British Journal of Management, Vol. 20, S194–S203 (2009) DOI: 10.1111/j.1467-8551.2008.00638.x
Health Promotion and Flexibility: Extending and Obscuring Power in Organizations Christian Maravelias School of Business, Stockholm University, 106 91 Stockholm, Sweden Email:
[email protected] This paper explores the intersection between pursuits of improving organizational flexibility and pursuits of improving employees’ health. It is argued that health promotion programmes have the potential of operating as mechanisms of power, which assist organizations in making up self-governing employees who flexibly adapt their lifestyles to the criteria of health and professional success. The paper shows how the fact that health promotion programmes are handled by ‘independent’ and legitimate health experts, and are provided to employees in the name of their health and well-being, obscures the forces of power in them, making them seem merely as informed ways of helping employees help themselves towards healthier and more successful lives. The paper concludes that health promotion programmes help to establish a new work ethic that challenges the boundary between work and private life. Furthermore, they make a healthy lifestyle part of the competencies that employees are responsible for developing and nurturing.
Introduction This paper explores the intersection between two themes which have received considerable attention in managerial theory and practice: flexible organizations and pursuits of promoting employees’ health. Critical organization studies have demonstrated how contemporary organizations’ pursuits of developing flexibility lead them, on the one hand, to distinguish between core and non-core employees, and on the other hand, to devise human resource management techniques which mobilize not only the competencies but the selves of core employees. It is argued that health promotion programmes have the potential of further expanding these principles beyond the The author is grateful for the helpful comments and critique of the two anonymous reviewers and of the two special issue editors. A special thanks also to my friend and colleague Lars Albert for his careful and critical reading of earlier versions of the paper.
sphere of work: they subtly distinguish those employees who have career potential from those who do not, and they contribute to making up self-governing subjects who flexibly adapt their lifestyles to the criteria of health, well-being, and professional success. The paper first outlines the principles of organization and control in flexible organizations. Against this background it then analyses and discusses some central publications on health promotion and data concerning the Swedish occupational health service sector.
Flexibility and organizational control The end of the hierarchic and integrated organization and the rise of flexible modes of organization has been prophesized since at least the early signs of post-industrialism were reported by Bell (1973) in the 1970s. Initial contributions in managerial theory saw the pursuit of flexible
r 2009 British Academy of Management. Published by Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA, 02148, USA.
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Health Promotion and Flexibility organization as a one-dimensional and commendable process: work was to be handled within informally constituted teams, which were formed to deal with temporary projects, and which were coordinated by way of shared values and trustbased relations (e.g. Halal, 1994; Heckscher and Donnellon, 1994). Such characterizations were seen to imply fundamental changes in the nature of managerial work and in the principles and techniques of controlling employees. Employees were not seen to be controlled but empowered to work in teams in relation to which managers orchestrated (facilitated relationship building and trust, inspired, promoted learning etc.) rather than managed (Mintzberg, 1998). However, critical studies have shown this process to be multidimensional and fraught with negative social consequences. On the one hand, the pursuit of flexible organization has been demonstrated to involve an increasing polarization between core employees and peripheral employees (Harvey, 1989; Smith, 1997). Smith (1997) uses the notion of ‘numerical flexibility’ to describe how the pursuit of flexibility led organizations to ‘down size’, employing only a limited number of core employees on a continuous basis and sourcing in non-core employees on a temporary basis for standardized non-core activities. The flexible and autonomous work of the core employees thus relies on a fund of regulated, manual work of peripheral employees who lack stable employment and the benefits associated with it (Bauman, 2004; Beck, 2000). On the other hand, the pursuit of flexibility has also been found to involve an intensification of the forms of controlling core employees (Vallas, 1999). ‘Empowering’ and ‘orchestrating’ management principles have been shown to involve human resource management (HRM) techniques, which do not seek to regulate the behaviour but the selves of employees (e.g. Casey, 1999). In this connection Michel Foucault’s works on power and subjectivity (e.g. 1977, 1980, 1997) have been widely drawn on to analyse how HRM techniques are used to make up ‘appropriate individuals’ who can be trusted with considerable autonomy because they already subscribe to the values of the organization (Alvesson and Willmott, 2002; Covaleski et al., 1998; Townley, 1994). More specifically, HRM techniques such as assessment centres, performance appraisals, attitude surveys, mentoring etc. discipline emr 2009 British Academy of Management.
