Unbenanntes Dokument

1 Introduction

This article is based on three processes of change connecting to two studies, where the main focus has been on changes in the social care services for older persons in Sweden. One study had its focus on the care manager reform and its diffusion, while the other investigated into the logic of prioritizing within the social services. We argue that changes that took place reflect a general trend in the transformation of the welfare state. The processes of change indicate a transition from a “moral” to an “administrative” welfare regime. This implies that the essence of social policy, i.e. the articulation of values and principles (see for example Drake, 2001), becomes embedded in the sphere of administrative practices rather than in the sphere of policy formation and outcome. The shift from the policy level further implies the de-politization of the welfare state and a move towards a focus on administrative techniques in the shade of managerialism. The role of managerialism has been highlighted by many researchers, but in this article it is our aim to contribute to a broader understanding of change as well as to underline the potential for understanding the modern welfare state through the three specific processes of change.

2 Reforms and new organizational ideals

On a general level, changes in the social care services for older people in Sweden during the 1990s is linked to the decentralization of the welfare state and altered organizational ideals. With regard to the care for older people, a number of reforms during the 1990s contributed in different ways to a shift in the responsibility for welfare delivery from the state (national level) towards a greater reliance on the local municipalities (Blomberg et al, 2000). The breaking up of the public monopoly of production of welfare services and the possibility of freer forms of organization within the public administration are examples of reforms that have created new conditions for and contributed to the development of new forms of organizing, controlling, and steering within the municipal administrations (Blomqvist, 2004). In a reflection on the organization of the welfare state, Premfors (1998) has also argued that the development can be characterized as a trend towards increased independence/autonomy amongst those organizations that together make up the public sector (i.e., the state). Further, during the 1990s, public administrations were increasingly forced, or chose to regard themselves as free-standing organizations (Brunsson and Sahlin-Andersson, 1998; Premfors, 1998). This opened up for differences in priorities and outcomes in municipalities. However, as will be discussed later in this paper, difference was not to become the general trait in the organization of social care services for older people in Sweden. The three processes (or layers), besides giving a key role to the administrative sphere, in different ways also represent converging forces as to intentions and outcomes.

This renewal and change of welfare production in Swedish municipalities is closely connected to an international trend (i.e., new public management [NPM]). With its focus on developing new and more effective forms for the organization of public sectors and management, NPM has since the beginning of the 1980s dominated the reform agendas in many of the Western industrialized nations (Hood, 1995; Christensen and Laegreid, 1996; Blom, 2001; Pollit and Bouckaert, 2004). Contracts, competition, and management/control make up the three core elements in NPM (Vabö, 2005). In different ways, they were made concrete in the organizational changes that took place also within the care of older persons in Sweden from 1990s and onwards (Blomberg, 2004). The impact of management ideas in the municipal care of older people is more abstract, but is in line with the notion that administrations should (and could) be managed as any company on a market (Bejeroth and Hasselbladh, 2002; Petersson, 2006).

In this paper we will connect to the last of the core elements presented, i.e. the process in which the administrative practices adapt to new ideas of managerialism. In the extension, administrative practices are highlighted in the welfare provision and argued to become a key element in understanding the logics behind welfare regimes. It implies a move away from the political level and ideology to bureaucratic norms surrounding the assessment of needs and their delivery. We argue that this development comes about through interplay between driving forces working both on an organizational and political level, as well as through local and global mechanisms. In general this development is characterized as a passive adaption rather than a matter of active choice.

3 Methods and materials

Two studies will serve as the empirical base for our argumentation. The first is an analysis of the diffusion of the care manager reform in Sweden (Blomberg, 2004). The second is also a study conducted in Sweden, on how priorities are formed within the social services (Petersson, 2006). Both studies had the social care services for older persons as its main study object, but connected it to a broader perspective on local welfare policy when studying particular aspects. Both studies were further conducted in the same eight Swedish municipalities and as parallel investigations could be viewed as collective case studies (Stake, 1993; Yin, 1994). The case study design matched the formulation of research questions in terms of How? and Why? It was preferable due to the fact that the phenomenon of interest in the study represents an uncontrolled course of events (i.e., a process) and the case study design allows for a study of that process in its real context. Thus, a collective case study will generate rich over-all information of the phenomenon of interest, such as the implementation of the care manager reform, as well as more detailed knowledge and insights about that phenomenon from a number of different local contexts. Obviously, a case study cannot serve as a basis for empirical generalizations. But, and this is a very important point, the knowledge and insights that a case study produces could be generalized analytically in relation to the overriding purpose of the study and/or theoretical reasoning.

