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How Welfare Professions Contribute to the Making of Welfare Governance: Professional Agency and Institutional Work in Elder Care

Published online by Cambridge University Press:  12 April 2021

KATHRINE CARSTENSEN
Affiliation:
DEFACTUM – Public Health & Health Services Research, Central Denmark Region, Aarhus, Denmark
VIOLA BURAU*
Affiliation:
Department of Political Science, University of Aarhus, Aarhus, Denmark, email: [email protected] Department of Public Health, University of Aarhus, Aarhus, Denmark
HANNE MARLENE DAHL
Affiliation:
Department of Public Health, University of Aarhus, Aarhus, Denmark
ANDREAS NIELSEN HALD
Affiliation:
Department of Political Science, University of Aarhus, Aarhus, Denmark, email: [email protected]
*
Corresponding author. Viola Burau, Department of Political Science, Bartholins Allé 7, DK-8000 Aarhus C, Denmark, email: [email protected]

Abstract

Welfare governance in elder care has undergone significant changes, but we know less about the processes and actors of making welfare governance. This is problematic, as the concern for process is a key strength of the welfare governance perspective. Based on a case study of elder care in Denmark, and drawing on studies of professions, the aim is to analyse how welfare professions contribute to the making of welfare governance. Our analysis shows that welfare professions bring unique resources into play. They have strong professional agency, drawing on both broader institutional roles and more specific professional projects. The institutional work itself is highly complex and the welfare professions combine not only formal and informal coordination, but also do so in ways that are closely tailored to specific contexts. The analysis makes important empirical and theoretical contributions to the study of welfare governance in elder care.