ployees not by force, but by accumulating knowledge about employees, which can then be used to advise and persuade them to work on themselves to become better adapted to the values and norms of the organization. Hence, in that HRM techniques are based on ‘knowledge/ truth’ claims about employees, they are alleged to make the exercise of power in organizations at once more intimate and intense, and more invisible and unobtrusive; HRM appears less as an exercise of power and more as a form of care for employees (Barratt, 2002, 2003). It is in this way that HRM has been seen as instrumental in contemporary organizations’ pursuits of providing their employees with autonomy for the sake of flexibility while maintaining overarching control: it contributes to making up the employee as ‘a ‘‘corporate clone’’, a distinct entity that nevertheless maps the goals of the organisation’ (Covaleski et al., 1998, p. 294). Below I relate the critical discourse on flexible organizational control to the discourse on work site health promotion, i.e. various initiatives which are taken to improve employees’ health and organizational efficiency (Conrad and Walsch, 1992). Based on a study of central publications on health promotion and of the Swedish sector for occupational health services, I develop the argument that health promotion programmes operate as extensions of contemporary organizations’ pursuits of using HRM to make up flexible and self-governing employees. More specifically, I argue that health promotion programmes, on the one hand, harbour an ‘elitist inclination’ in that they are geared towards high end companies’ core employees, and on the other hand, operate as expert-led means of accumulating knowledge about employees, which is used to govern the identity and lifestyle of employees for the sake of health and organizational efficiency. Hence, I seek to show how such programmes operate as flexible forms of control, which provide organizations with legitimate means of transcending the boundary between work and private life.
Methodological considerations Following Foucault (1980) the study is based on the assumption that modern forms of control are intertwined with forms of producing knowledge,
S196 and that such power/knowledge not only operates on individuals, restraining and directing them, but also seeps into the identities of individuals, constituting them as particular types of subjects. Hence, the basic interest of this study is how health promotion programmes constitute employees as objects of knowledge and what types of subjectivity this knowledge enables and seeks to normalize. The study consists of two parts, one that outlines the general principles of health promotion in organizations, and the other that analyses health promotion practices in the Swedish sector for occupational health services. In both parts health promotion has been analysed as a discourse, i.e. as a collection of statements that together constitute a narrative about health promotion. A basic assumption in discourse analysis is that such narratives are based on rules and produce ‘truths’ that participants need to follow in order to be understood and trusted (Fairclough, 1992). That is, a discourse is a vehicle of knowledge/power that sets boundaries around how we can think, what we can say, what we can do, and who we can be in different social settings (Tonkiss, 1998). Hence, rather than seeking to assess if statements about health promotion programmes are true or not, the study seeks to analyse what forms of knowledge the health promotion discourse produces and what this knowledge does. In particular I focus on the ethical imperatives of the health promotion discourse and seek to reveal how these are connected with individuals’ self-making activities, i.e. the ways in which individuals shape their conduct so as to transform themselves into a person who is healthier, more efficient etc. The material used for the first part of the study is taken from publications that revolve around health promotion in working life. The choice of publications was based on the extent to which a publication made use of basic concepts and discussed basic issues in the health promotion discourse and how often the publication figured as a reference in other publications. The material used for the second part of the study comes from ongoing research of the Swedish sector for occupational health services. Twenty-three indepth interviews were conducted with three separate groups of interviewees: (1) professional and administrative staff from seven different organizations within this sector; (2) human
C. Maravelias resource managers working for firms which are customers to the occupational health service companies; (3) employees who had taken part in some kind of health promotion programme or service. Fifteen of these interviews were held with people from the first group, four with people from the second, and four with people from the third group. The interviews with the first two groups of interviewees were conducted between 2004 and 2006 and those with the third group during 2007.
