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Ethnographic reflections on access to care services

Jeppe Oute (Department of Psychology and Behavioural Sciences – Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark)
Bagga Bjerge (Department of Psychology and Behavioural Sciences – Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark)

Journal of Organizational Ethnography

ISSN: 2046-6749

Article publication date: 4 December 2018

Issue publication date: 2 October 2019

Abstract

Purpose

The purpose of this paper is twofold: to explore how gatekeepers’ ways of regulating the researchers’ access to knowledge in/about care services reflect the systemic and interpersonal values that inform Danish welfare systems’ daily workings at the street level; and also explore how the authors’ methodological experiences mirror the value-informed regulatory strategies that professionals and users themselves experience in their daily encounters in the same local practices that the authors have studied.

Design/methodology/approach

The paper takes its empirical point of departure in a multisited ethnographic field study of the management of citizens with complex problems in Danish welfare systems.

Findings

By means of Michael Lipsky’s outline of access regulation, the authors will analyze the following regulatory strategies that are identified during the fieldwork: “Gatekeepers’ sympathy and creaming,” “Queuing and delay,” and ‘Withdrawal of consent and “no resources.” The paper suggests that trust, shared goals and sympathy seem to be key to the process of getting access.

Originality/value

Despite principles of neutrality, equal rights and access to services in welfare systems, the authors’ experiences thus tend to support other research within bureaucratic and care organizations, which has found that interpersonal relations, sympathy, dislikes, norms and values, etc., can heavily influence timely access to services, tailored information and support.

Keywords

Acknowledgements

The research is funded by the Independent Research Fund Denmark. The authors would like to thank the anthropologist, PhD student Louise Christensen, for her valuable contribution to the production of empirical materials and the early draft of this paper.

Citation

Oute, J. and Bjerge, B. (2019), "Ethnographic reflections on access to care services", Journal of Organizational Ethnography, Vol. 8 No. 3, pp. 279-297. https://doi.org/10.1108/JOE-12-2017-0064

Publisher

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Emerald Publishing Limited

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