Beneath the numbers: a qualitative study of the politics of resistance to transparent workforce data reporting

Abstract

Purpose – The purpose of this paper is to go beyond assumptions of “objective” transparency in data reporting within healthcare systems by examining forms of resistance among general practice providers to sharing workforce data and managers’ interpretations of, and responses to, these resistances. Framing data reporting as a “calculative practice”, the article analyses the neglected political and/or performative dimensions of data to examine contested meanings and motivations, reflecting power struggles with implications for wider health and public sector policy. Design/methodology/approach – Drawing on qualitative individual and group interviews with 56 general practitioner service providers and managers (commissioners and/or policymakers), using thematic template analysis informed by the literature on reactivity effects, the article explores the nature and implications of resistances in this data reporting practice. Findings – Felt but hidden tensions between stakeholders involving distinct forms of resistance to workforce data reporting (the calculative practice) were revealed. These “surface”, “deeper” and “root” layers of resistance saw providers covertly contest the practice, which some believed was designed to scrutinise business models. Solutions presented to address resistance often misdiagnosed the nature of providers’ concerns by focusing on less political sources of resistance and neglecting root challenges of power and trust. Originality/value – The article highlights the value of political rather than rationalistic understandings of behaviours among healthcare providers and managers in relation to data reporting. Recognising the performative (and counter-performative) nature of this activity, the paper demonstrates how calculative practices may be the arena for critical but obscured dependencies and power struggles that may paradoxically impede effective governance.