Julie Henderson

This paper explores labour negotiations between nurses and government in the public health sector in Australia between 1996 and 2005. During this period, industrial negotiations between nurses and government in the public health sector moved from centralized wage determinations to agreements made at the level of the enterprise through the Workplace Relations Act 1996. Simultaneously, public sector nurses reported increased work intensification, a result of new public management strategies. This led to the Australian Nursing Federation negotiating enterprise agreements that included the introduction of highly specified workload algorithms in an attempt to de‐intensify nurses’ labour. The irony of this strategy is that these calculations and tools operate as both a human resource mechanism for maximizing productivity as well as an industrial relations tool for reducing work intensification.

Approaches to self‐management traditionally focus upon individual capacity to make behavioural change. In this paper, we use Bourdieu's concepts of habitus and capital to demonstrate the impact of structural inequalities upon chronic illness self‐management through exploring findings from 28 semi‐structured interviews conducted with people from a lower socioeconomic region of Adelaide, South Australia who have type 2 diabetes. The data suggests that access to capital is a significant barrier to type 2 diabetes self‐management. While many participants described having sufficient cultural capital to access and assess health information, they often lacked economic capital and social capital in the form of support networks who promote health. Participants were often involved in social networks in which activities which are contrary to self‐management have symbolic value. As a consequence, they entered relationships with health professionals at a disadvantage. We conclude that structural barriers to self‐management arising from habitus resulting in the performance of health behaviours rooted in cultural and class background and limited access to capital in the form of economic resources, social networks, health knowledge and prestige may have a negative impact on capacity for type 2 diabetes self‐management.