Table 1: Municipalities studied

Municipality

Number of inhabitants

Implementation of the reform (year)

Local political majority at the time of implementation (right wing/left wing and the dominating coalition party) [a]

Helsingborg

119 300

1993

Right wing coalition. The conservative party

Gislaved

30 000

1993

Right wing coalition. The conservative party

Ludvika

26 000

1997

Left wing. The social democratic party had its own majority

Sunne

13 600

1998

Right wing coalition. The centre party, a party with its roots in the political organisation of farmers

Gävle

91 300

1999

Left wing coalition. The social democratic party

Hagfors

13 800

2000

Left wing coalition. The social democratic party

Kristianstad

74 900

1997- 2001

Right wing coalition. The conservative party

Lund

100 500

2001

Right wing coalition. The conservative party

[a] In Sweden, left wing in practice means that the social democratic party governs in coalition with the left party (socialists) and sometimes the environmental (green) party or in rare occasions by own majority. Contrary to the tradition on the national level, social democratic minority governments are rare at the municipal level. Right wing local government means, in practice, a coalition of several parties often with the conservatives as the largest and thus the dominating party. Coalition partners are foremost found among the liberal party, the centre party, and the Christian democratic party.

As shown in the chart, the municipalities studied implemented the care manager reform at different points in time. They also differed with respect to the number of inhabitants, socioeconomic structure, and geographic location. Decisions to implement the care manager reform were taken under the left wing local government, as well as the right wing local government. Those differences were, however, not strategically chosen independent variables in the selection of municipalities, but the observation was not trivial and was useful in the analysis.

These differences were also used in the study of how priorities in the social services are formed. In the analysis used in that study there were no claims for empirical generalizations due to the small number of cases. However, differences and similarities that showed up were carefully examined. In the case where different municipalities behaved similar there were tendencies that could be perceived to have a congruency that pointed to a common development and views, the pattern of which were analyzed. The main examination in this study, to sum up, was to understand why different municipalities behaved similar as well as why similar municipalities behaved differently. The general conclusion was that there was a strong case for the convergent forces in the study.

The empirical material in the studies consisted of strategic interviews and documents. Extensive interviews (n= 89) were held with the local actors involved in the implementation, such as politicians and public servants at different positions in the local administration, e.g., heads of the administration of care services for older people, care managers, and union representatives for the occupational groups involved (i.e., care keepers and assistant nurses, nurses, and civil servants). The composition of respondents was the same in all municipalities. Semi-structured interviews were conducted face-to-face and recorded on a mini-disc. The interviews lasted between 60 and 90 minutes and were all transcribed. The idea behind the low level of structure was to make the respondents themselves present their experiences and perspectives. Though an interview guide was followed, additional questions for validation and clarification were asked (Kvale, 1997).

The studies were also based on documents consisting of official local documents, for example budgets, annual reports, goal formulations, protocols from the municipal council and committees, as well as documents produced within or by initiative of the administration of care services for older people. The latter were mainly documents that had been referred to in the interviews, for example, local investigations, consultant reports, evaluations, PMs, and other written material connected to the initiation, discussion, and implementation of the reform.

4 The local diffusion of the care manager model

Blomberg (2004, 2008) put a focus on the diffusion of a new organizational model within the social care services for older people i.e. the care manager reform. In the traditional organization of care for the elderly, needs assessment and provision of care (the actual care work done and the supervision of that work) were integrated functions in a single occupational role. The new model implied a split of assignments, i.e. a new division of labour and a specialization of occupational roles within the municipal administrations. The take-over time profile in the studied municipalities corresponds to different problematizations or discourses concerning the advantages of the model. This is summed up in figure 1.

Figure 1: Characteristics of the implementation discourses  [2]

Implementation Apprehension of Status of the reform in the

discourse the reform context of overall change

 

Market orientation

 

Necessary

 

Indirect

 

Legally correct practice

 

Desirable

 

Direct

 

Cost-efficiency (NPM)

 

Instrumental

 

Indirect

 

Organizational fashion

 

Keep up with time

 

Direct

The first discourse of market orientation is an ideological (neo-liberal) discourse of economic reform, which implies an adjustment of the elderly care system to allow for market provision of care i.e. a quasi-market reform (Le Grand 1993), which in turn requests a purchaser-/provider split. The reform was in this early stage incorporated by those municipalities that had started to break up the public monopoly of provision. These municipalities were generally politically dominated by right wing/liberal majorities. Among municipalities that were characterized by social-democratic majorities, this line of argumentation had no support in favouring the incorporation of the reform. The care manager reform becomes an indirect and necessary component in this new market orientation.

