Restructuring and the Production of Occupational Stressors in a Corporatised Ambulance Service

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Restructuring and the Production of Occupational Stressors in a Corporatised Ambulance Service

Kerry Mahony
School of Management, University of Western Sydney, New South Wales

Abstract

The work of ambulance personnel is considered to be a 'high stress' occupation by lay and scientific communities alike. Findings from the study at hand support these perceptions but for reasons that are not given primacy in the literature.

Restructuring of a UK ambulance service informed by neoliberal ideology is producing new and additional stressors for members and exacerbating the unavoidable stressors of the occupation. Less worker autonomy, indeterminate hours, work intensification and the infinite expansion of shift times are creating stressors that the officers can no longer accommodate. Discourses on the aetiology of occupational stress are played out in the analysis and structural theories were found to be the most apposite.

Keywords

sociology, economic rationalism, occupational stress, ambulance services, restructuring, managerialism

Article Text

In the limited literature on the work of ambulance personnel the research emphasises the unavoidable and intrinsic stressors of witnessing human tragedy and trauma. I found, in a much larger comparative study (Mahony 2003), that stressors generated by the organisation and value of ambulance officers' work, were the most likely to have officers seeking respite (sick leave/stress leave) and/or alternative employment.

The dominant discourse on the aetiology of stress locates the cause of stress within an individual's personality. Proponents of this discourse study hardiness, locus of control, coping and adaptation skills as well as stress-generating personality types (see Rice 1999 for details). This discourse allows stakeholders to either focus on the intrinsic stressors of the occupation, or the supposedly stress-generating personality of individual ambulance officers. This emphasis on intrinsic stressors takes the focus away from stressors originating in the organisation and value of work. Furthermore, with the accent on intrinsic stressors, employers and their managers can abrogate responsibility for creating stressors at the workplace.

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Findings in this paper establish that the risk of experiencing occupational stressors for the on-road ambulance personnel in Service UK is located in the class relations of the UK society. Though the service is not constituted as a direct capitalist/labourer relationship as in the private sector, the capitalist class has presided over the rolling back of the welfare state and the restructuring of public services as business units. The capitalist class is in the ascendancy of the class struggle and is determining the pay and working conditions in the Civil Service as well as in private industry.

While the new ways of working in the transformed entrepreneurial corporations were intended to counteract alienated and degraded work (du Gay 1996:26), the new ways of working at Service UK are precipitating an increase in the number and magnitude of occupational stressors for on-road ambulance officers. Restructuring at Service UK means a greater work intensification for all officers, longer unremunerated hours and less control over the pace or timing of assignments. Corporate objectives are clearly privileged over staff needs or health. As one officer summed up the situation, 'we're supposed to be a caring service but that doesn't extend to staff'.

Marx's philosophical tracts in the 1844 Paris Manuscripts (Marx 1964:106-119) have a resonance with the research findings. Occupational stressors are demands which cannot be accommodated by human labour without imposing enormous health costs. This is in direct contrast to the 'crisis-in-adaptation' theories of occupational stress. Why should humans adapt to a non-human way of working?

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