The concept of the lifeworld as a tool in analysing healthcare work: exploring professionals’ resistance to governance through subjectivity, norms and experiential knowledge

Health-care work is increasingly practiced within governance frameworks. These ‘softer’ forms of new public management typically seek to shape working practices and cultures around key organising principles such as risk, knowledge and performance. Yet the implementation of these control mechanisms through standards, monitoring and auditing is problematic, with limited evidence of success. This article highlights the important contribution that understandings of the lifeworld can offer in analysing resistance to governance frameworks, through a positive critique of Habermas. Drawing on qualitative data from interviews with health-care professionals, evidence of both opposition and acquiescence to governance frameworks suggests a state of reflexivity as much as ‘colonisation’. The components of the lifeworld - culture, society and personality - thus represent important bastions of resistance, regulating system intervention through standards of perceived truth, legitimacy and authenticity. Habermas's concerns about the continuing sustainability of this struggle against instrumentalism are considered.