In a second step, the arguments in favour of care management were connected to a discourse of creating a legally correct practice. This attracts some municipalities to incorporate the reform on its own ascribed merits, also favoured by left-wing politicians. It cleared the way for the second wave of incorporation and re-directed the arguments in favour of the reform from the ideological sphere to the realm of administrative considerations.

In the third phase the specialization was presented as a way to be more economically efficient and making stricter application of the rules in the assessment of needs, i.e. a cost-efficiency discourse. This meant that model was connected to economic arguments within the reform agenda of New Public Management. One could say that market style management sneaked in the back door as part of becoming a more efficient organization but with arguments that were ripped off its ideological connotations.

In the last phase, the reform had become the predominant model of organization. The care manager model had been established as a modern, effective, and thus as a rational principle of organization that no longer could be questioned – had become an organizational fashion.

5 Why different municipalities become similar – the first layer

We should bear in mind that the essence in a diffusion process is a logic of becoming similar with others, a process of convergence. Now, a neo-institutional analysis can provide theoretical support and shed light on processes of diffusion. Firstly, the notion of isomorphism (DiMaggio and Powell, 1991/1983) becomes central. Isomorphism (structural similarity) is an effect of a strive for legitimacy. Organizations within a common organizational field become increasingly similar as a consequence of their search for legitimizing formal structures among institutions they are dependent on and would like to be compared with. Within this line of thought, organizational change is seen as a passive more or less deterministic adaption to institutional pressures in the surrounding society.

Secondly, the process of incorporation also conforms to the claim from the neo-institutional perspective, that organizational change should be understood as a process, where a solution i.e. organizational models, looks for problems to underpin it, rather than as in the traditional rational choice approach, where the opposite is believed to occur ( i.e. problems seek solutions). In our example it is obvious that the diffusion of the care manager reform is propelled by a continuous ascription of different and new problem-solving features within the laps of time.

We claim that this process of diffusion connects to a more general trait of the modern welfare state, focusing on the legitimacy issue of the administrative practices within the welfare state. It is difficult to withstand fashions that are travelling around. It is easier to take up than resist, especially when there is openness for formulating a variety of discourses that support claims for reformation as in the case studied. To look like others, also makes one feel safe and modern (Furusten and Lerdell 1998). Rövik (1998) claims, that the incorporation of what he calls “super standards” is a feature of being or becoming a modern organization.

The impact of the study is that we witness a move from goals and aims of social programs towards the use and benefits of administrative techniques. The process of diffusion has so far been examined in a local setting but can however also be connected to a broader understanding i.e. through examining the perspective of globalization.

6 Organizing in a global context

The notion of globalization has become a feature of the modern world that has to be recognized in almost every sphere of transformation of societies - also in social policy. Globalization can be viewed as a complex totality, but it is also possible to look at some of its specific aspects. We will do the latter. Beck (2000) talks of it in terms of globalism, which identifies the economic aspects. The story is that economic forces have become transnational to an extent we have not experienced before. These economic forces make demand for national transformation to adapt to the general economic reforms of free competition and efficiency, bypassing the national political level.

In this process there are transmitting forces. Altogether the working of these transmitting forces can be characterized as a process of convergence and a pressure for conformity on national policies. It should be seen that it also works within countries. Also on this level, there exist “... a number of mediators of reform ideas and experience such as organizations, consultants and publications” (Sahlin-Andersson, 2000, 3).

In this aspect of globalization, New Public Management (NPM) can be identified as an overall reform agenda for the public sector. NPM “… consists of a cluster of ideas borrowed from the conceptual framework of private sector administration practices” (Power 1997, 43). In this process of claim for change the notion “best practice” has become a key notion. Best practice has a number of determining points. It asks for evidence of the performance of social programs to be used. Evaluation becomes a key concept. Best practice also involves reaching goals at lowest costs. Another key concept is “bench-marking” which looks even more closely to the efficient use of resources. Bench-marking aims at creating an awareness of how “alike” actors behave in terms of the use of means i.e. resources. In the Swedish case, social authorities serve local welfare administrations by providing “twin” units which have the same characteristics as to demographic structure, size, taxes etc. Another concept that sets focus on the use of resources and procedures in authorities is systems of quality assurance. The most prominent is Total Quality Management (TQM). But as Tuckman (1995) concludes, the name is a bit confusing since TQM is basically not an evaluation of the quality of a product (the term comes from industrial processing), but of practices and procedures of manufacture and provision. Brought together, these components direct public bodies to focus on means, i.e. resources/procedures, and less on goals/outcome. This is another way of observing that the political sphere (goal formulation) is weakened and administrative considerations (means used) are strengthened in the public sector.

