| 1. |
- Hollertz, Katarina, 1974, et al.
(författare)
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Den transparenta organisationen. Handläggaren och visibilitetskulturen i Försäkringskassan.
- 2017
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Ingår i: Socialvetenskaplig tidskrift. - Växjö, Sweden : Förbundet för Forskning i Socialt Arbete. - 1104-1420 .- 2003-5624. ; :3-4, s. 239-260
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Tidskriftsartikel (refereegranskat)abstract
- The expansion of ”audit culture” in public sector governance is well documented, including its implications for caseworkers whose performance is constantly monitored. Transparency is an inherent part of the audit culture, yet there are fewer studies researching how the ideal of the transparent organization plays out in everyday life in welfare bureaucracies. Drawing on ethno-graphic research in five local offices of the Swedish Social Insurance Agency, this article investigates how the transparency ideal is enacted on an everyday basis in this agency. The analysis reveals how the transparency ideal penetrates the organizational life in a much more pervasive way than is usually acknowledged in the audit society literature. Special attention is given to the relevance of a horizontal dimension of transparency. It is argued that the horizontal dimension of transparency is a central aspect in relation to goal achievement and the normative governance of the caseworkers. However, even if the transparency ideal is central to the internal organizational life of the Swedish Social Insurance Agency, transparency is much less salient in relation to clients and the outside world. The article explores this organizational regime of visibility, as established in every-day social interaction as well as in organizational routines.
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| 2. |
- Hollertz, Katarina, et al.
(författare)
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Organizational Governance of Activation Policy : Transparency as Organizational Ideal in the Everyday Life of a Welfare Agency
- 2017
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Ingår i: New Horizons of European Social Policy.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- A critical task of sickness insurance policy in most Western welfare states during recent decades has been to reduce the economic burden on society due to sick leave, by stimulating and enforcing labour market participation. In Sweden, strong activation requirements have been implemented in the health insurance in the past decades. Currently, this orientation is reflected in the politically set objective to reduce the sickness absence rate in Sweden; the center-left government in 2016 stated that “the sickness benefit rate may not exceed 9.0 days per individual and per year in 2020”. Furthermore, it was stressed that “newly granted disability pension shall not exceed 18 000 per year during the period 2016-2020”. In achieving these targets, the Swedish Social Insurance Agency (SSIA) and their frontline staff have a key role. This paper explores the organizational mediation of ’welfare to work’ policy by investigating the organizational governance and modes of operating set in place in local SSIA offices in order to fulfill the political objectives and reach these targets. More specifically, the paper focuses on one dimension of the local governance of ’welfare to work’ policy, namely the role that transparency plays in the alignment of frontline staff with the normative regime of the agency as well as its effects on caseworker subjectivity. The paper is based on an ethnographic study consisting of participant observations (mainly at work meetings with caseworkers, managers and insurance physicians/specialists) and qualitative interviews in the SSIA head office as well as five local offices. In total 57 interviews have been conducted and 37 meetings observed during 2015-17. Inspired by institutional ethnography (D. Smith) as well as ethnomethodology, the paper conceives of institutional settings as creating specific environments for the management of responsibility and accountability. Transparency is here key.The paper shows how the transparency ideal is an integral part of the organizational governance in the agency, and implemented through tools, technologies, infrastructures, teamwork, and socio-spatial governance. The analysis reveals how the transparency ideal penetrates the organizational life in a much more pervasive way than is usually acknowledged in the ’audit society’-literature (following Power 1997), colouring not only case management but also the relations between colleagues and between management and staff. As an internalized ideal, transparency affects caseworker subjectivity, lending the welcoming of audit as a way to self-improvement along with the improvement of organizational performance. However, transparency is much less salient in relation to clients and the outside world. Thus this everyday regime of visibility, as established in social interaction as well as in organizational routines, is at the same time part of an organizational politics of visibility designed to facilitate the organizational performances and the smooth implementation of welfare-to-work policies in the health insurance.
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| 3. |
- Hollertz, Katarina, 1974, et al.
