Power and Resistance: A Foucauldian Analysis of Workplace Bullying and Harassment in the National Health Service

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Abstract

There has been a lot of recent media coverage of, and research that has drawn attention to, the increase in reporting of workplace bullying (WPB) and harassment in the National Health Service (NHS). These reports have indicated that this culture of bullying has impacted on the quality of care for service users (Francis, 2013). The first aim of this research was to understand the lived experiences of WPB or harassment in the NHS and to examine the dynamics of power that construct the bullying relationship at different levels; the institutional level (macro level), the workplace (meso level) and at the individual level (micro level). The second aim was to understand how employees are both affected by, and resist power. The potential for resistance in an organisation could be used to expand knowledge in the counselling psychology profession (CPP) at the level of both research and intervention. This is an area that the CPP is well able to support. Therapists and Healthcare Professionals (HCP), who had left the NHS, were recruited from WPB websites and word of mouth and invited to attend a narrative interview. All were from different parts of the UK, representing varied NHS healthcare settings. Therapists and HCP were chosen because they are situated at the interface of the competing institutional systems that often reproduce bullying cultures, whilst at the same time could be facing the challenges of offering therapy to some service users who could be experiencing the same thing. Narratives were transcribed and analysed using narrative inquiry (NI) and a Foucauldian Discourse Analysis (FDA) as these allowed a deepening of an analysis of power at different levels. WPB and harassment manifested as discrimination, such as one narrator who was not offered a senior post for being black and challenging, whilst at other times this was impersonal, such as the general pressure of not conforming to workplace standards, such as working overtime, manifesting in group ganging. Whilst racism manifested as a visible, personal and humiliating attack, WPB experienced by the white narrators tended to be job related where the main threat was being made invisible in the service. All the narratives indicated how WPB and harassment reproduced normative structures in NHS workplace cultures that often discriminated against difference. They also revealed that not only were the narrators subject to WPB and harassment at an individual level, but this was also manifested through the organisation and institutionally, as racism and sexual discrimination. In summary, these findings indicated strongly that ‘the personal’, is indeed, ‘political’. Implications and recommendation for the counselling psychology profession were made and expanded upon.

Keyword(s)

Foucault; Harassment; NHS; Power; Resistance; Workplace Bullying

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