Type
Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Ackroyd, S. (2016), Sociological and organisational theories of professions and professionalism, in Dent, M., Bourgeault, I. L., Denis, J. L. and Kuhlmann, E. (eds.), The Routledge companion to the professions and professionalism, London: Routledge, 1530.Google Scholar
Allen, D. (2014), Re-conceptualsing holism in the contemporary nursing mandate: from individual to organisational relationships, Social Science and Medicine, 119, 131–8.CrossRefGoogle ScholarPubMed
Bertilsson, M. (1990), The welfare state, the professions and the citizens, in Torstendahl, R. and Burrage, M. (eds.), The formation of professions: knowledge, state and strategy. London: Sage, 114133.Google Scholar
Braun, V. and Clarke, V. (2006), Using thematic analysis in psychology, Qualitative Research in Psychology, 3, 77101.CrossRefGoogle Scholar
Breit, E., Andreassen, T. A. and Salomon, R.H. (2016), Modification of public policies by street-level organisations: an institutional perspective, Journal of Social Politics, 45, 4, 709728.Google Scholar
Brinkmann, S. and Kvale, S. (2015), InterViews: learning the craft of qualitative research interviewing, 3rd ed. Los Angeles: Sage Publications.Google Scholar
Brint, S. (1994), In an age of experts: the changing role of professionals in politics and public life, Princeton, NJ: Princeton University Press.CrossRefGoogle Scholar
Burau, V. (2016), Governing through professional experts, in Dent, M., Bourgeault, I. L., Denis, J. L. and Kuhlmann, E. (eds.), The Routledge companion to the professions and professionalism, London: Routledge, 91101.Google Scholar
Burau, V., Theobald, H. and Blank, R. H. (2007). Governing home care, a cross-national comparison, Cheltenham: Edward Elgar.CrossRefGoogle Scholar
Carey, M. A. and Asbury, J. E. (2012), Focus group research, Walnut Creek, California: Left Coast Press.Google Scholar
Clarke, J., Newman, J. and Smith, N. (2007), Changing publics and changing public services, London: Sage.Google Scholar
Cloutier, C., Denis, J.-L., Langley, A. and Lamothe, L. (2016), Agency at the managerial interface: public sector reform as institutional work. Journal of Public Administration Research and Theory, 26, 2, 259.CrossRefGoogle Scholar
Dahl, H. M. (2000), Fra kitler til eget tøj: diskurser om professionalisme, omsorg og køn, Aarhus: Aarhus Universitet.Google Scholar
Dahl, H. M., Eskelinen, L., and Boll Hansen, E. (2015), Coexisting principles and logics of elder care: help to selfhelp and consumer-oriented service? International Journal of Social Welfare, 24, 3, 287295.CrossRefGoogle Scholar
Daly, M. (2003), Governance and social policy Journal of Social Policy, 32, 1, 113128.CrossRefGoogle Scholar
Denis, J. L., van Gestel, N. and Lepage, A. (2016), Professional agency, leadership and organisational change, in Dent, M., Bourgeault, I. L., Denis, J. L. and Kuhlmann, E. (eds.), The Routledge companion to the professions and professionalism, London: Routledge, 215–27.Google Scholar
Dickinson, H. (2014), Performing governance: partnerships, culture and new labour, Basingstoke: Palgrave Macmillan.CrossRefGoogle Scholar
Doessing, A. (2018a), Formal and informal inter-organisational coordination: how nurses adapt in complex pathways, International Journal of Health Planning and Management, 33, 690703.Google Scholar
Doessing, A. (2018b), Sygeplejersker som ‘organisatorisk lim’ i sundhedsvæsenet: interorganisatoriske, professionelle og feminine perspektiver [Nurses as ‘organisational glue’ in the healthcare system: inter-organisational professionals and feminine perspectives], Aalborg: Aalborg Universitetsforlag.Google Scholar
Evertsson, L. (2000), The Swedish welfare state and the emergence of female welfare state occupations, Gender, Work and Organization, 7, 230–41.CrossRefGoogle Scholar
Fleming, S. S. and Osborne, S. (2019), The dynamics of co-production in the context of social care personalisation: testing theory and practice in a Scottish context, Journal of Social Policy, 48, 671–97.CrossRefGoogle Scholar
Hammersley, M. and Atkinson, P. (2007), Etnography: principles in practice, 3rd. ed., London: Routledge.Google Scholar
Hayes, L. J. B. and Moore, S. (2017), Care in a time of austerity: the electronic monitoring of homecare workers’ time, Gender, Work and Organization, 24, 329–44.CrossRefGoogle Scholar
Henriksson, L., Wrede, S. and Burau, V. (2006), Understanding professional projects in welfare service work: revival of old professionalism?, Gender, Work and Organization, 13, 174–92.CrossRefGoogle Scholar
Hjörne, E., Kirsi, J. and van Nijnatten, C. (2010), Negotiating practices of street-level welfare work, International Journal of Social Welfare, 19, 303–9.CrossRefGoogle Scholar
Järvinen, M. and Mik-Meyer, N. (2012), At skabe en professionel: ansvar og autonomi i velfærdsstaten [To create a professional: responsibility and autonomy in the welfare state], Copenhagen: Hans Reitzel.Google Scholar