(författare)
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Organizational governance of activation policy: Transparency as an organizational ideal in a Swedish welfare agency
- 2018
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Ingår i: International Social Security Review. - : Wiley. - 0020-871X .- 1468-246X. ; 71:4, s. 71-89
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Tidskriftsartikel (refereegranskat)abstract
- The Swedish Social Insurance Agency (Försäkringskassan – SSIA) and its frontline staff have a key role in the implementation of activation policy. Drawing on ethnographic research conducted at local offices, this article investigates how the transparency ideal, as an integral part of the organizational governance of the activation policy, is negotiated and enacted in the everyday life of a welfare bureaucracy. The analysis shows the central role that the transparency ideal plays in the alignment of frontline staff with the normative regime of the agency. While the transparency ideal is central to the internal organizational life of the SSIA, the analysis shows how transparency is much less salient in relation to clients and other relations with the outside world.
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| 4. |
- Jacobsson, Kerstin, et al.
(författare)
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Följsamhet som styrningsideal hos Försäkringskassan - ett hot mot rättssäkerheten?
- 2019
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Ingår i: Socialmedicinsk Tidskrift. - 0037-833X. ; 96:5, s. 682-689
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Tidskriftsartikel (refereegranskat)abstract
- Baserad på en etnografisk studie av styrningen av handläggarna inom sjuk-försäkringen reser denna artikel ett antal kritiska frågor om konsekvensernaav den informella styrningen inom Försäkringskassan. Trots självbilden aven formell organisation som fattar ”korrekta” beslut i försäkringsärenden vi-sar studien att den informella styrningen – genom sociala normer, grupptryckoch legitimerande organisationsberättelser – är påtaglig i det dagliga arbetetoch riskerar leda organisationen i en annan riktning är den parlamentarisktbeslutade. Artikeln påtalar att följsamhetsnormen och duktighetskultureninom myndigheten riskerar hota – och inte stärka – rättssäkerheten
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| 5. |
- Jacobsson, Kerstin, 1966, et al.
(författare)
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Street-level bureaucrats under new managerialism : a comparative study of agency cultures and caseworker role identities in two welfare state bureaucracies
- 2020
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Ingår i: Journal of Professions and Organization. - : Oxford University Press (OUP). - 2051-8803 .- 2051-8811. ; 27:3, s. 316-333
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Tidskriftsartikel (refereegranskat)abstract
- Officials in welfare state bureaucracies face the challenge of negotiating their role identities in the context of changeable organizational priorities and managerial styles. Previous studies have found that the professional values may mediate top-down demands and enable the preservation of professional autonomy also under public management reforms. But how do street-level bureaucrats who lack a common professional or occupational training respond to shifting organizational demands? Based on comparative ethnography, the present article investigates how caseworkers’ role identities are conceived and practised in two of the largest state bureaucracies in Sweden, the Social Insurance Agency (SIA) and the Public Employment Service (PES). The article identifies two radically different agency cultures, resulting in rather opposite caseworker role identities. These role identities affect how front-line staff respond to organizational demands, either by focusing externally on client-related outcomes (PES) or internally on organizational output (SIA). The analysis suggests that agency culture may shape caseworker responses to governance in patterned ways, also in the absence of joint professional training or strong occupational communities.
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| 6. |
- Kallemose, Thomas, et al.
(författare)
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Political trust in the handling of the COVID-19 pandemic: a survey in Denmark and Sweden
- 2023
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Ingår i: BMC Global and Public Health. - : BioMed Central (BMC). - 2731-913X. ; 1:12
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe initial responses to the COVID-19 pandemic in Denmark and Sweden differed markedly. Balancing disparate concerns was crucial to generate trust in the COVID-19 restrictions. The aim was to investigate the extent to which there was trust in the handling of the pandemic by the Danish and Swedish governments and public health authorities in each country. A further aim was also to investigate the characteristics of those in Denmark and Sweden who expressed the lowest degree of trust.MethodsCross-sectional surveys were conducted in 2021, using web panels that are nationally representative of the socio-demographic characteristics. The population consisted of 2619 individuals from Denmark and 2633 from Sweden, representative of the age, sex and region of residence of the populations aged ≥ 18 years. Trust in government and health authorities was captured in two separate trust questions on a 5-point Likert scale and dichotomized into low trusters and non-low trusters for analysis.ResultsApproximately, 61% of the Danish respondents expressed moderately large or very large trust in the government’s handling of the pandemic. The corresponding proportion for Sweden was 42%. The proportion of low trusters was 11% in Denmark and 34% in Sweden (p < 0.001). Moderately large or very large trust in the public health authority’s handling was expressed by 83% of the Danish respondents and 74% of the Swedish respondents. The proportion of low trusters was 5% in Denmark and 17% in Sweden (p < 0.001). In both countries, trust was lower among men than among women. Age and education were associated with trust but differed between countries (p < = 0.011).ConclusionsIn this study, differences in trust between Denmark and Sweden and both overall and within socio-demographic factors were observed. However, given the limitations and bias in the study, it is difficult to determine the cause and true size of these differences. With that in mind, we still believe specific populations and subgroups within those populations have the potential to affect trust in handling of the COVID-19 pandemic, and that these should be kept in mind when developing and communicating responses to pandemics.
