Performance of Service Delivery in Mental Health Care Systems: a case of Third Cybernetics Evolution in the NHS, England.

摘要

A welfare state has a responsibility, by virtue of its 'social contract' with its citizens to provide health and social services to the citizenry. The state delegates that responsibility to a number of actors, each of which has its own strategy-as-practice as one among many. To ensure coherence, it is important to manage their performance collectively, including inputs from the patients groups. This process of management turns out to be difficult, especially that of the mental healthcare services because of lack of communication among the actors. The author will be looking at a possible solution to this problem based on the assumption that it is possible to change the way the actors act by bringing them together to share their purposes and common actions through the notion of dialogism as way of maintaining plurality of logics: different voices (polyphonic), styles (stylistic), space-time conception (chronotopic), interanimating discourse (architectonics) and the dynamic interplay of different dialogues (polypi). It is this process of plurality of logic that the researcher termed, the Third Cybernetics Evolution as a way of sequential processes from the First Cybernetics through the Second Cybernetics to the Third Cybernetics. It is argued that implementing these, allows for improved communication among actors, as a way of achieving high quality service delivery via increase in their interactions.