In this paper, we approach the study of power from the viewpoint of health systems. Power and politics are both critical concepts to engage with in health systems and policy research, as they impact actions, processes, and outcomes at all levels in health systems. Engagement with and empirical research on the concepts of power and politics, however, remains rare in health systems research, and the political aspects of health are often rendered invisible under techno-managerial, professional language.
We approach the COVID-19 pandemic as a case study for investigating how power and politics manifested in the Finnish health system, posing the following research question: in what ways did health system leaders and experts experience issues of power and/or “politicization” during COVID-19, and how did they impact health system governance? We present empirical findings from our qualitative research in which we interviewed health system leaders and experts (n=53) at the local, regional, and national level in Finland during the first year of COVID-19.
The results demonstrate that power and politics affected health system governance in Finland during COVID-19 in a multitude of ways. These can be summarized through the following themes: credit and blame, framing, and transparency. Overall, political leaders were heavily involved in the governance of COVID-19 in Finland, and the “politicization” of the pandemic took health officials and civil servants by surprise. The results suggest that calls for better health system resilience are likely to leave out critical factors if left absent of an explicit analysis of power and politics. Furthermore, the findings are discussed to elaborate how health system leaders’ and experts’ experiences regarding power and politics in a pandemic might inform preparedness to future shocks and crises, particularly as it relates to accountability, fairness, and equity in health systems.
The Endure project examines the short- and long-term consequences of COVID-19 from a comparative perspective. In line with the research priorities specified in the United Nations Research Roadmap, ENDURE studies the COVID-19 crisis holistically as a new source for mobilization of societies and political systems. It also examines (de-)mobilization of communities and how this has ushered in a new era of change and transformation. Drawing on insights from a transatlantic team experienced in studying “inequalities”, “gender”, “resilience”, “migration”, “crisis management”, and “radicalisation”, this project is guided by four objectives:
1. Drivers of inequalities and new forms of (de-)mobilizations: To identify how inequalities in their various dimensions (ethnicity, class, migratory status, gender, and age) have been reinforced and challenged, and to map how new forms of (de-)mobilization evolved during and after the pandemic.
2. Governance and (De-)Mobilization: To analyse the governance of Covid-19 at local, national, and global levels from a comparative, transatlantic perspective, and to explore the societal, political, and ethical consequences of these governance practices on social inequalities, on political systems, people’s rights, and freedoms as well as in the context of the increasing divide between Global North and South.
3. Community resilience and building back better: To understand community resilience practices through the study of grassroots solidarity movements and the mobilization of social groups and communities to generate social and political collective action.
4. (Dis and mis)information, Conspiracy theories, and Social media: To analyse the sources and promotion of dis and mis-information in social and mainstream media and to assess social media’s empowering and repressive roles in the context of COVID-19.
In order to address these research objectives, ENDURE will develop transatlantic platforms, co- produce practical tools and methodologies that will form a systematic basis for post-pandemic recovery and aid in fostering a culture embedded with everyday forms of resilience.
In the case of the Covid-19 pandemic a new political will and collective subject “us” was articulated to challenge the crisis and the enemy that was becoming visible and more concrete to tackle. Neither the process of the virus or its response was not even. But the effort to combat or choose one’s policy path was performing leadership and evoking contestation. This presentation introduces recent work on the pandemic from a special issue that invited contributions from all around the world to reflect on the way in which the pandemic response was performed. Starting the work in 2020, we expected to see curbing-in nationalism and performance of statehood, contestation between different levels of administration and expertise. Much of this happened. The articles give testimony of the year 2020 in particular, and develop new methods to study social media and government relations
We had a structured approach to what we wanted, but finally pandemic-performative power relations were different in each of the case countries, from New Zealand and Italy to Sweden and the Czech Republic. We paid particular attention to the way in which (social) media was used in this context to perform gendered responses (Hungary) or other ethnic minorities in Romania. We were able to capture the contestation between local and federal levels (Germany) and the capital’s locals and the president (Czech Republic) also through onsite/online mobilisations and images. The performance of the government’s pandemic control and its contestation revealed differences in power dynamics or sites of criticism (Finland and Italy). With the special issue "Performing Control" of the Covid-19 Crisis in Frontiers in Political Science coming to its administrative close, we would take this opportunity to explore, synthetise, and discuss the finding – and how they inform our further work.