Understanding Risk Work As Pastoral Power: The Governance of ‘Risky’ Subjectivities in the English Healthcare System

The concept of risk work attends to the situated practices of interconnected actors in the identification, assessment and management of risk. As many risk scholars remind us, the social meaning and governance of risk is inherently political. In this paper, we draw upon Michel Foucault's concept of ‘pastoral power’ to offer a new perspective on risk work. Foucault's ideas have been used effectively to explore the social control of risk. However, analysis often focuses on the broader discourses or technologies of risk, and not necessarily the relational practices of risk work. A focus on the practices of risk work can illuminate how discipline and governmentality is achieved. This paper draws upon his concept of pastoral power to examine how ‘risk workers’ define moral imperatives of risky conduct, shape group identities, and promote desirable conduct. These ideas are explored in the context of strategies to manage clinical risk in the English health system. The paper highlights a range of risk work practices across different occupational and organisational communities. Although shaped by similar risk management discourses, these practices vary according to the target subjects, the moral imperatives, and the influence of other discourses. The paper suggests risk work centres on the dynamics of morality, self and identification. But it also shows how the risk work of one pastor is often at odds with that of another, where risk management resembles a ‘multi-faith’ congregation. This creates the possibility for subjects to move between moral codes and maintain an ambiguous notion of risk. The paper extends the Foucauldian analysis of risk management through re-visiting his concept of pastoral power.