Jessop, B. (1999), The changing governance of welfare: recent trends in its primary functions, scale, and modes of coordination, Social Policy and Administration, 33, 4, 348359.CrossRefGoogle Scholar
Knoben, J. and Oerlemans, L. A. G. (2006), Proximity and interorganizational collaboration: a literature review, International Journal of Management Reviews, 8, 7189.CrossRefGoogle Scholar
Kuhlmann, E. (2006), Modernising health care: reinventing professions, the state and the public, Bristol: Policy Press.Google Scholar
Lewis, J. and West, A. (2014), Re-shaping social care services for older people in England: policy development and the problem of achieving ‘good care’, Journal of Social Policy, 43, 118.CrossRefGoogle Scholar
Lipsky, M. (1980), Street-level bureaucracy: dilemmas of the individual in public services, New York: Russell Sage Foundation.Google Scholar
Madsen, S. B. and Burau, V. (2020), Relational coordination in inter-organizational settings: How does lack of proximity affect coordination between hospital-based and community-based healthcare providers? Journal of Interprofessional Care, DOI: 10.1080/13561820.2020.1712332.CrossRefGoogle Scholar
Madsen, S.B., Beedholm, K., Bro, F., Døssing, A., Ledderer, L.K., Vestergård, L.O., and Burau, V. (2020), Implementing integrated community-based primary healthcare: spplying the iCoach-approach to case selection to Denmark, International Journal of Integrated Care, 19, 4, A3.CrossRefGoogle Scholar
Maxwell, J.A. (2013), Qualitative research design: an interactive approach. 3rd ed., Thousand Oaks, California: Sage.Google Scholar
Mik-Meyer, N. (2018), Organizational professionalism: social workers negotiating tools of NPM, Professions and Professionalism, 8, e2381.CrossRefGoogle Scholar
Moberg, L. (2017), Marketisation of Nordic eldercare: is the model still universal?, Journal of Social Policy, 46, 603–21.CrossRefGoogle Scholar
Moberg, L., Blomqvist, P. and Winblad, U. (2018), Professionalized through audit? Care workers and the new audit regime in Sweden, Social Policy and Administration, 52, 631–45.CrossRefGoogle Scholar
Moe, A. and Brataas, A. V. (2016), Interdisciplinary collaboration experiences in creating an everyday rehabilitation model: a pilot study, Journal of Multidisciplinary Healthcare, 9, 173182.CrossRefGoogle ScholarPubMed
Muzio, D. and Kirkpatrick, I. (2011), Introduction: professions and organisations – a conceptual framework, Current Sociology, 59, 389405.CrossRefGoogle Scholar
Muzio, D., Brock, D. and Suddaby, R. (2013), Professions and institutional change: towards and institutionalist sociology of professions, Journal of Management Studies, 50, 699721.CrossRefGoogle Scholar
Newman, J. (2001), Modernising governance: New Labour, policy and society, London: Sage.CrossRefGoogle Scholar
Newman, J., Glendinning, C. and Hughes, M. (2008), Beyond modernisation? Social care and the transformation of welfare governance, Journal of Social Policy, 37, 531–57.CrossRefGoogle Scholar
Petersen, A., Graff, L., Rostgaard, T., Kjellberg, J. and Kjellberg, P. K. (2017), Rehabilitering på ældreområdet. Hvad fortæller danske undersøgelser os om kommuners arbejde med rehabilitering i hjemmeplejen? [Rehabilitation in elder care: what do Danish studies tell us about the municipalities’ work with rehabilitation in home care?] Sundhedsstyrelsen. KORA.Google Scholar
Ranci, C. and Pavolini, E. (2012), Reforms in long term care policies in Europe: investigating institutional change and social impacts, New York: Springer.Google Scholar
Strandaas, M., Wackerhausen, S. and Bondas, T. (2019), Gaming the system to care for patients: a focused ethnography in Norwegian public home care, BMC Health Services Research, 19, 115.CrossRefGoogle Scholar
Sundhed og Omsorg (2018), Forløbsmodellen trin for trin. [The Care Pathway step by step] Sundhed og Omsorg, Aarhus Kommune.Google Scholar
Szebehely, M. and Meagher, G. (2014), Four Nordic countries – four responses to the international trend of marketization, in Meagher, G. and Szebehely, M. (eds.), Marketization in elder care, Stockholm University: Department of Social Work.Google Scholar
Sørensen, E. and Torfing, J. (2017), Offentlige frontlinjemedarbejdere. Responsive brobyggere som alternativ til regelsfølgende omsorgsgivere og incitamentsstyrede lønarbejdere [Public frontline employees: responsive bridge-builders as alternative to rules following caregivers and incentive driven employees], in Torfing, J. and Traintafillou, P. (eds.), New public governance – på dansk, Copenhagen: Akademisk Forlag, 121–38.Google Scholar
Torfing, J., Andersen, L.B,. Greve, C. and Klausen, K.K. (2020), Public governance paradigms: competing and co-Existing, Cheltenham: Edward Elgar.CrossRefGoogle Scholar
Wallenburg, I., Weggelaard, A. and Bal, R. (2019), Walking the tightrope: How rebels “do” quality of care in healthcare organizations, Journal of health organization and Management, 33, 7/8, 869883.CrossRefGoogle Scholar
Yin, R. K. (2017), Case study research: design and methods (6th edn.), Thousand Oaks, CA: Sage.Google Scholar