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- Andersson, Fredrik, et al.
(author)
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Organisatoriska vägval -- En studie av Försäkringskassans förändringsarbete
- 2011
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In: Nordiske Organisasjonsstudier. - 1501-8237. ; 13:4, s. 53-76
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Journal article (peer-reviewed)abstract
- The Swedish Social Insurance Agency is an important part of the Swedish welfare state. The Agency has recently made a number of major changes, such as establishing a new internal organization and reforming processes for decision making. Many of these changes have been controversial. Critics have complained that the Agency shows a lack of efficiency, has failed to make payments on time, and has been too harsh in its application of eligibility rules. The changes have put the agency at a number of crossroads, many of them recurring from earlier reforms, in dealing with problems such as regional differences in the application of rules. In this article, some of these choices are discussed. The discussion departs from four dichotomies: uniformity-local adaptation; centralization-decentralization; specialization-generalist approaches; and closeness-distance. These dichotomies are illustrated with examples from the agency. The general conclusion is that although the change process has taken a rocky road, there has been a great deal of internal consistency in the combination of measures taken.
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- Andersson, Fredrik, et al.
(author)
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Speglingar av en förvaltning i förändring: Reformeringen av Försäkringskassan
- 2012
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Book (other academic/artistic)abstract
- Svensk statsförvaltning genomgår, precis som privat sektor, ständigt förändringar och omstruktureringar, drivna av olika samhällstrender, ledarskapsidéer och politiska styrfilosofier. Vid dessa förändringar ställs verksamheten inför vägval som på olika sätt kan påverka dess förmåga att leva upp till omgivningens krav och förväntningar. Samtidigt finns inte utrymme för risktagande, eftersom förvaltningens agerande och beslut kan vara avgörande för individers försörjning och framtid. Det ställer stora krav på dessa myndigheter, som balanserar ekonomimål, demokratimål och rättssäkerhetsmål. Denna bok avser att spegla olika organisatoriska dilemman och utmaningar som myndigheter i svensk och internationell statsförvaltning kan möta. Detta sker med utgångspunkt i en studie av Försäkringskassans enmyndighetsreform år 2005 och dess förändringsarbete under åren därefter. Bokens författare kommer från tre olika ämnesområden: företagsekonomi, nationalekonomi och statsvetenskap. Samtliga är knutna till Lunds universitet och till forskningsprogrammet ”Från många till en?” (2008-2012). Programmet finansierades av Försäkringskassan, men genomfördes självständigt. Med boken hoppas författarna kunna öka förståelsen – och intresset - för frågor om organisation, styrning och ledning i en statsförvaltning i förändring.
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- Karlsson, Tom S., 1979-
(author)
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Manager and civil servant : exploring actors' taken-for-granted assumptions in public administration
- 2014
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Doctoral thesis (other academic/artistic)abstract
- Manager and Civil Servant is an exploration of actors' taken-for-granted assumptions that govern perceptions concerning how public administration should be undertaken within contemporary welfare states. It is argued that more than 30 years of continuous reforms directed towards public administration have caused dilemmas to arise. These dilemmas have resulted in a shifting of balances regarding the underpinning pillars of public administration. These reforms have furthermore resulted in an emergence of challenging social systems, entailing new beliefs and practices. The question posited is "how do actors engaged in public administration make sense of the dilemma(s) they face". Theoretically, this dissertation entails institutional theory as well as Structuration Theory. These are combined in a framework, wherein agency and structure are used in order to characterise manifestations of taken-for-granted assumptions. The framework is furthermore elaborated through conceptual perspectives concerning Management as well as Civil Service in order to model a framework for public administration. Empirically, this dissertation entails a use of qualitative as well as quantitative methods. Open-ended interviews are combined with self-administered surveys, statistical analysis, and focus groups. Two important contributions are highlighted. Firstly, actors engaged in public administration reject the idea of polarisation concerning inherent public administrative activities and that the dilemma being accentuated within public administration. As such, instances of making sense are reduced due to an unconscious enactment of meanings and sanctions that reject the presence of dilemmas. Secondly, actors' ability to reject polarisation, and thus dilemma, can be explained through compartmentalising interdependent perspectives. On the one hand actors enact an internal perspective wherein instances of Management make sense. On the other hand actors enact an external perspective wherein instances of Civil Service make sense. The separation and compartmentalisation of these perspectives not only enable actors to reject dilemma, they are enabled to enact seemingly different roles at once. They become both Managers and Civil Servants.
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- Nylinder, Pia, 1973-
(author)
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Budgetary control in public health care : a study about perceptions of budgetary control among clinical directors
- 2012
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Doctoral thesis (other academic/artistic)abstract
- Health care expenditures have increased rapidly in most OECD-countries, and several reforms have been considered for the improvement of cost-containment in the health care sector. Physicians in particular have been recognized to have considerable impact on health care expenditures and as a result they have become increasingly involved in budgetary control with the hope of a more efficient use of resources. Until 1997 only physicians were allowed to take clinical directional positions in Sweden. Then a new regulation made it possible for non-physicians to become clinical directors of a hospital department or primary care centre. Most often it has been nurses who entered such positions in the Swedish health care. The overall aim of this thesis was to analyse perceptions of tight budgetary control among clinical directors with different professional backgrounds in public health care organizations. Three questionnaire surveys of clinical directors in both hospitals and primary health care have been conducted. The results suggest that the perception of budgetary control differs between groups of clinical directors. The nurses often perceived the budgetary control as tighter than the physicians. The findings adhere to previous theories that nurses in directorial positions adopt administrative principles more easily; they accept and feel more bound by budgetary control than physicians in the same position. An alternative interpretation is that nurses in these positions actually are more controlled by the hospital management than the physicians. The nursing profession has a lower status and nurses in directorial positions may have less autonomy for managing their department.
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