This is Definitely Not a Hospital:Intimacy and Other Forms of Psycho-social Interventions in Danish Cancer Services

Modern health care is coupled with the management of ever-expanding institutions, staff and clients, and with recent development of rehabilitation facilities health care becomes more and more intertwined with the administration of citizens’ everyday life. Most of existing literature has been occupied with exploring how health regimes and medical regimes in particular have influence the environments and conditions of help seekers in a more or less totalitarian way. It has been demonstrated how patients and clients have a manifest dependency of the groups of specialists and institutions, they consult for help. However, this paper sets out to analyse how the providers of the services have a much less apparent, latent dependency of the people who asks for help. The aim of the paper is therefore to explore some latent conflicts and dependency in what goes on in the intersection of personal lives, intimate relationships and professional/institutional spheres. Theoretically, the paper examines this intersection using Elias’ (1978) concept of figuration and interdependency between people and it introduces to Swan’s (1990) idea of protoprofessionalization, as well as the way that their ideas might be interrelated and extended in analysing organizational life in health and welfare institutions. Based on a case study of the Danish cancer services, the paper draws on empirical data - foremost semi-structured interviews with staff and clientele and observation of patient trajectories, derived from three different fields: a cancer department (located at a major teaching hospital); a rehabilitation castle (located on the countryside) and a cancer and health centre (located across the road of the teaching hospital). In the paper’s analyses a repeated truism coined in the case study is followed. The truism tells: ‘This is definitely not a hospital’ and points to the fact that cancer staff and clientele use the presence/non-presence of the hospital institution to either align or differentiate from it. It is suggested in the paper that the more the hospital is manifest, i.e., discursively, physically, imaginatively and so on and so forth, the more delimited and well-defined are the professional roles, organizational coordination mechanisms, and the active contribution of practices on the managed areas of the patients. This also means that in those cases where the hospital is profoundly absent, it has some major impact on the helping professions and how they arrange among themselves a division of tasks and of claims of competences, detachment and intimacy.