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| 7. |
- Karlsson, Elin, 1985-, et al.
(författare)
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Communication characteristics between clients and stakeholders within the Swedish sickness insurance system : a document analysis of granted and withdrawn sickness benefit claims
- 2020
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Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 42:23, s. 3316-3326
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this study was to investigate how communication within the Swedish sickness insurance system differs between cases of sick leave and how this may affect clients’ cases.Materials and methods: This was a document study using 30 client files from the Swedish Social Insurance Agency (SIA). The clients included had been on a work ability evaluation during their sick leave spell and were aged 32–64 years. The material was analyzed using qualitative document analysis.Results: The results show different approaches to communication, characterized by emotional argumentation, matter-of-fact driven argumentation and information exchange, which have diverse success in affecting official decisions. Arguments characterized by emotions such as frustration or desperation are to a larger extent neglected by the authorities compared to those characterized by a matter-of-fact driven approach and referring to regulations and medical certificates.Conclusion: There are differences regarding how clients and stakeholders communicate the clients’ needs and pre-requisites, and how this affects official decisions. Further research must be carried out in order to establish social insurance literacy, initially for individuals on sick leave within the sickness insurance system, and whether there are differences between diverse groups that could lead to injustices.Implications for rehabilitationWithin a social insurance context, professionals need to provide clients with adequate and individually adapted information in order for procedures to be perceived as comprehensible and manageable by the clients.The support from stakeholders such as the treating physician and/or employer can affect clients’ sick-leave process.Clients’ treating medical professionals can contribute to ensuring that clients rights are met by communicating the clients’ needs to other stakeholders in a formal way.
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| 8. |
- Karlsson, Elin, 1985-, et al.
(författare)
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Communication Characteristics Between Clients And Stakeholders Within The Swedish Sickness Insurance System – A Document Analysis Of Granted And Withdrawn Sickness Benefit Claims
- 2019
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Konferensbidrag (refereegranskat)abstract
- INTRODUCTION: Previous studies show differences regarding which clients receive sickness benefits as well as which clients are questioned or not within the sickness insurance system. There are indications that the characteristics of communication can have an impact on the sick leave process, which motivates this study with the following purpose.PURPOSE: The purpose of this study was to investigate how communication within the Swedish sickness insurance system differs between cases of sick leave and how this may affect the clients’ case.MATERIALS AND METHODS: This was a document study using thirty client files including the correspondence between clients, their case-manager at the Swedish Social Insurance Agency (SIA) as well as other stakeholders. The clients included had been on a work capacity evaluation during their sick leave spell and were aged 32-64 years. There were twenty women and ten men in this study, with a variety of the degree of sickness absence, disability pension and part time work. The material was analyzed using qualitative document analysis.RESULTS: The results show different approaches in communication, characterized by emotional communication, matter-of-fact driven communication and information exchange, which have diverse success in affecting authority decisions. Arguments characterized by emotions such as frustration or desperation are to a larger extent neglected compared to those characterized by a matter-of-fact driven approach and referring to regulations and medical certificates. There are also differences in how information about the client is interpreted by different professionals.CONCLUSION: There are differences regarding how clients and stakeholders communicate the clients’ needs and prerequisites, and how this affect the SIA. Further research must be carried out in order to establish social insurance literacy, initially for individuals on sick leave within the sickness insurance, and whether there are differences between diverse groups that could lead to injustice in the system.
