Hard and soft medicine: Doctors’ framing and application of the disability category in their assessments of grant claimants’ fitness to work in South Africa

dc.contributor.authorKelly, Gabrielle
dc.date.accessioned2016-08-29T12:41:31Z
dc.date.available2016-08-29T12:41:31Z
dc.date.issued2016-07
dc.description.abstractUsing the framework of street-level bureaucracy theory, this paper examines the work of medical doctors in assessing eligibility for disability grants (DGs) in South Africa. Observations of doctor-patient encounters showed that, despite the state’s attempts to standardise disability assessment, significant variation remains in doctors’ decision-making. I argue that doctors’ divergence from rules and guidelines is driven by differences between the government’s bureaucratic framing of disability and the alternative frames used by doctors for making sense of cases and thinking about disability, illness and employability in the South African context. Doctors’ framing of DG cases was shaped by their social and cultural backgrounds and dispositions, their professional knowledge and values, and their broader discursive framings of rights and social justice. This paper makes an original empirical contribution to the study of conceptions of disability as a category of the ‘deserving’ poor in a context of high poverty. It also highlights the relationship and potential conflicts between professional expertise, social norms and values, and bureaucratic rules at the street-level, and shows how this shapes policy implementation and the ensuing ‘gap’ between policy and practice.en_ZA
dc.identifier.apacitationKelly, G. (2016). <i>Hard and soft medicine: Doctors’ framing and application of the disability category in their assessments of grant claimants’ fitness to work in South Africa</i> University of Cape Town ,Faculty of Humanities ,Centre for Social Science Research(CSSR). Retrieved from http://hdl.handle.net/11427/21584en_ZA
dc.identifier.chicagocitationKelly, Gabrielle <i>Hard and soft medicine: Doctors’ framing and application of the disability category in their assessments of grant claimants’ fitness to work in South Africa.</i> University of Cape Town ,Faculty of Humanities ,Centre for Social Science Research(CSSR), 2016. http://hdl.handle.net/11427/21584en_ZA
dc.identifier.citationKelly, G. (2016). Hard and soft medicine: Doctors’ framing and application of the disability category in their assessments of grant claimants’ fitness to work in South Africa. CSSR Working Paper No. 384. Centre for Social Science Research, University of Cape Town.en_ZA
dc.identifier.isbn978-1-77011-371-8en_ZA
dc.identifier.ris TY - Working Paper AU - Kelly, Gabrielle AB - Using the framework of street-level bureaucracy theory, this paper examines the work of medical doctors in assessing eligibility for disability grants (DGs) in South Africa. Observations of doctor-patient encounters showed that, despite the state’s attempts to standardise disability assessment, significant variation remains in doctors’ decision-making. I argue that doctors’ divergence from rules and guidelines is driven by differences between the government’s bureaucratic framing of disability and the alternative frames used by doctors for making sense of cases and thinking about disability, illness and employability in the South African context. Doctors’ framing of DG cases was shaped by their social and cultural backgrounds and dispositions, their professional knowledge and values, and their broader discursive framings of rights and social justice. This paper makes an original empirical contribution to the study of conceptions of disability as a category of the ‘deserving’ poor in a context of high poverty. It also highlights the relationship and potential conflicts between professional expertise, social norms and values, and bureaucratic rules at the street-level, and shows how this shapes policy implementation and the ensuing ‘gap’ between policy and practice. DA - 2016-07 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 SM - 978-1-77011-371-8 T1 - Hard and soft medicine: Doctors’ framing and application of the disability category in their assessments of grant claimants’ fitness to work in South Africa TI - Hard and soft medicine: Doctors’ framing and application of the disability category in their assessments of grant claimants’ fitness to work in South Africa UR - http://hdl.handle.net/11427/21584 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/21584
dc.identifier.vancouvercitationKelly G. Hard and soft medicine: Doctors’ framing and application of the disability category in their assessments of grant claimants’ fitness to work in South Africa. 2016 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/21584en_ZA
dc.languageengen_ZA
dc.publisher.departmentCentre for Social Science Research(CSSR)en_ZA
dc.publisher.facultyFaculty of Humanitiesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/en_ZA
dc.titleHard and soft medicine: Doctors’ framing and application of the disability category in their assessments of grant claimants’ fitness to work in South Africaen_ZA
dc.typeWorking Paperen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceWorking paperen_ZA
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