Paper short abstract:

This paper examines the materiality of fiscal theory, the ways by which thought regarding fiscal issues enables practices with particular outcomes in Welsh health care. The goal is analysis that transcends the relationship of theory to reality, and considers theory’s objectification and recursivity.

Paper long abstract:

In this paper, I examine the health care system of Wales in order to interrogate the materiality, or materialization, of fiscal theory. I am interested in the ways by which thought regarding fiscal issues, especially in terms of a neoliberalist approach, enables the construction and enactment of specific institutions and practices which result in particular patterns of effects in the health system of a particular 'postcolonial' national and territorial setting. The emphasis on theory, practice, and effects hints at the materiality of fiscal theory, and enables an analysis that transcends conventional approaches which emphasize the relationship of theory to reality. This allows for an understanding of the objectification and recursivity of theory as it materializes through institutional and political practices and the effects that result. Theory is therefore sustained despite particular realities, and this capacity confers power on both the theory and on those who deploy it in policy settings. Drawing on recent devolution legislation and subsequent policy divergence in Wales, I will address the ways in which neoliberal fiscal theory materializes in institutional practice and patterns of effects in the Welsh health care system.