Trust and moral motivation: redundant resources in health and social care?

Abstract

English The government's modernisation programme for health and social care has introduced institutional arrangements that are characteristic of ‘late modernity’. These support heightened surveillance of organisational performance and professional practice, increased bureaucratisation of operational arrangements, instrumental decision making about service provision and a drive to centralise consumer empowerment. Such developments are designed to (re)establish political and public confidence in professional interventions and services that are predictable, reliable and safe. A focus on confidence, however, necessarily neglects the significance of trust for service users and providers. This article argues that privileging confidence over trust fails to acknowledge the role of uncertainty, morality and discretion in the provision of care and has important consequences for service users, managers and frontline practitioners.

Patients' views of pay for performance in primary care: a qualitative study

“…13,22,32,33 This study suggests that the majority of patients do not believe that pay for performance has had a negative effect on their experience of care. The use of computers and GP-initiated health checks were seen by some patients as reassuring and valued additions to the consultation.…”

The Role of Social Work Professional Supervision in Conditions of Uncertainty

“…Increased focus on performance measurement goes hand in hand with increased surveillance and evaluation of professional practice through bureaucratisation and instrumentalism thus undermining empowerment and collaborative models of practice. According to Harrison and Smith (2004), this emphasis on prioritising confidence (in services) over trust (between workers and users) affects worker's 'moral motivation'.…”

Achieving Care and Social Justice for People With Dementia

“…[9][10][11] Others have been concerned with issues of ethics and values in social work practice [12][13][14] and other health and social care practices. [15][16][17][18] In this journal considerable attention has been given to the everyday ethics of caregiving, especially to marginalized groups such as older people and those residing in nursing homes. 19,20 'Care' is a contested concept from the perspective of service user movements.…”