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- Fredriksson, Mio, 1976-, et al.
(författare)
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Cuts without conflict : The use of political strategy in local health system retrenchment in Sweden
- 2019
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Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 237
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Tidskriftsartikel (refereegranskat)abstract
- Disinvestment in health services is seen as challenging by decision-makers as the public usually reacts strongly to rationing and retrenchments. Drawing on the literature on welfare state retrenchment - the reduction of public expenditure by cutting costs or spending - this article explores the development and implementation of a comprehensive retrenchment programme in one local health system in Sweden (a so-called region). According to theory, retrenchments are both electorally risky and institutionally difficult. Nonetheless, they take place and in the local health system we investigate, without too extensive public protest and without decision-makers having to resign. The main question in this qualitative study is: why and how was it possible to make such comprehensive retrenchments despite being unpopular and facing many political and institutional barriers? Interviews with 18 local politicians and public servants were carried out between January 18 and April 3, 2017, and analysed from the perspective of political strategy. They showed that the serious budget deficit, and a shared understanding of what the region's problems were, are important explanations for why the retrenchment programme was possible to develop and implement. Based on a thorough internal review of the health system, a crisis discourse developed which partly depoliticized the retrenchment programme. Justification and framing are keys to how it was possible. The retrenchment programme was justified by arguing that current service provision exceeded that in comparable regions, and framed as necessary saving the local health system and enhancing quality. Important strategies were thus to redefine the retrenchments and to blame-share, the latter through politicians and public servants claiming responsibility together after involving the clinic managers. In sum, our study shows that the retrenchment literature and theories on political strategy may be fruitfully applied to the health-care sector as well. By studying the local level, our findings contribute to the retrenchment literature, indicating that political strategy at the local level is more about justification and blame sharing, than blame avoidance.
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| 2. |
- Sundqvist, Pernilla, 1979-
(författare)
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Teknik i förskolan är inte något nytt, men idag är vi mera medvetna om vad vi kallar teknik : Personalens beskrivningar av teknik som innehållsområde i förskolan
- 2016
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This study investigates what preschool staff include in the technology subject in preschool education, what content they view as relevant and how the teaching of this content can be organized. This is motivated by the fact that technology as subject have not been clearly defined, leaving the teachers insecure and unconfident about what to teach and how to teach it. In addition, preschool do not have a tradition of addressing teaching and learning the way they are now obliged to do according to the curriculum and many studies have shown subject teaching to be a challenge in preschool. Thus, the preschool staff’s challenge is twofold regarding the teaching of technology.The aim is addressed by a mixed methods design, starting with questionnaires and followed by interviews with preschool staff (daycare attendants and preschool teachers). The questionnaire was completed by 102 preschool staff members and interviews were held with seven of these participants.A key results is that technology in preschool involves building and creating. Emphasized is that children should be offered much and varied materials and that it should be available in the environment and inspire creative activities. Another key result is that every-day use of artifacts is viewed as part of technology education. Children should learn to handle artifacts by using them, e.g. pulling up the zipper to close the jacket or cut with scissors. These are activities preschool have always engaged children in, which the staff now name technology. However, there are variations in the result and there are preschool staff members who express a more conscious teaching where children are able to learn about things like the purpose of technology, what parts an object consist of and how these parts are connected, and about technological systems, e.g. how the water get from the lake to the tap and how it is purified on the way. But there are also examples where technology activities are used as a means for working towards the striving goals of other areas, such as math, science and social behavior.Implications are that preschool staff need to develop their teaching in order to work in accordance with the curriculum. A relevant first step is to strengthen their content competence in technology, but also, they need tools for how to teach subject matter like technology in a practice characterized by children’s own choice and influence.
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