Waiting as a Temporal Practice of Everyday Life Inside the National Health Service

The timeframes for care in general practice can be unpredictable, prolonged and intermittent particularly in relation to chronic, multiple or undiagnosable illness of the kind that now makes up most of the general practice workload.  During periods of suspense, observance or endurance, what might be required more than anything else is a temporality of waiting, where time can be allowed to pass without necessarily moving people along or bringing forward a premature conclusion.

The sustainability of the National Health Service might even be said to depend on the willingness of the general practice workforce to become almost ‘bedrock-like’ by allowing patients to go through stages of suffering without either turning away or collapsing into something else.  But whilst the expectation on Practices to hold patients and to delay referring them onto specialist services is strong, the ambiance needed for waiting to take effect has had to make way for productionist rhythms.  This presents obvious difficulties for situations needful of a temporality of waiting and provokes questions about how waiting in these settings is infact, being done everyday, and what forms it might be taking in the absence of any ‘official’ forms of representation.

Through ethnographic observation of care work in two English surgeries, one in central London serving a large diverse population and the other in rural Devon serving the surrounding villages, the aim of this study is to look beyond the exteriority of time as a means of producing healthcare, to investigate the question of what waiting is as a practice of everyday life in the NHS now.  How is it made using the materials to hand in healthcare work?  How is it used?  What does it look like?  And how is made readable or unreadable in the eyes of the organisation?

Adopting the same approach to everyday life ethnography that Michel de Certeau and his collaborators experimented with for their project of ‘grasping the activity of those who practice the ordinary’, it attempts to grasp waiting as the singular practice of being in time that comes from the necessity of having to continue to uphold, organise and cohere the temporal demands of public healthcare.  But also as a particular mode of being in relation to time for practitioners who find themselves caught between the slow and stumbling rhythms of caring for the chronically ill, and the tightly controlled timeframes of care work in the contemporary world of the National Health Service.

Image: Fatal Attraction, 2006 © David Oates