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In Building the Trident Network, Maggie Mort approaches the United Kingdom's Trident submarine and missile system as a sociotechnical network. Drawing on the sociology of scientific and technical knowledge and on actor-network theory, Mort recounts how the Trident program was stabilized in the United Kingdom and brought into "successful" production. She uncovers the nature of this success by retelling unofficial histories of Trident, of production roads not taken, and of potential technological "distractions." The production of Trident, she shows, was not inevitable but contingent and problematic.Using material from interviews and local texts, Mort explores the emergence of a counternetwork in the form of a workers' campaign for alternative technologies. She develops concepts of "disenrollment" and "absent intermediaries," in which redundant workers and marginalized technologies serve to discipline and reinforce the dominant network as production shrinks. She also examines the maintenance of the barrier between the technical and the social/political in this context. The management of uncertainties within the Trident production program emerges as critical to its successful completion.

Recovery practices following the loss of home, sense of security, space and possessions, have recently become a focus of UK government attention. How people recover from disasters is seen to have a direct bearing on individual, community and economic well-being, so that the recovery itself becomes a form of social change. A plethora of instruments: templates, checklists and guidance documents have been produced to effect this recovery. We term these 'technologies of recovery', which work within a wider context of disaster planning aimed at bringing order where much is uncertain, reactive and dependent on emerging relations between people, things and spaces. While such protocols are not necessarily unwelcome, they carry many assumptions. We show how these technologies are built from official, distal narratives, versions of recovery remote from situated practices or recovery-in-place. Official emergency planning builds on 'lessons' from previous emergencies, to be then applied to future crises. Knowledge that is situated, complex and partial is potentially useless because emergency planners seek accounts that don't depend on highly localized circumstances. From a five-year ethnography of both a flooded community and the development of government recovery guidance, it became clear that technologies or recovery became transformed and remade in localized practice when enacted by newly formed and precarious collaborations of residents and local responders. Operating alongside, and sometimes underneath, the official response, residents and local responders demonstrated a remaking of the politics of recovery.

More and faster information will transform our experience of healthcare, according to policymakers, while social theorists have argued that medicine has become `informatized': a new medical paradigm is being shaped. We question both the policy-led conflation of `information' and `healthcare' and ideas about the extent of the informatization of medicine, by exploring how these ideas resonate in medical work, revisiting our studies of expertise in two clinical domains where information technologies are central to practice. The projection of new information programmes as creating knowledge which is independent of space and time runs the risk of devaluing the experiential, haptic and affective knowledge of both apprentices and practitioners. Information, we argue, cannot underpin medicine unless it is recognized and defined as generative, dynamic and intimate, rather than storable and deliverable.

In this paper, we are concerned with the ways in which pain and redundancy might be accommodated within the framework of Actor-Network Theory. We pose the question: what are the consequences, both analytic and human, when technologies and humans are removed from sociotechnical networks? Taking the production of Trident as the `core business' of the nuclear submarine manufacturers VSEL, and addressing not only the process of technological innovation, but also of technological production, we explore how both workers and `alternative' technologies were rendered redundant, or `disenrolled'. However, we view these redundant actors as retaining a lingering presence, in the form of what we call `phantom intermediaries'. These, we argue, continue to shape the relevant sociotechnical network by `disciplining' the remaining actors. Over and above this, they also serve to signify preferred futures, and the possibility of resistance. Finally, we will draw out some of the broader implications of our approach for the study of sociotechnical networks and their relation to redundancy and pain.

This paper concerns two practices, public consultation and user involvement, whose adoption has been urged upon the UK National Health Service in recent years. Public consultation is a local attempt to seek the views of a broad constituency of persons. User involvement is a local attempt to include organized groups of service users in the planning, and occasionally the management, of such services. The paper has four objectives. First, it locates the topic in the context of several related current debates. Second, it outlines the main findings of a recent empirical study of public consultation as they relate to the above debates. Third, it summarizes the relevant findings of an empirical study of user involvement. Finally, it examines these two practices as "technologies of legitimation" which can be seen as a means by which managerial legitimacy is maintained in the context of an increasingly pluralistic policy arena.

User groups of social and health care services are playing an increasingly significant part within systems of local governance. This report examines the strategies user groups adopt to seek their objectives, and explores conceptual issues relating to notions of consumerism and citizenship. It should be read by anyone involved in health and social care policy making and practice

The provision of 'distant' care to older people living at home through telecare technologies is often contrasted negatively to hands-on, face-to-face care: telecare is seen as a loss of care, a dehumanization. Here we challenge this view, arguing that teleoperators in telecare services do provide care to older people, often at significant emotional cost to themselves. Based on a European Commission-funded ethnographic study of two English telecare monitoring centres, we argue that telecare is not 'disembodied' work, but a form of care performed through the use of voice, knowledge sharing and emotional labour or self-management. We also show, in distinction to discourses promoting telecare in the UK, that successful telecare relies on the existence of social networks and the availability of hands-on care. Telecare is not a substitute for, or the opposite of, hands-on care but is at its best interwoven with it.

The emergence of the field of health care at a distance, or "telehealth," has been embedded within discourses of high ambition about health improvement, seamless services, empowerment, and independence for patients. In this article, the authors examine how telehealthcare technologies assume certain forms of patients—or "telepatients"—who can be mobilized and combined with images and artifacts that speak for them in the clinical encounter. Second, a tentative intervention is made in these emerging identities in the form of facilitating some alternative discourses about telehealthcare. The aim is to stimulate debate by presenting and contrasting these different approaches to technology development. Such differences take material and discursive shape in the making and unmaking of telepatients, showing important interferences in the shaping of identity and possibilities for governance and participation.

'User involvement' is a contemporary policy initiative in the UK National Health Service which requires the managers of the service to pay greater attention to the wishes of individual patients/clients and their carers, but also to the representatives of users and the general public. This paper focuses on the responses of health and social care managers to user groups: on the the employment of groups outside the policy/managerial hierarchy as contributors to and legitimators of decisions. Such an approach to legitimation poses the risk that such outside groups will express views or engage in activities which are unacceptable to the hierarchy. This paper provides illustrative evidence about how such tensions may be dealt with in order to maintain tactical policy/managerial independence and to buttress representative democracy against the spread of participatory democracy.