In this chapter, the author utilizes ideas drawn from governmentality to explore the emergence, and sometimes uneasy co-existence, of the biomedical discourses in the mental health policy arena. As Michel Foucault and other authors have noted, discourses constructing mental health have been strongly tied to biomedical understandings of mental illness and the medical speciality of psychiatry. The operational elements of A Vision for Change: Report of the Expert Group on Mental Health Policy (AVFC) betray the claims to whole-population relevance of mental health and reinforce a narrow conception of mental health as a euphemism for mental illness. The theoretical framework of governmentality can be helpful in exploring tensions between the mentalities and practices of governing, and discourses as they have developed around mental health policy and practice in Ireland.

This conclusion presents some closing thoughts on the concepts discussed in the preceding chapters of this book. The book explores the potential of governmentality-inspired ideas to develop a more nuanced and indeed critical understanding of the construction of health-based policy in Ireland. One of the key points underpinning accusations of governmentality's limited critical potential relates to the suggestion that studies often fail to capture the messy actualities of social and political relations. The book provides a clear example of how different and often competing voices, each drawing on different types of knowledge, build into governmental visions and approaches to organ donation. It illustrates how the management of obesity is increasingly being placed in the hands of individuals, by vesting them with a technology designed to monitor their waist circumference.

This chapter seeks to analyse the reform process initiated in 2005, examining the policy tools used to improve care provision and their impact on older people. It examines the impact of recent budgetary constraints on the long-term care sector, as a result of the recession in Ireland's free market economy. The chapter also examines how older people are conceptualised and analyses the relationships between the state and other stakeholders in the design and implementation of long-term care reform policies between 2005 and 2015. It is guided by a governmentality perspective, critically analysing the changing power relations within the long-term care sector in Ireland. Drawing on the particular conceptualisation of power, Michel Foucault developed the concept of governmentality, or 'the art of government'. Foucault's work on governmentality has been used by many other scholars as a framework for analysing power relations in society.

The Irish government has developed policies that set out its vision, priorities and direction for improving and sustaining the health of its people. This chapter critically appraises how these strategies have been configured to structure responsibility for health. It exposes a number of key characteristics of neoliberal governmentality, including the shift towards a market-based model of health, and the distribution of power across a range of agents and agencies of health. The need to reduce healthcare expenditure appeared in the first national, strategic public health policy, Shaping a Healthier Future. The chapter illustrates three evolving rationalities in strategic public health policies in Ireland. They are a market-based model of healthcare, devolution of responsibility, and capabilities and techniques to manage the self and ensure individual behaviour aligns with political objectives.

This chapter adds to historical studies of artificial body parts by exploring the reciprocal relationship between fictional texts and the prosthesis industry in nineteenth-century Britain and America. Focussing primarily on prostheses—including artificial legs, dentures, and glass eyes—in relation to female users, it demonstrates that fictional writing was a key component of nineteenth-century prosthesis discourse. The chapter argues that literary stories provided practical advice for readers on the kinds of prostheses that should be avoided for both social and functional purposes. Women in particular were targeted as consumers who should pay special attention when choosing prostheses. Popular literary sources, often packaged as marriage plots, provided kinds of advertisements not for but against certain prostheses. Meanwhile, both entire fictional works and particular representational strategies were used by contemporary prosthetists interchangeably as means through which to subtly disparage the devices of opposing makers, reinforce the proprietary ownership of particular designs, or promote the concealing abilities of particular devices to female users.

While aids to hearing were ubiquitous in nineteenth century middle class culture, they have only recently attracted attention among historians. Many such devices were inscribed with patent markings officially approved by the London Patent Office. Others instead simply bore claims to expired patents or the name of apparent ‘patentees’: such inscriptions served to persuade prospective purchasers that certain devices were ‘genuine’ inventions. The purchase of hearing aids was thus subject to complex relationships between designers, users, and user-designers centred on issues of trust, identity and efficacy.Drawing on patent records, advertising, the writings of ‘deaf’ journalists and artefacts, this chapter explores the selling of hearing aids as both a commercial and cultural encounter. First it looks at how the Rein and Hawksley companies adopted different strategies with regard to patenting and engaging prospective customers. Second it examines how hard-of-hearing journalists critiqued the opportunist vendors that often cited patents in their ‘advertising’ as a guarantor of effectiveness. The chapter concludes by examining the lived experiences of hearing aids purchasers, showing how such research affords historians the opportunity to investigate the histories of the deaf and hard of hearing through the material culture they accessed, whether designed for them or sometimes even by them.

This chapter focuses on one of the most well-known episodes in the history of tobacco control in Ireland: the introduction of an overall workplace smoking ban in 2004. It draws some key ideas and concepts put forward by governmentality studies. The introduction of the smoking ban in Ireland is considered by politicians, public health and anti-smoking advocates and Irish citizens as one of the biggest success stories in the history of public health policy and tobacco control. The chapter discusses some of the social and political implications of conducting a governmental analysis by drawing attention to the fact that the regulation of smoking became interlinked with social and moral processes. It exposes how some of these processes played a symbolic role in promoting boundaries between different social groups.

This chapter analyses recent Irish interventions into the 'obesity' discourse from the critical stance. It focuses on evidence from the first longitudinal study of children in Ireland, Growing Up in Ireland (GUI), and how its findings have entered the media and policy arenas. The analysis is based on secondary documentation, including published reviews of childhood obesity prevalence and GUI reports. Families and children were to be responsibilised to protect against the risks of overweight and obesity through educational and lifestyle interventions. The chapter considers some examples of how child fatness nevertheless continues to be framed as a pervasive and urgent issue in Irish society. The framing of childhood obesity illustrates how 'governmentality works by positioning or representing a problem in particular ways'. Body Mass Index (BMI) is even less satisfactory as a measure of childhood 'obesity'.