Referral to Occupational Health: A Foucauldian discourse analysis of statutory documents and student nurses’ perceptions

This study was carried out using a Foucauldian discourse analysis and involved the examination of three statutory reports into the provision of occupational health in the workplace. The reports analysed were the Report of the Select Committee on the Bill for the Regulation of Factories (1832); the Safety and Health at Work Report (1972); and Working for a Healthier Tomorrow (2008). Additionally, analysis was carried out on oral events with nursing students, which sought to understand their perceptions of referral to occupational health. The objective of this study is to explore how referral is constructed through discourse, categorising how this practice is constrained or liberated by specific discourses and how nursing students are positioned by these discourses. My study highlights both structural and subjective barriers to the use of occupational health. At the structural level, it is observed that referral to occupational health commenced as a form of governmentality, introducing dividing practices which subjected the workforce to forms of classification and surveillance. For those classified as healthy a culture developed within workplaces in which health behaviours needed to comply with the standards set down by occupational health and by the risk management approach. Risk management processes and stigmatisation are used to ensure compliance with the state’s wishes for a healthy and productive workforce. This trend is seen across the reports analysed, and is increased within the Black Report to the surveillance of health both in and out of the workplace for those of a working age. Subjectively, occupational health was identified as a disciplining and subjugating structure by the nursing students. The students evidenced notions of Cartesian duality in their discussions of the outcomes of referral, as they readily accepted surveillance of the body whilst seeking to avoid surveillance of their mental health capabilities. Through observation of architectural signs and organisational images of discourse, ...