CONTROLLING THROUGH AND IN SPACE: AN INTER-ORGANIZATIONAL APPROACH IN THE HEALTH SECTOR

Abstract

Can we control others by using spatial norms? This contribution proposes to address this question, which also allows us to develop the traditional approaches of the school of proximity by integrating the question of power, a dimension somewhat understudied according to the supporters of this approach. To do this, we have mobilized the concept of the dispositif as defined by Michel Foucault as well as a vast literature in social and critical geography. Empirically, our research is based on the study of a unique case: the action of a regional health agency. The aim of this governmental organization is to manage the health system in a defined area by organizing the actions of operators in the territory through various mechanisms (contract agreement, adjudication, resource allocation, inspection, etc.). This contribution thus improves our understanding of formal control mechanisms by proposing a typology of these mechanisms and by anchoring them empirically. It also underlines that space must be considered simultaneously as a generator and a product of power relations in the organizational field – i.e. a space to be aligned with when one is in a dominated position, or a space that one must attempt to contest. Finally, it proposes a dynamic vision of inter-organizational control through the use of the concept of dispositif. However, using this concept at the inter-organizational level leads us to essentialize organizations as black boxes. This prevents us from understanding the influence of intra-organizational perspective – for example, professional groups – on spatial relations. This could be the subject of further stimulating research.