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Article
Publication date: 16 March 2022

Therese Dwyer Løken, Marit Kristine Helgesen, Halvard Vike and Catharina Bjørkquist

New Public Management (NPM) has increased fragmentation in municipal health and social care organizations. In response, post-NPM reforms aim to enhance integration through service…

1096

Abstract

Purpose

New Public Management (NPM) has increased fragmentation in municipal health and social care organizations. In response, post-NPM reforms aim to enhance integration through service integration. Integration of municipal services is important for people with complex health and social challenges, such as concurrent substance abuse and mental health problems. This article explores the conditions for service integration in municipal health and social services by studying how public management values influence organizational and financial structures and professional practices.

Design/methodology/approach

This is a case study with three Norwegian municipalities as case organizations. The study draws on observations of interprofessional and interagency meetings and in-depth interviews with professionals and managers. The empirical field is municipal services for people with concurrent substance abuse and mental health challenges. The data were analyzed both inductively and deductively.

Findings

The study reveals that opportunities to assess, allocate and deliver integrated services were limited due to organizational and financial structures as the most important aim was to meet the financial goals. The authors also find that economic and frugal values in NPM doctrines impede service integration. Municipalities with integrative values in organizational and financial structures and in professional approaches have greater opportunities to succeed in integrating services.

Originality/value

Applying a public management value perspective, this study finds that the values on which organizational and financial structures and professional practices are based are decisive in enabling and constraining service integration.

Details

Journal of Health Organization and Management, vol. 36 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 26 April 2011

Gro Sandkjær Hanssen and Marit Kristine Helgesen

Based on a case study of Norway, the purpose of this paper is twofold: to present recent trends in the development of the multi‐level governance of the care services for the…

943

Abstract

Purpose

Based on a case study of Norway, the purpose of this paper is twofold: to present recent trends in the development of the multi‐level governance of the care services for the elderly and people with mental illness towards what we call the cooperative turn; and to discuss the implications of this trend for universalism in service provision.

Design/methodology/approach

The paper is a study of documents and the recent research literature.

Findings

A shift towards the cooperative turn can be identified as a change from command‐and‐control instruments to soft regulation mechanisms. Regulations and economic means are increasingly complemented by informational means. Soft versions of the steering instruments are used to target the results and processes of local policies. Hard instruments do not disappear, and a mixture of all the abovementioned instruments governs the two policy fields. This has implications for universalism defined as territorial uniformity, accessibility and coverage as user groups are competing for scarce resources, professionals are gaining autonomy in decision making and users are involved in service provision.

Originality/value

The originality of this paper is the discussion of the development of multi‐level governance towards a cooperative turn and the implications of this for universalism in service provision.

Details

International Journal of Sociology and Social Policy, vol. 31 no. 3/4
Type: Research Article
ISSN: 0144-333X

Keywords

Article
Publication date: 26 April 2011

Viola Burau and Signy Irene Vabo

The purpose of this paper is to introduce the papers included in this special issue and discuss the theme – shifts in Nordic welfare governance.

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Abstract

Purpose

The purpose of this paper is to introduce the papers included in this special issue and discuss the theme – shifts in Nordic welfare governance.

Design/methodology/approach

The paper discusses the major themes and sets out the structure of the special issue.

Findings

The picture emerging is mixed and there is evidence for strong decentralisation where policy instruments allow for considerable local room to manoeuvre. Organisational arrangements for governance are also highly localised, but (over time) oscillate between decentralisation and centralisation. As for the consequences for universalism, the contributions point to three contrasting scenarios. The first, relatively optimistic assessment suggests that while decentralisation challenges territorial equality, in some Nordic countries there seems to be inbuilt self‐correcting mechanisms pulling in the opposite direction. The second scenario is more critical and here it is argued that shifts in welfare governance, such as decentralisation and the introduction of elements of self and market governance, challenge universalism; universalism has become highly contingent on local circumstances and the practice of welfare delivery mixes different types of justice. The final scenario is rather pessimistic about the prospects of universalism and suggests that the shifts in welfare governance challenge universalism on all counts and lead to a wide range of new inequalities among citizens. This echoes the analysis of non‐Nordic countries in Europe where the scope for universalism remains limited.

Originality/value

The contribution of this special issue is twofold. First, using elderly care as a case study, the special issue analyses the complexity of welfare governance by looking at changes in both the vertical and the horizontal dimensions of governing. Second, focusing on Nordic countries, it assesses the substantive implications of shifts in welfare governance, notably in terms of universalism.

Details

International Journal of Sociology and Social Policy, vol. 31 no. 3/4
Type: Research Article
ISSN: 0144-333X

Keywords

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