Humanization through discipline? Foucault and the goodness of employee health programmes[1]

Tamara: Journal of Critical Postmodern Organization Science, 2003 by Haunschild, Axel

ABSTRACT

There is no doubt that health management can improve employee well-being and can have positive outcomes for the organization. But, the mere goodness of such programmes has to be questioned. First, the paper shows how health management activities fit in processes of discipline in our society as extensively analysed by Foucault particularly in his genealogical works. Second, it discusses possible normative implications of such a Foucauldian analysis. What is the alternative to taking care of employee health in organizations?

INTRODUCTION

Human resources are more and more becoming the most valued asset of organizations. To keep and to improve this asset, employee health has to be a major focus of (human resource) management. By improving individual well-being, employee health programmes in the end serve both individual and organizational needs... but STOP! Does any of this provoke feelings of uneasiness? Any objections? Why? Isn't healthiness good and illness bad? Isn't the healthiness of employees good for organizations and the employees themselves? Are there any reasons for saying that organizational health management is not just good? Clearly there are issues here which deserve scrutiny and not least the very taken-for-grantedness of the assumption of what is good.

In addition to external control over bodies in organizations, particularly in routinized job designs (e.g. assembly lines, call centre work places, jobs designed using work measurement studies), health management commonly addresses the individuals' consciousness and internal control. The image of a healthy and fit body or employee, respectively, functions as a norm which results from processes of normalization and which leads to continuous self perception identifying deviations from these norms. While it can be said that health management improves employee well-being and can have positive effects for the organization (image, reduced absenteeism in the long run etc.), the mere goodness of such programmes has to be questioned. Consequently, there are two related starting points for critique which arise here and which will be developed in more detail in the paper.

(1) For various reasons, in our narcissistic culture of modern capitalism (Turner 1996) actual and simulated physical fitness becomes a new and important criterion for career decisions and, therefore, becomes (much more) decisive for life opportunities. A growing pressure on employees to preserve their health and to demonstrate fitness causes individual stress. For example, managers may feel that they have to justify every risky activity they participate in (smoking, consumption of alcohol, high cholesterol food, certain sports, no sports and so forth) so that they become regulated between excess and moderation in order to demonstrate commitment, for example, some sports might be considered dangerous yet to not participate in any sports might suggest a lack of activity, excess drinking would be regarded as a problem whereas total abstinence might show a lack of sociability) and are held responsible for the consequences. Employees bearing health risks for whatever reasons cannot count on (organizational) compassion and solidarity. If there should be or ever was a right to illness, the propagation of healthiness and fitness in organizations with its consequences for opportunities and careers undermines this right. But, even if health management had only positive consequences for the actors involved, another more fundamental level of critique would remain and this is where Foucault's work comes into play.

(2) Health management activities, especially when successful, can be described as additional building blocks of power mechanisms which Foucault subsumes under the notion of 'disciplines' (see his genealogical middle works as Discipline and Punish, 1977; The History of Sexuality: Vol. I, 1981; Power/ Knowledge, 1980), These disciplines increase control over human beings and produce them as subjects. Health management activities can be interpreted as micro-practices in this respect: All systematic conceptions of health management support the formation of a coalition of different professions, e.g. work safety, company doctors, psychologists, medical insurance, trade associations etc., and include instruments and methods of gathering information on individuals and their bodies and therewith creating knowledge/power complexes. In analogy to Foucault's societal macrostrategy of bio-power that 'concerns the management of the production and reproduction of life in modern society' (Fraser 1981), employee health strategies aim at or contribute to administering, cultivating and controlling personnel/the workforce as population of the organization (see also Deetz 1992; Townley 1993, 1994; McKinlay and Taylor 1998), finally to produce 'docile and useful bodies' (Foucault 1977). In this respect, characterizing health promotion at work merely as a direct path to the humanisation of work or a philanthropic act seems to be quite naive and neglects the underlying, to a wide extent not directly intended structures of control- and power-strategies in modern society.