The Social Spaces of Accountability in Hybridized Healthcare Organizations

UK healthcare organizations are undergoing progressive changes to become more flexible and cost-effective (Kernaghan, 2000). Recently, the government’s latest incarnation of New Public Management, ‘open public services’ (Cabinet Office, 2012), has articulated a shift from traditional organizational forms to a more indeterminate organizational landscape of shifting social and spatial relations (James and Manning, 1996; McNulty and Ferlie, 2004; Dunleavy et al., 2005). As a result, formulation and execution of public health policy occurs increasingly in complex networks featuring multiple, overlapping coordination between government, third sector organizations and the citizen/service user, so that ‘accountability… gets lost in the cracks of horizontal and hybrid governance’ (Ferlie et al., 2007: 240; also see Frolich, 2011). It is to an interrogation of accountability within such increasingly hybridized healthcare organizations that we address ourselves in this chapter.