There is another aspect to this development which can be connected to Michael Power’s discussion of the “Audit Society”. The audit society proclaims new and distinct forms of documentation. Documentation is crucial in a development that is characterized by a new steering/control model. Instead of relying on inspection top-down, this practice claims for proof of accountability from the bottom-up. The term “excellence“ becomes the attainable idea and should be coined by the organization itself.

The essence of the audit society is found in a weak form of steering from above. Thus, it is related to governance rather than government. Governance as notion is closely linked to this new form of steering and control since, as Power concludes, it is characterized by a “…increasingly prominent role for internal control systems” (Power 1997, 41-42). In relation to governmental demands these new control systems create, in a Foucauldian way, a form of self-disciplinary practice (Petersson, 2006). Much pressure is set on the local welfare administrations to explain why they are different from their “alikes”.

To sum up, governments have lost capacity to steer but have instead created new forms of control. In this process a weakened steering is exchanged for enhanced control.

7 Why different municipalities become similar – the second layer

In his study of how priorities are formed within the local social services, Petersson (2006) observes how the new steering and control systems are practiced by local administrations. He finds that comparisons with other municipalities are an important element when decisions on the welfare services are taken. What the comparisons deal with is a rather one-sided inspection of costs, i.e. the means used become the primary target for investigations, while goals come in as a secondary consideration. One example of this logic was evident in an attitude survey of how citizens apprehend different public services, conducted in one of the municipalities studied. The result that was analyzed by an independent consultative body showed a discontent with the social care services for older people. The consultants made the point that this was nothing to worry about since discontent with these services are present in most other municipalities. This is one of the elements that underpin a conclusion that the focus on goals is exchanged for a focus on means. There is generally no defence of goals and greater ambitions and advantages of this in relation to others, but a focus on higher costs and its disadvantages. This means that there exists a rhetoric of cutting down rather than expanding welfare, that is hidden in this new systematic comparative routine. The ideological side is downplayed. Petersson talks of a new administrative welfare regime emerging on the expense of a moral (or ideological) welfare regime. This leads to the observation that symbolic rationality and instrumental rationality no longer represents separate logics. Rather, the instrumental means oriented measures become the symbols for a successful and legitimate social welfare administration. Comparison of means used is the mechanism that creates similarity on this level.

8 The third way agenda

The recognition of globalization and the creation of a modern society are advocated by neo-liberals. As a consequence, they are strong protagonists for reforms associated with NPM, and argue for the limitation of government influence in steering national development. Summing up, Hirst and Thompson (1998) maintain that “globalization has reduced the capacity of states to act autonomously on their societies” (p. 263). Some neo-liberals even argue that there is no such thing as society, meaning that there is very little space for collective actions and public arrangements. The idea that the role of politicians should be restricted is underpinned by neo-classical economists drawing on public choice theory and its critique of politicians (Buchanan and Tullock 1962). This theory brings the idea of rational choice – a cornerstone in the theory both as an explanatory and normative device – into the political sphere. Taken together, politicians maximize votes and are neither at the service of the public nor skilled enough to represent it. The fusion of neo-classical economics and neo-liberalism has paved the way for a welfare policy centred on individualization, privatization and fragmentization.

On the political centre-left, the idea of modernization has been brought forward in the form of third way politics. This was initially a Clinton idea, but much more strategically practiced by New Labour in Britain, which had Tony Blair as the political portal figure and Anthony Giddens as the scholarly thinker. Arguments are centred on community, opportunity, responsibility and accountability (Le Grand 1998), or responsibility, inclusion and opportunity (Lister 1998) as two among many alternative descriptions (Lewis 2004). The Le Grand vocabulary shows resemblance with doctrines connected to NPM. Modernization became also in this political reform agenda tied to marketization (Mooney, 2001). While neoliberalism uses ideology to shape practice, third way social democracy is letting administrative reform de-ideologize policy. In this way managerialism is dubious “… because it can hide genuine differences in ideology and political value” (Cutler and Waine 1994, 141). This implies that politicians hide behind bureaucrats, leaving norms to them rather than taking ideological stands on moral issues (cf. Evens and Harris 2004).

9 Why different municipalities become similar – the third layer

The first and the second layers are both located on a local level and together they enhance tendencies towards similarity. The process is interactive and focusing on problems as administrative rather than ideological. Now, this process is further boosted by development on a national and international political level as described above. This reduces the political influence in exchange for the focus on administrative logic (linked to managerialism and marketization) through a process of de-politization .

