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McIntosh, Michele G. (2021) Constructing the model citizen in healthcare communication. PhD thesis, University of Nottingham.

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Abstract

This thesis investigates the discursive construction of the model citizen, or ideal user, in public information from the UK’s National Health Service (NHS). Employing Multimodal Critical Discourse Analysis, it unearths evidence that the model citizen is a frequently-used and multimodal discursive strategy. The study takes as its texts an extensive range of health promotion and public information from the NHS. These include a multimedia health campaign, leaflets, posters and other materials found in A&E waiting rooms, web pages and health promotion messages attached to the exteriors of hospitals and ambulances. They are grouped and analysed according to the stage at which they are found in a theoretical ‘journey to emergency healthcare’.

In an NHS under constant pressure, the field of emergency healthcare has often been the setting for news stories of overcrowding, missed waiting time targets and chaos. Published by an organisation known for its political impartiality, these texts fulfil an information-providing, or ideational, function. Yet this study finds that they are ideologically motivated artefacts, which can be classified as technologies of governmentality, shaping ideologies in this emotive corner of the healthcare system. The thesis seeks to understand the nature and the purpose of the model citizen construct, and finds it is intertwined with other multimodal strategies to perpetuate asymmetric power relations. Furthermore, the model citizen becomes an instrument of governmentality, as it is manipulated and remade depending upon the requirements of the NHS in different circumstances. The texts are also found to expand the remit of ‘health’ into new subject areas and new settings, combining neoliberal and collectivist ideologies whilst transferring responsibility for ‘saving the NHS’ from Government to citizen.

By considering the semiosis present in all communicative resources across a range of linked texts, the study demonstrates an effective way of expanding the use of established analytic tools to study large and diverse datasets. Modes are consolidated into lexical and multimodal communicative strategies, one of which is the construction of the model citizen. The findings are likely to be of interest to researchers in CDA, multimodality and health communication, and to practitioners and policymakers in health and other public services.

Item Type:	Thesis (University of Nottingham only) (PhD)
Supervisors:	Harvey, Kevin Mahlberg, Michaela
Keywords:	Applied Linguistics, Multimodal Critical Discourse Analysis, Health Communication
Subjects:	P Language and literature > P Philology. Linguistics R Medicine > R Medicine (General)
Faculties/Schools:	UK Campuses > Faculty of Arts > School of English
Item ID:	65275
Depositing User:	McIntosh, Michele
Date Deposited:	18 Jan 2024 10:17
Last Modified:	18 Jan 2024 10:17
URI:	https://eprints.nottingham.ac.uk/id/eprint/65275

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