Health promotion In the pioneering paper Ottawa Charter for Health Promotion, health promotion is defined as ‘the process of enabling people to increase control over, and to improve, their health’ (WHO, 1986, p. 1). The definition indicates that health promotion is rooted in a critique of traditional medicine’s restricted focus and treatment of individuals as passive objects. Long-term health allegedly presupposes that individuals actively take part in managing their health and that a holistic focus on the family relations, working life and – in particular – lifestyles is used when examining individuals’ health (Downie, Tannahill and Tannahill, 1996). A vital distinction in such holistic assessments is that between work and private life. The health promotion discourse underlines the importance of balance between these two spheres of life, yet does not assume that healthy lifestyles are necessarily at odds with efficiently organized labour processes. On the contrary, healthy individuals are typically seen to be able to work harder and longer, especially if their work is stimulating – and stimulating work is by itself positive for individuals’ health (Gillies, 1998; Ziglio, Hagard and Griffiths, 1999). Four principles appear to be central to such synergies. First, employees’ situation at work should be approached holistically (Davies and Macdonald, 1998). Management should consider how its decisions affect employees’ lives and whether or not employees’ lifestyles make them up to the challenges that management lets them face. Second, management should further the development of an honest and ‘family like’ atmosphere where interaction and cooperation between colleagues is genuine as opposed to formal r 2009 British Academy of Management.
Health Promotion and Flexibility (Hansson, 2004). Third, individuals should be empowered with enough autonomy to handle their tasks flexibly and with self-control (Docherty, Forslin and Shani, 2002; Kira, 2000). Finally, management must respect and secure employees’ need of maintaining a balance between professional life and private life (Hansson, 2004). Here, however, the discourse on health promotion is placed in front of a dilemma. For all the foregoing characteristics of the supposedly ‘healthy and efficient organization’ (Huzzard, 2003) tend to lead to the distinction between work and private life being increasingly blurred. Work should be infused with personal values and genuine motivation and commitment; colleagues should be friends; and cooperation should be informal rather than formal. Together this makes work a very direct and integrated part of life in general. The health promotion discourse solves this dilemma by pointing towards the role of selfdiscipline and expertise. It is then the role of health promotion experts to examine employees’ work and lifestyles, but not in order to tell them what to do, but to counsel them in the art of selfdiscipline (Korp, 2004). Hence, the health promotion discourse relies on experts who treat individuals at once as full subjects capable of handling the freedom they are given, and as incomplete subjects that need to be socialized and informed with ‘proper’ knowledge to be able to handle this freedom (Lupton, 1995). Below I will further develop this role of selfdiscipline and expertise via empirical data from a study concerning the industry for occupational health services in Sweden.
The turn towards health promotion in the Swedish occupational health service sector Traditionally occupational health service (henceforth OHS) providers in Sweden were primarily loyal to trade unions’ pursuits of defending employees against the risk of over-exploitation. The utilization of OHS was regulated by agreements between unions and employer organizations and 50% of the costs were subsidized by the Swedish state. When state funding was terminated in 1993 this organized system fell apart. It was replaced by a market-based system, which drove OHS companies to establish relations with r 2009 British Academy of Management.
S197 and win the loyalty of employer representatives – their customers – by serving their pursuits of developing their human resources to greater flexibility and efficiency. This transformation towards a market-based system has played a part in transforming the content and objectives of the services offered. Previously, OHS involved medical treatment and rehabilitation of work-related injuries or illnesses. Today, attention is increasingly directed towards health promotion. The head of customer relations in an OHS company explained: Ideally, we do not wish to work with people who are ill or injured. We want to work with companies who are prepared to invest in furthering the health of their most important asset: their employees.
As the quote indicates, the OHS industry actively seeks to turn away from sick and injured employees, i.e. employees with actual and acute problems, so that they instead can turn to those who have the potential of becoming healthier and more efficient. Basically it is the new competitive pressures that have driven OHS companies in this direction. For whereas companies that employ people with low qualifications usually do not have the incentive or the resources to invest in OHS – other than on the minimally required level1 – higher end companies that employ qualified people and grant them stacks of resources and autonomy have considerable incentives to make such investments. Furthermore, such employees were explained to have fewer problems with work-related injuries and illness. A health pedagogue explained: Qualified employees tend to have problems with stress, burnout, and other socio-psychological problems, which concern just as much their lifestyles as their ways of handling work.
Hence, the turn towards health promotion is closely connected with a shift in the type of customers and clients that OHS companies seek: customers and clients who do not suffer from physical ill health, but where a high tempo, an abundance of choices and opportunities, and potentially conflicting interests – private/family life – place them in front of constant health risks. 1 Swedish law obliges employers to provide employees with OHS if it is immediately required, i.e. if the employee has been injured or has become ill because of conditions in which he or she works.
