First, the study shows that discourses not only provide different senses of meaning and warrant particular social actors a louder voice than others, but that these actors also develop discursive legitimizing strategies and translate particular meanings into the organization and organizational practices. Second, when the strategies make a discourse resonate with the local context, in this case a highly political context, then specific organizational practices become more legitimate than others, and the discourse is more inclined to become manifest. Finally, the findings indicate that the manifestation of a discourse can also be explained by how successful this discourse can be carried out in practice.

Keywords:

• Critical discourse analysis
• discursive legitimizing strategy
• translation
• public sector change
• health care

Acknowledgements

The author would like to acknowledge the valuable comments and guidance provided by the special issue editorial team and the three anonymous reviewers at the Journal of Change Management. In addition, she thanks Peter Kjær, Eva Boxenbaum, and Renate Meyer, who have greatly helped her in the development of this article. Finally, she is very appreciative of the Fredensborg Municipality for providing insights into the healthcare centre development.