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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester

The ‘politics’ of a changing institutional ecology: coordination, prioritization and labour in Norwegian health, care and welfare services

Alternative title: Dynamikker i en endrende institusjonell økologi: samhandling, prioritering og arbeid i helse, omsorg og velferdstjenestene i Norge

Awarded: NOK 23.9 mill.

This strategic project to build institutional expertise aims to develop the field of services research through a multidisciplinary and comparative exploration of the ways services interaction and coordination are politicized, prioritized, organized and experienced at different levels and by different actors in the Norwegian welfare state. We focus on how social and structural dynamics shape conditions for municipal welfare services, and identify factors that may promote or hinder priorities related to service collaboration. Our project relates to the contemporary societal challenge of welfare regime capacity, and how to build sustainable public services based in the value of equal access to services of equal quality. The healthcare sector is one of several sectors of the Norwegian welfare state. Primary care is decentralized and the municipal healthcare services constitute the institutional backbone of the welfare state. The municipal healthcare services are our point of departure. Our research focus in four work packages are; conditions for developing sustainable services; labour that produces healthcare services; organization and governance of the municipal services; policies and practices of services coordination; international policy trends in healthcare and welfare. The project is managed by the Center for Care Research (CCR) west, Western Norway University of Applied Sciences (HVL), and includes five national partners - CCR East, South, Mid, North and NORCE Society, and four international partners UCSF, MSU, NIVEL and Aarhus University. Preliminary findings in our policy analysis indicate that logics in healthcare policy tend to forefront the content of the services and to a lesser degree focus on the work-intensity required to produce them. This issue might contribute to promote the importance of quality in the services while at the same time silence the conditions for labour in the services.

This strategic project to build institutional expertise aims to develop the field of services research through a multidisciplinary and comparative exploration of the ways services interaction and coordination are politicized, prioritized, modelled and experienced at different levels and by different actors in the Norwegian welfare state. We will identify social and structural factors that may contribute to reduce unwarranted variations and priorities related to services coordination, and potentially contribute to ensure sustainable services. The project is situated within a contemporary paradox faced by every European state. On the one hand, there is a need for cutting public expenditure because of lower state remuneration and of austerity, an effort given force through current NPM policies. On the other hand, there is a greater demand for public services caused by societal changes spurred by changes in the market, such as the global decline in employment, increased migration flows and increased complex health care issues in the population. This projects ambition is to build a theoretical informed and potent policy influential services research through a practice-based methodological and critical multi-scalar scope on the challenge fragmented services provision represents for a sustainable welfare regime. We explicitly aim at developing services research by the use of a range of theoretical prisms, whereby the overall prism opens for an understanding of public services as co-related within a particular Norwegian ‘institutional ecology’. Understanding public services as a key to the welfare states’ egalitarian ideology, we also explore the role of municipals as agents counteracting inequality. The project is managed by the Center for Care Research (CCR) west, Western Norway University of Applied Sciences (HVL), and includes five national partners - CCR East, South, Mid, North and NORCE Society, and four international partners UCSF, MSU, NIVEL and Aarhus University.

Publications from Cristin

Funding scheme:

HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester

Thematic Areas and Topics

ArbeidPolitikk- og forvaltningsområderVelferdBransjer og næringerAnnen tjenesteytingAnvendt forskningDemokrati, makt og styringInternasjonaliseringInternasjonalt prosjektsamarbeidFNs BærekraftsmålMål 3 God helseLTP2 Fornyelse i offentlig sektorGrunnforskningPortefølje HelsePortefølje Velferd, kultur og samfunnPolitikk- og forvaltningsområderForskningFNs BærekraftsmålPolitikk- og forvaltningsområderHelse og omsorgFornyelse og innovasjon i offentlig sektorInnovasjonsprosjekter og prosjekter med forpliktende brukermedvirkningLTP2 Utenforskap, inkludering, kulturmøter og migrasjonPortefølje Industri og tjenestenæringerVelferdVelferdssamfunnets tjenester og organiseringFornyelse og innovasjon i offentlig sektorPolitikk- og forvaltningsområderVelferdVelferdVelferdssamfunnets kulturelle basis, bærekraft og oppslutningLTP2 Helse, forebygging og behandlingLTP2 Utvikle fagmiljøer av fremragende kvalitetLTP2 Demokrati, styring og forvaltningLTP2 Innovasjon i stat og kommuneFornyelse og innovasjon i offentlig sektorForskning for fornyelse av offentlig sektorUtviklingsarbeidHelsePortefølje LivsvitenskapLTP2 Styrket konkurransekraft og innovasjonsevneBransjer og næringerTjenesterettet FoULTP2 Fagmiljøer og talenterResponsible Research & InnovationLTP2 Et kunnskapsintensivt næringsliv i hele landetPortefølje Demokrati, styring og fornyelseInternasjonaliseringOrganisasjon og ledelseResponsible Research & InnovationRRI MedvirkningLTP2 Samfunnssikkerhet og samhørighetLTP2 VelferdstjenesterArbeidArbeidsliv