S198 Furthermore, it implies a change from a restricted focus on directly work-related health issues to a holistic focus on employees’ lifestyles. A psychologist explained: Even though we still officially say that we investigate, counsel, and treat work-related health issues, in reality it is the combination of peoples’ personalities, lifestyles, and their styles of working that our services concern.
A service which illustrates this turn towards the promotion is the so-called ‘individual action plan’ (IAP). The IAP is based on an examination not only of the work situation but of the complete lifestyle of the employee. The employee is given an extensive questionnaire with a range of questions about his/her habits with regard to eating, drinking, smoking, physical training etc., as well as with regard to personal ambitions, stress factors, social relations, daily routines etc. The information from the inquiry is used as a foundation for work/lifestyle coaching and therapy, the result of which should be an IAP, i.e. a guide as to how the employee can improve his or her health and well-being and professional efficiency. The IAPs can be seen as expressions of how OHS companies seek to exploit a growing concern among human resource managers that employees who may have the proper formal competencies lack the necessary and required social and lifestyle skills (e.g. the capacity to flexibly adjust to changes in the work situation, to cope with stressful situations, staying fit and healthy etc.). As expressed by a human resource manager in a large Swedish insurance company: Of course, companies have always been searching for excellence when they hire and promote people. But today, the meaning of the word ‘excellence’ has much wider connotations. It is no longer just a statement about the particular set of occupational skills that a person may hold. Now, excellence is also used to characterize a person who leads a particular type of life; who is physically active, who eats proper food, who avoids unnecessary risks, who is moderate on drugs and alcohol etc.
The IAP is supposed at once to help companies monitor the potential of their human resources and to help employees help themselves become healthier, happier and in that process better able to match the expectations of their employers. In this respect it is a direct example of a power/
C. Maravelias knowledge technique, which does not give employees orders, but careful advice as to how he or she should or could live and work in order to become healthier, happier and more efficient (Peterson and Lupton, 1996). As said by an accountant working for a big six public accounting firm: The company I work for has invested a lot of money in various programmes that are meant to help us take better care of ourselves. . . . I go to a therapist who helps me cope with what he calls the ‘life puzzle’. Basically I have been asked questions about my work, ambitions, family, hobbies etc. It has been interesting, because by telling my therapist how I live and work I have come to understand myself much better. It has also made me more efficient at work, for I see clearer how I can combine the different parts of my life and where and when I should draw the line between work and family life.
A vice president of a medium sized company expressed a similar view: My company has given me the opportunity to see a family therapist. . . . It has helped me understand how the different parts of my life are related. . . . Yet, it is no secret that it is supposed to be a win– win situation: I learn how to maintain a more harmonious private life and my employer expects the energy that comes from this to positively affect how I do my job.
Several OHS professionals emphasized that the effective implementation of the IAP was fundamentally based on the active and voluntary participation of the individuals concerned. However, this does not make the counselling and training of OHS professionals a simple matter of free choice. First, by investing in OHS managers point out that a healthy lifestyle – and the committed and motivated work performances that it is assumed to lead to – is a central and endorsed value that individuals are expected to live up to. As said by a key accounts manager in a bank: We are offered great opportunities to take better care of ourselves, mentally, socially and physically. Yet, this is not just something we are enabled to do; it is also something we are expected to do. Of course, no one forces us or tells us to do it, but you still feel that it is expected.
Hence, in the long run a healthy lifestyle may become a norm that automatically determines r 2009 British Academy of Management.
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Health Promotion and Flexibility unhealthy lifestyles as inappropriate or even unaccepted. The opinion of a human resources manager in a large Swedish corporation points in this direction: It is just as reasonable to expect employees to take care of their health as it is to expect them to care for their competence.
However, there is a second and more fundamental reason to question this notion that employees could simply choose freely whether or not they wish to follow the advice of OHS experts. It concerns the general process of diagnosing health risks. As explained by a psychologist: For instance, when we analyse stress-related problems, we frame them as problems which are caused by factors outside the individual. That is, even though stress is in part caused by the choices the individual makes, we treat it as a more or less objective and external phenomenon that the individual, as it were, is struck by. We do this in part because the individual is more likely to accept the problem if he or she does not feel responsible for having caused it. Once the individual has accepted the problem and the fact that change is required, we turn things around. We then make it the individual’s responsibility to live and work in such a way that he or she avoids the risks. Hence, it is our job to equip individuals with the necessary knowledge and skills, but once we have done so it is their responsibility to handle the risks they confront.