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| 9. |
- Karlsson, Elin, 1985-
(författare)
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Legitimacy and comprehensibility of work-related assessments and official decisions within the sickness insurance system
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to contribute to the development of empirical and theoretical knowledge about the legitimacy and comprehensibility of assessment- and decision-making processes within the sickness insurance system from a client perspective. The focus has been on interactions between clients and other stakeholders within the system, and the extent to which the clients understood and accepted the procedures. In addition, the legitimacy and comprehensibility of the system were studied through the lens of three theoretical concepts: social validity, social insurance literacy (SIL), and moral hazard. For this thesis, a mixed methods approach was adopted, consisting of one quantitative and three qualitative studies, including interviews, files, register data, and a questionnaire. Overall, the findings demonstrates that interactions between clients and other stakeholders were important both for the client’s sick-leave case and for their perceptions of sickness insurance procedures. A continuing dialogue between client and case manager tended to facilitate the client’s understanding and acceptance of the steps taken in the sick-leave process. Furthermore, a client’s perception of the justice of processes in the system was associated with the system’s ability to provide understandable and logical information and procedures. This thesis also demonstrates that assumptions of moral hazard were clearly present and that acts of power and mistrust occurred between stakeholders, as different stakeholders tried to influence the client’s sick-leave process. An acceptable and fair sick-leave process was described by the clients as being one that consisted of relevant procedures, was applicable to the unique client, and was a result of support from other stakeholders. In order to increase the comprehensibility, as well as the legitimacy and fairness, the authorities need to explain and justify a diverse range of steps beyond just the official decisions, so that clients are able to comprehend the what, how, and why of sickness insurance. In terms of SIL, clients’ abilities to obtain, understand, and act on information, did not influence whether they received sickness benefits or their perceived justice. On the other hand, higher scores of perceived justice was associated with high scores of perceived system comprehensibility and being granted sickness benefits. This indicates that what the system does, and what it does not do, influenced clients’ opinions of it, regardless of their own prerequisites.
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| 10. |
- Karlsson, Elin, 1985-, et al.
(författare)
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Maktspel och arbetsmoral bland sjukskrivna och andra aktörer - Sjukförsäkringssystemet och moral hazard
- 2021
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Aktiveringspolicy och teorier om moral hazard har influerat utformningen av sjukförsäkringssystem i flera delar av västvärlden. Detta har lett till att sjukpenning blivit allt svårare att erhålla, mer kopplat till arbete och aktivitet, samt insatser för att genomskåda fusk bland sjukskrivna.Syftet med studien var att utforska hur makt och arbetsmoral uttrycks av sjukskrivna och andra aktörer i sjukförsäkringssystemet.Metod: Detta var en kvalitativ longitudinell studie baserad på intervjuer och akter från 31 sjukskrivna som varit på en försäkringsmedicinsk utredning. Data analyserades genom tematisk analys.Resultat: Resultatet visar hur olika aktörer misstänkliggör varandras agendor och kompetens, samt hur olika maktmedel används för att rättfärdiga deras slutsatser. Det framkom även vissa allianser mellan aktörer där dessa präglas av samsyn och samarbete mot gemensamma mål i sjukskrivningsprocessen. Primärt ses dessa allianser mellan sjukskriven och sjukskrivande läkare, men även i enstaka fall mellan handläggare och sjukskrivande läkare i de fall läkaren förespråkar aktivering. De sjukskrivna personerna uttryckte en stark vilja och försök mot arbete eller aktivitet, och deras arbetsmoral verifierades ofta av andra aktörer. Slutsats: Maktspel förekommer på olika sätt inom sjukförsäkringssystemet och de medel som användes i den här studien gavs olika betydelse beroende på vilken aktör som använde dem (exempelvis tolkningen av en försäkringsmedicinsk utredning). Den här studien kan ifrågasätta vissa antaganden om moral hazard och simulering bland sjukskrivna då personerna ofta presterade över sin förmåga under en försäkringsmedicinsk utredning i förhoppningen om att i någon mån visa sig förmögen att bidra till samhället, vilket även verifierades av andra aktörer.
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