Assembling Homo Qualitus: Accounting for Quality in the UK National Health Service

Abstract

This paper describes the historical emergence of an accountable quality in public policies and reforms of the UK National Health Service: that is a notion of quality which is expressed through accounting and other formal measurement and management devices. It also specifies the idealized subject of an accountable quality, homo qualitus, and attends to instances of his/her incomplete realization. Doing so contributes to the problematization and rethinking of the way that accounting, professionalism, and the relationship between the two, are often understood. It shows that an accountable quality involves attempts to transform accounting from something external to, and imposed upon, or selectively adopted by, medical professionals into a measure of, in principle, any healthcare workers’ individual enthusiasm for, and commitment toward, quality itself. The incomplete nature of this transformation offers insights into complex ways in which discourse and practice may interact.

Keywords: Healthcare, quality, professionalism, affect, New Public Management