It is thus via the voice of expertise that risks which in part are not caused by the individual become the individual’s own responsibility. Once the individual has been taught to understand what causes the risks and how they should be handled, the individual cannot blame anyone but him or herself if he or she is still struck by them. An accountant in a public accounting firm who had suffered from ‘burnout’ explained: When I began working here I was young and ambitious and the company literally gave me loads of work. . . . Once I started showing signs of being overworked I was given plenty of opportunities to see various experts. Still, I more or less ‘ran into a wall’ after three years of hard work. Now I have not been able to work full time for about two years. At first my bosses and colleagues were quite nice and understanding. After some time, however, I began to feel that they saw me not only as a burden, but also as some kind of loser. Because I had been r 2009 British Academy of Management.
warned and given counselling and still I kept putting too much pressure on myself.
Hence, failure becomes a matter of lack of selfdiscipline and, to the extent that this lack affects the organization’s chances of performing its tasks and pursuing its objectives, it also deserves blame.
Discussion In this paper I have sought to show how health promotion programmes are designed to operate as central components in the system of power that permeates contemporary flexibility seeking organizations. I pointed towards how the pursuit of flexibility has given rise to an increasing polarization between core and non-core employees (e.g. Harvey, 1989). We saw how the doctrines as well as the practice of providing health promotion programmes emerged as well attuned with this development. Health promotion is not directed towards those who are ill or injured, but towards those who are not suffering from ill health at present and who are seen to have the potential to improve themselves (Conrad, 1987). The Swedish OHS industry illustrates this ‘elitist inclination’; it has not only turned away from its traditional focus on treating workrelated illness and injuries, but in addition turned away from low paid groups of employees who are typically struck by injuries and illness. Providing health promotion programmes to core employees of high end companies is well aligned with this strategic reorientation. Basically it is the fact that such high end organizations provide core employees with considerable autonomy that gives them reason to pay closer attention not only to employees’ formal competencies, but also to their health, well-being, work–life balance etc. It is this role that health promotion programmes play; they seek to help core employees become healthier and happier and in that process more useful to their employers. However, the novel feature of the system of power that emerges as health promotion programmes are combined with flexible modes of control is not that it seeks to combine employees’ physical and mental health with organizational success. Rather, it is the way in which health promotion programmes become instrumental in
S200 pursuits of substituting direct control of employees’ behaviour with liberal or indirect control of individuals’ social identities (cf. Becker, 1986). It is in this respect that we can see these programmes as expansions of the type of control that critical scholars have found in contemporary HRM techniques (e.g. Barratt, 2002; Covaleski et al., 1998; Townley, 1994). Health promotion programmes are set up to adjust employees’ subjectivity so that the choices they make at work as well as in their private lives are to become aligned with the values and principles that lead the organization towards its goals. It is also in this respect that we can see health promotion programmes as significant parts of what Foucault (1980) and his followers refer to as ‘power/ knowledge regimes’. For to prevent such forms of control that focus on individuals’ selves becoming offensive and intrusive they must be exercised indirectly by way of the distance and legitimacy provided by knowledge and expertise (Rose, 1999). The health promotion expertise establishes that necessary distance between the individual subject and organizational power. It seeks to help employees choose ‘freely’ to eat proper food, exercise, balance work and private life etc. for their own but also for their employers’ benefit. The type of power exercised via health promotion programmes is hereby not repressive and restrictive, but supportive; it promotes individuals in making themselves up as particular types of subjects who are at once geared towards good health and professional development. Hence, it is the fact that health promotion programmes are provided to employees in the name of their health and well-being, and are handled by ‘independent’ and legitimate health professionals, that tends to obscure the forces of power in them, making them seem merely as informed ways of helping employees lead healthier and more successful lives. More specifically, I would suggest that the subtly efficient form of control that health promotion programmes make possible comes from the way in which they combine the two principally – but not practically – distinct power/knowledge regimes that Foucault termed ‘disciplinary power’ and ‘pastoral power’ (Covaleski et al., 1998; Foucault, 1997). Disciplinary power is then exercised via knowledge generated through examinations of individuals, whereas pastoral power is exercised via knowledge that comes from individual confes-