10 Conclusions – implications for social work and social policy

In this article we have described three different processes of change with examples taken from the social care services for older persons in Sweden. They all point to a common direction of change - not clearly seen, when these processes are studied separately. When looked upon as supportive and complementary trends, they turn out as three layers of reinforcing change that help to understand why administrative practice has become such a dominant feature in the re-shaping of the welfare state. Further, as we argue in this ending paragraph, due to this it becomes a key to understand and describe differences and similarities in welfare regimes.

The implications for social work lies in the stricter regulation of needs assessment and delivery of services, reflecting the importance of cost containment connected to NPM. An administrative practice characterized by standardization and formalization is developed, resulting in a limited possibility for a flexible handling of the individual case. In its extension, an interactive process between the street-level bureaucrat and the client is exchanged for a categorization of clients based on municipal pre-determined guidelines, i.e. interaction is replaced by a one-sided application of rules. Paradoxically, social rights are strengthened at the same time as the social citizenship is weakened, since the social rights become more transparent but the defining of individual need now to a larger extent rests in the hands of bureaucrats (Blomberg and Petersson, 2007).

Emphasizing the administrative side of welfare policy is of course not new. It is at heart of the critique formulated by for Tom Bottomore (1992) against T.H Marshall, i.e. that one has to look at the substantial level rather than the formal in getting a grip on social rights. It is also in line with Robert Pincer’s critique of Richard Titmuss on the essence of stigmatization (Pinker, 1971). From his perspective, stigmatization does not originate in social interaction, but is already shaped at the encounter with the administration. However, our message here has a more profound ambition in lifting the administrative level to become the starting point in the analysis of social policy and worlds of welfare regimes.

As to the implications for social policy, scope and focus are no longer reflecting values and principals located at the political level. Instead, administrative considerations related to costs in comparison with others form the goals and aims for social policy in municipalities. Restriction replaces ambition. This transformation in the welfare state, might further shed light on what we mean is a change of position for values and principles in social policy. Referring to experiences from our empirical findings in Sweden, these have moved out from the policy level to the level of administrative practices. Today, the focus on the perception and reception of citizens and the articulation and visualization of the values underpinning care work are examples reflecting this change in the Swedish case.

What does this analysis tell us concerning the conceptualization of welfare regimes and in particular to that of Esping-Andersen (1990)? We argue that there is a need for new parameters to focus on, which will distinguish countries (or clusters of countries) with the administrative practice approach. The key operational notion in the Esping-Andersen regime construction is degree of de-commodification, both as intention and outcome. Moving to the administrative sphere, we suggest that major differences are better understood through introducing the notion of degree and form of discretionary practice. This concept could serve as a device to examine a range of welfare provisions and serve as the starting point when distinguishing differences between welfare service provision in one country as well as between countries (or regions). We meen that he administrative practices of discretion are formed on a scale of authoritarian (top-down), responsive (formed in a dialogue) or user driven (bottom-up). As an example of a new responsive model we have introduced the “negotiated rights model” as a description of the discretionary practice connected to the socio-psychiatric field in Sweden, where two representatives, one on behalf of the user and one on behalf of the organization negotiate the rights (Järkestig Berggren, Blomberg and Petersson forthcoming).

What become indicators in the approach we suggest? One important part in the creation of difference is the legislative structure, i.e. the composition between frame-work versus rights law constructions. Another is the competence requirements on professionals (connected to education systems). Further, essential components of administrative practices are thresholds for entrance, division of responsibilities, custodial or non-custodial systems etc. Such components allow for the construction of multi-dimensional indexes or specific focuses to be used in the classification of welfare regimes and the construction of such typologies.

With these reflections we end our quest for change of paradigm in distinguishing welfare regimes.



[1] This article fetches some main arguments from a paper presented at the International conference ”Transforming elderly care at local, national and transnational levels” at the Danish National Centre for Social Research (SFI), 26-28 June 2008, , Copenhagen, Denmark.

[2] From Blomberg (2008)

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Author´s Address:
Staffan Blomberg
FD, Universitetslektor
School of Social Work
Lund University
Gula huset, Bredgatan 15
SE - 221 00 Lund
Sweden
Tel: ++46 046-2223162
Email: Staffan.Blomberg@soch.lu.se

Professor Jan Petersson
Department of Social Work
Linné University
Georg Lückligs väg 8
SE-351 95 Växjö
Sweden
Tel: ++46 480-44 67 03
Email: jan.petersson@vxu.se

urn:nbn:de:0009-11-26936