Ordering, enrolling, and dismissing: moments of access across hospital spaces

Drawing on ethnographies of three areas of hospital life in the United Kingdom, this article explores the different logics played out through moments of access to hospital services. The authors make explicit the character of the hospital as heterotopia where different social actors are required to “fit” in with the organizational requirements of the hospital. What becomes clear is how the hospital as institution can accommodate particular logics at particular times that are incommensurate with the organization of the hospital and the “care” of patients. Such accommodation makes explicit the contestable characteristics of the hospital where alignments are made between multiple logics. Through processes of ordering, enrolling, or even dismissing potential patients (or even logics), the authors argue that divisions are labored across hospital life and are worked to accomplish particular social worlds. The issue of which social worlds are being labored and how they work for or against a logic of care is made explicit here. Through their ethnographic work, the authors show how through processes of ordering, enrolling, and dismissing persons, subject positions, and logics during moments of access, the hospital can be understood as a complex heterotopia that works politics through clinical and managerial practice.