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SYKEFRAVÆ årsaker til sykefrav

The politics of sickness. A policy discourse approach to sickness absence

Awarded: NOK 4.3 mill.

While retrenchment and reform characterize welfare policy throughout Europe, the Norwegian sick pay scheme appears incredibly robust and generous. This project has studied the conditions for stability and change in the Norwegian sick pay scheme with particular emphasis on the discourse on sickness absence. How do we talk about and understand the phenomenon of sickness absence? Has this discourse changed over time, and how has this affected policy making? At the core of the project is the analysis of the institutionalization of the sickness absence discourse. Repeated attempts at extending employer funding in the 1990s failed. The arguments were weakly developed, and changing minority governments failed in establishing a coordinating discourse where opposing parties could agree on a description of reality that legitimated policy change. The Sandman-report from 2000 on the other hand presented a comprehensive analysis and package of measures to reduce sickness absence. While this committee was divided on the issue of sick pay, it agreed on the main perspective: That the work places were to be the key arena for fighting sickness absence. This idea also paved the ground for an efficient coordinative discourse, with cognitive as well as normative appeal. Coordinating because it offers a shared language and guidelines for action, instead of dividing blame between lazy workers and poor work environment. Cognitive appeal in the sense that it draws both on research and on common sense perceptions of the significance of the work place for health and sickness absence. Normative appeal in the sense that it emphasizes inclusion and the right to work, thus linking to fundamental values in a welfare state based in ideals of high employment. This is arguments and modes of understanding that have become institutionalized in the shape of the agreement for an inclusive working life (the IA-agreement) and through the numerous work groups and collaborative forums that are continually engaged in this work. It is also a discourse that is embedded in a range of regulative changes that have been done to enforce the agreement, with consequences for local practices in workplaces and GP surgeries. Webpage :

Politics and policymaking have been largely absent factors in existing research on sickness absence in Norway. This is surprising considering that the reduction of sickness absence levels is an issue of considerable political importance in Norway, where t he choice of policy instruments to control sickness absence levels to a large extent is a result of negotiations and struggles between political parties and the social partners. The aim of this project is to produce a better understanding of the policies that have been chosen - and alternatives that have been rejected - in order to affect sickness absence levels. We ask questions about the ideas that lie behind the choice of policy aims and instruments, and about the processes wherein different actors str uggle and negotiate over the best ways of understanding, or framing, the issues of sickness benefits and sickness absence. We propose to structure the analysis around four different themes: (1) Framing of interests: who are the main interest formations a nd how to they make their interest heard? (2) How is expert knowledge being used in policymaking. (3) What are the understandings of sickness that drive policies to control sickness absence levels? (4) Modes of governance: Through what kind of instruments and relations do political actors propose to work? Norwegian experiences will be contrasted to other countries, particularly to Sweden. The project will provide a better understanding of the political processes that give shape to our sickness benefit pro grammes. While political struggles take place within limitations set by economic and institutional constraints, as well as by available research and knowledge, political actors may have considerable latitude in framing policy responses. We therefore belie ve that an improvement of our understanding of the politics of sickness is essential to understand the dynamics behind contemporary attempts at reducing the levels of sickness absence through political measures.

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SYKEFRAVÆ årsaker til sykefrav