Welfare politics on the streets : the case of medical social workers

The themes of individual responsibility, independence and self-reliance are salient in welfare discourse in Singapore and the healthcare policies formulated against the backdrop of these ideas are implemented by street level bureaucrats like medical social workers. Using the structuration theory by...

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Bibliographic Details
Main Author: Lim, Yan Ming
Other Authors: Teo You Yenn
Format: Final Year Project
Language:English
Published: 2014
Subjects:
Online Access:http://hdl.handle.net/10356/55821
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Institution: Nanyang Technological University
Language: English
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Summary:The themes of individual responsibility, independence and self-reliance are salient in welfare discourse in Singapore and the healthcare policies formulated against the backdrop of these ideas are implemented by street level bureaucrats like medical social workers. Using the structuration theory by Anthony Giddens, this paper examined how state discourse and ideology are embedded within the practice of medical social work and how conditions on the ground relate to the exercise of discretion by medical social workers. Drawing from the narratives of medical social workers in local public hospitals, this paper showed that while state discourse and ideology are being reproduced at the street level, medical social workers are knowledgeable agents who create new meanings of welfare through their practices. Also, it was illustrated that the state-endorsed notion of reliance in welfare discourse is limited because it ignores the multidimensionality of reliance and neglects the chance of understanding how and why reliance perpetuates itself. Finally, that conditions that face medical social workers on the ground are proven to be both constraining and enabling.