Abstract:
This thesis analyses 11 breast cancer patients’ preconceptions and experiences of public
and private health sectors in New Zealand. Previous studies exploring breast cancer
have analysed a range of issues including race, socio-economic and age inequalities,
issues occuring between the public and private sectors, and the communication
strategies patients preferred with health providers. In contrast, this thesis uses concepts
from Pierre Bourdieu’s theory of practice to explore breast cancer patients’ accounts of
the public and private sectors and how these accounts are shaped.
For many of the women interviewed, cultural and social capital played an important role
in the negotiation of the health system, whether public or private. This is because both
sectors, at times, provided little information about the disease, treatment, side effects,
and entitlements. In these circumstances, social and cultural capital were valuable
resources providing alternative health assistance.
Participants’ preconceptions when relating their choice of public or private health
systems showed clear positive associations with the private health sector. When
discussing their experiences, the women that used the public sector showed a positive
turnaround in their opinions related to the public sector. In comparison, the women that
used the private sector maintained their views regardless of some negative issues being
experienced. Despite their personal experiences, both public and private participants
maintained positive associations with the private sector.
The reliance many of the participants had on social and cultural capital in both the
public and private health sectors raises questions regarding processes related to patient
information, access to services, and about whether case management of cancer services
might be appropriate. The contrasts between participants’ preconceptions of the public
sector in comparison to experiences highlights the need for a public campaign
celebrating the successes of public cancer services.
