Peripheral governance: administering transnational health-care flows

Abstract

This paper develops the concept of peripheral governance as a kind of legal transnationalism that is being generated by responses to outward travel for health care. I argue for a recuperation of the ‘peripheral’ in order to think through the ways in which marginal actors and marginal objects contribute to transnationalism. The paper draws on the idea of networked governance, nodal governance in particular, to capture governance mechanisms that have emerged in response to outward flows for healthcare. Peripheral governance comes into being through the cultivation of dependency on core provision of healthcare in other jurisdictions and by focusing domestic provision on those services (information, counselling, check-ups), which lie on the margins of healthcare. Peripheral governance has 4 key technologies: non-development, exit, use and return. These technologies illustrate how state agencies may actively mobilise the peripheral as they claim to address local needs through participation in the regulation of cross-border health care. In so doing they configure a conception of the peripheral that does not want to become core, participates in transnational networks on its own terms, and focuses on marginal objects of healthcare. I develop this account of peripheral governance through a critical reading of the strategies that the Irish Crisis Pregnancy Agency has adopted in response to women’s practices of travelling for abortion care.