Knowledge and knowing in policy work: a case study of civil servants in England’s Department of Health
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Date
Authors
Abstract
Contemporary
English
health
policy
is
saturated
with
claims
about
what
the
world
is
like
and
how
it
might
be
otherwise.
These
claims
span
the
wide
range
of
subject
matters
covered
by
health
policy,
from
hospital
waiting
times
to
our
preparedness
for
major
disease
outbreaks;
from
structures
for
the
planning
and
purchasing
of
healthcare
to
requirements
around
the
sharing
of
patient
records.
Despite
this,
empirical
studies
of
health
policymakers
working
at
the
national
level
in
the
UK
suggest
that
research
evidence
plays
only
a
very
limited
role
in
policy
development
(Lavis
et
al.
2005;
Dash
2003;
Dash
et
al.
2003;
Innvær
et
al.
2002;
Petticrew
et
al.
2008).
This
apparent
contradiction
was
the
starting-‐point
for
this
project.
If
civil
servants
are
not
drawing
on
research
knowledge
in
their
work,
how
is
it
that
they
are
able
to
devise
policy
about
such
complex
and
technical
policy
issues?
Policy-‐making
requires
knowing
the
world
in
some
way
in
order
to
act
upon
it.
My
research
asks,
what
kinds
of
knowledge
are
civil
servants
in
England’s
Department
of
Health
using
in
their
work,
and
what
forms
does
this
use
take?
This
thesis
is
situated
in
an
emerging
field
of
interpretive
policy
analysis
which
treats
policymaking
as
realised
in
the
daily
work
practices
of
communities
of
individuals
(Wagenaar
&
Cook
2003;
Wagenaar
2004;
Colebatch
2006;
Colebatch
et
al.
2010;
Freeman
et
al.
2011).
I
have
adopted
an
ethnographic
approach,
conducting
60
hours
of
original
data
collection
in
the
form
of
interviews
and
meeting
observations
among
mostly
mid-‐ranking
civil
servants
working
on
various
high-‐profile
health
policies
in
2010-‐11.
By
analysing
my
fieldwork
experiences
and
the
resulting
data,
and
by
relating
these
to
insights
from
theoretical
resources
in
sociology,
psychology
and
philosophy,
I
offer
an
account
of
the
different
forms
of
knowing
and
knowledge
entailed
in
the
practice
of
policy-‐making.
I
identify
three
forms
of
knowledge
and
knowing
that
were
integral
to
the
work
of
the
civil
servants
I
studied:
the
‘practices
of
knowing’
by
which
they
came
to
understand
the
objects
of
their
policies
and
think
through
the
possibilities
for
their
reform;
the
‘pragmatic
use
of
knowledge
claims’
in
which
facts,
figures
and
stories
were
invoked
to
generate
support
for
policies
and
to
defend
decisions
taken;
and
the
‘know-‐how
of
policymaking’,
which
was
the
most
important
form
of
knowledge
for
the
civil
servants’
professional
identities.
In
the
conclusion,
I
reflect
on
the
aspects
of
knowledge
and
knowing
which
are
shared
by
the
civil
servants’
practices
and
my
own
work
in
producing
this
thesis.
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