Search results

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.

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.

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.

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.

This chapter analyses and discusses local government health promotion in Norway.

Institutional theory indicates that political and administrative jurisdictions are path dependent in their policy formation and implementation. By using data from different sources this assumption is analysed and discussed according to health promotion in Norwegian municipalities. The main methodology is cross tabulations, bivariate correlations and regression is carried out to supplement analyses.

Municipalities are path dependent in their health promotion policies. They acknowledge and prioritize health behaviour independent of experienced socio-economic challenges, municipal capacity as size and income, and local government political profile. Competence devoted to health promotion can create changes in policies.

The rhetoric on determinants and social determinants in particular is new in Norway. Rhetoric on, and interventions, that highlight the social determinants of health need to be coordinated.

The chapter presents new knowledge on Norwegian local government health promotion and how this is implemented in relation to the challenges experienced.

This chapter provides both an introduction to the volume and a brief review of literature on technology, communications, and health disparities.

Literature review.

The chapter argues for the importance of greater examination of technology, communications, and their linkages to health disparities and other related factors.

Reviews the topic of technology, communication, and health disparities and previews this book.

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.

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

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.

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.