C. Maravelias sions. Both disciplinary power and pastoral power are thus based on knowledge and expertise. Yet, whereas the expert in disciplinary power is a ‘neutral’ observer, the expert in pastoral power is a moral guide (Townley, 1995). The IAPs that OHS companies in Sweden offer their customers’ employees are here good examples. By first examining the employee’s lifestyle, family situation, work habits etc., the employee is constituted as an object of knowledge that can be categorized, compared and advised more discretely, intimately and possibly with less conflict and friction. Yet, as Foucault has shown (1977), this disciplinary gaze not only operates on the exterior of individuals; for individuals’ desire to understand themselves better coupled with their awareness of being under observation tend to lead them to gradually internalize the disciplinary gaze, thereby making them their own judges. In ways principally similar to what Townley (1994) has found in her studies of HRM techniques such as assessment centres and performance appraisal systems, the examining part of the IAP can hereby be said to discipline the employee from the outside in; i.e. ‘objective and legitimate knowledge’ is attributed to the employee who becomes ‘subjectified’ by gradually internalizing this knowledge, letting it define his or her identity. However, the examining part was merely the foundation or point of departure for the more significant confessional/therapeutic part. In contrast to the examination part, the confessional/ therapeutic part of the IAP incites a form of discipline that operates on the employee from the inside out; i.e. it encourages the employee to declare, ‘reflect on and analyze his or her own thoughts and conduct, under the watchful gaze of an authoritative figure, and to correct or to reform him or herself’ (Barratt, 2002, p. 192). The confessional/therapeutic part of the IAP makes the employee avow his or her ‘inner truth’ to the therapist, making it available for interpretation and careful advice as to how the employee should work on him or herself in order to become better, more efficient etc. It is in this form that health promotion programmes have the potential of operating most delicately as mechanisms of power in organizations. For here the knowledge about employees’ lifestyles, professional ambitions, problems, social relations etc. does not come from an r 2009 British Academy of Management.
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Health Promotion and Flexibility observer, but from employees themselves. The therapist is seen merely to translate or interpret that inner truth of employees into what employees found to be a ‘better understanding for who they are’ and, possibly, for what they might become. Translated into a modified version of Townley’s (1994) terminology we may say that the confessional aspect of the IAP constitutes a pastoral form of power which leads to employees’ self-subjectification. That is, the employee does not only subject him or herself to the objectified image of the self that various examination techniques have generated, the employee is also made up as particular self by the ‘objectification of the self by the self’ (Foucault, 1980, p. 240). There is an interesting parallel here to Deetz’s (1998) study of a professional service organization, where he makes use of Burawoy’s (1979) famous notion of ‘strategized subordination’ to discuss forms of control where employees become ‘accomplices in their own exploitation’. Deetz (1998) shows how employees actively embrace managerial control by striving to achieve the identity as a flexible consultant that management has articulated for them, even though the price they have to pay is often ill health, divorce etc. The similarity between what Deetz (1998) refers to as ‘strategized subordination’ and what I refer to as ‘self-subjectification’ is fairly obvious: both terms refer to employees’ active subordination to a particular type of identity and style of work/ life. The differences, however, are more significant: for whereas ‘strategized subordination’ is driven by the abstract and status overloaded image of consultancy that management has played a part in articulating, ‘self-subjectification’ is driven by the intimate truth about the self that the individual him or herself has declared. Furthermore, whereas the ‘strategized subordination’ that results from the desire to earn a particular professional identity implies the suppression of conflicts between this identity and other identities associated with private life, the ‘self-subjectification’ that results from health promotion programmes implies that private life is treated as part of the compound totality that requires disciplined attention and self-managed control. In this respect, health promotion and the self-subjectification processes that it gives rise to can be seen as functionally linked to the work/life problems that strategized subordination among high end occupational groups tends to generate. r 2009 British Academy of Management.
