Governmentality and the spatialized discourse of policy: the consolidation of the post-1989 NHS reforms

There have been few studies of spatialized discourse within contemporary healthcare policy-making. This paper addresses this omission, focusing on the governmental presentation of the little-studied measures that consolidated the post-1989 reforms of the NHS in England and Wales, and culminated in the Health Authorities Act 1995. A short section places these measures in context and outlines their main components. An analysis of key documents and parliamentary exchanges is then used to show how spatialized language was central to the presentation of policy and its debate in parliament. In particular, the paper demonstrates how nuanced conceptions of space- and territorially-led service management provide a flexible basis for presenting notions of power and control. This ‘spatio-linguistic strategy’ is located theoretically within the concept of governmentality.