Living with neophilia: Case notes from the new NHS

Abstract

This paper considers the extent, experience and consequences of living with neophilia in the English National Health Service (NHS). Drawing on notes from an ethnographic case study of a new partnership between doctors and nurses in primary care, this paper considers how a fetish for novelty may both drive and destroy developments in organising. The context for the study is a national system driven by the demands of neophilia for over a quarter of a century. It is a system in which new answers to persistent problems of access, cost and equity are sought through innovation, novelty and change. Yet the results of each new change are disappointing as old problems re-emerge and national-level neophilia appears defunct. Searching for an alternative to the dysfunctional aspects of nationalised neophilia, this paper focuses on the possibility of engaging more localised experiences of innovation in organising. Employing Douglas' grid-group model of cultural theory, this paper explores the attempts of a group of doctors and nurses to develop the New Partnership. The partnership is shown to be new in so far as it stands as an example of that which Douglas defines as an egalitarian enclave, challenging dominant traditions of organising. However, it soon becomes clear that a fetish for innovation on the part of local neophiliacs is no less problematic than for their national counterparts. In a contribution to our understanding of neophilia, this paper considers how an accounting for different organising cultures can help to explain and possibly pre-empt the processes and problems of living with newness.