For in these processes of self-subjectification the health expert not only functions as a translator of the inner truth of the employee; he or she is also a moral guide, i.e. an authoritative figure who makes use of this inner truth for the sake of helping the employee adjust his or her self and lifestyle to the criteria of health and professional success (Conrad and Walsh, 1992). Hence, the therapeutic counselling of the health experts implies an ethic that is well aligned with high end groups of employees’ pursuits of flexibility and self-management. It is neither meant to drive a wedge between private and professional life, nor meant to subordinate the employee to authoritative and regulated rules. Rather, it is meant to lead the employee towards self-governance and cooperative movement. As said by a therapist in one of the OHS companies: ‘The goal of health promotion is to help clients become capable, confident, and active in moving themselves around in response to the changing conditions of both their working lives and private lives’. Notable here is also how this ethic tends to make the employee more responsible and the employer less responsible for the development of his or her health and professional capabilities. On the surface this suggestion may seem paradoxical. For as the holistic approach that underlies health promotion programmes enlarges the scope and multiplies the factors that are taken into consideration when analysing health risks, it seems plausible to assume that employees’ health and working ability would appear as effects of circumstances beyond the employees’ control. Yet, the contrary is in fact the case, because the target of health promotion programmes is the individual, not the environment surrounding the individual. More specifically, the combination of a holistic approach and therapeutic counselling draws attention towards the lifestyle that the individual is seen to have chosen. By doing so it draws the attention away from possibly health hazardous working conditions that employers rather than employees are responsible for (Conrad and Walsh, 1992).
Conclusions Michel Foucault (1980) stated that power is neither good nor bad, but always dangerous. This
S202 study has pointed towards at least two overarching dangers with the combined flexibility/ health regime. First, it contributes to establishing a new form of work ethic that challenges the boundary that has traditionally been drawn between work and private life. By crossing this boundary it does not dissolve or make the distinction between work and private life less important. On the contrary, it tends to make it more important not the least since stress, burnout and other health issues are typically seen to be related to a failure to maintain a proper balance and distinction between work and private life. Yet, it contributes to making management not merely a question of work, but of life in general. It is the life of the individual that should be managed, it is the work/life distinction that should be organized, and it is the individual him or herself that should handle this organization of ‘the life puzzle’ for the sake of remaining not only healthy and happy, but also employable and useful. Hence, this new work ethic opens a new allocation of responsibilities; for as the causes of health problems are sought and found in the lifestyles of employees, the responsibility for managing these risks tends to be transferred from employers to employees (cf. Allegante and Sloan, 1986). Whereas the employers’ responsibility becomes limited to that of providing employees with opportunities – e.g. in the form of health promotion programmes – that enable employees to manage their health and employability, the employees’ responsibility is extended so that healthy lifestyles become parts of the work/life capabilities that the employee is expected to have and to nurture. Hence, there is here a danger that health promotion programmes contribute to giving rise to a distinction between those that are and those that are not able to discipline themselves and their lifestyles in this sense. It is furthermore self-discipline that brings me to the second danger of the combined flexibility/ health regime. We saw how a main task of health experts was to provide employees with proper knowledge and skills to exercise self-discipline so that they sensibly could steer free from various health risks such as stress, burnout etc. Before individuals had been helped by the health experts these health risks were seen as external, threatening to strike them. However, after they had been helped by the health experts they were expected to be able to give these risks disciplined consideration. Hence, in the process of providing
C. Maravelias employees with the knowledge they required, external risks were transformed into internal risks. As shown by Lupton (1995), the ability or inability of managing internal risks easily turns into a question of moral character. For those who cannot deal with them will not only be seen as failures, they will also be seen as sinners whose lack of self-discipline means less help and more work for others. ‘Those who are deemed ‘‘at risk’’ become the sinners, not the sinned against, because of their apparent voluntary courting of risk’ (Lupton, 1995, p. 90). Such people are typically described as irrational and irresponsible, because their failure to avoid or to control health risks becomes a form of evidence of a lack of potential of mastering the self.
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Christian Maravelias teaches at the School of Business, Stockholm University. His research interests include transformations of the principles of governing work such as post-bureaucracy, cultural control, project work etc. and the role of health issues and health expertise in contemporary working life. His latest publications are ‘Freedom at work in the age of post-bureaucratic organization’, Ephemera – Theory and Politics in Organization, 7, pp. 555–574, and ‘Make your presence known – desire for recognition and fear of being overlooked as drivers of post-bureaucratic control’, Personnel Review, 38, forthcoming.
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