Bynke, G. & Johansson, R. Vårdval inom LARO (Läkemedelsassisterad rehabilitering vid opiatberoende). Examensarbete i Socialt arbete 15/30 högskolepoäng. Malmö Högskola: Fakulteten för hälsa och samhälle, Institutionen för socialt arbete, 2013.Det svenska vården håller på att förändras då allt fler företagsinspirerade idéer har börjat föras i den offentliga förvaltningen. I Region Skåne förs vårdval in i allt fler vårdområden. Turen har nu kommit till missbruksvården och just nu beslutar man om ett införande av vårdval inom LARO, läkemedelsassisterad rehabilitering vid opiatberoende. Debatten pågår med ideologiska argument mellan politiker. I det här arbetet ställs frågan vad de professionella i Malmö Stad och Region Skåne ser för konsekvenser för berörda patienter med ett införande av vårdval inom LARO. Frågan är hur de som faktiskt jobbar med LARO i praktiken argumenterar kring ett vårdval. För att studera detta har en diskursanalys gjorts med en teoretisk utgångspunkt i new public management. Resultatet visade att den diskurs som förs av informanterna talar för ett vårdval. De främsta argumenten är att valmöjligheten ger patienterna mer inflytande och att konkurrensen förbättrar vården. I diskursen finns en rädsla för minskad restriktivitet men vinsterna bedöms värda risken.Nyckelord: diskursanalys, LARO, läkemedelsassisterad behandling, new public management, opiatberoende, vårdval / Bynke, G. & Johansson, R. Care choice in LARO (Medication-assisted Treatment for Opioid addiction). Examination work in Social Work 15/30 credits. Malmö University: Faculty of Health and Society, Department of Social Work, 2013.The Swedish health care is changing as more ideas inspired by companies have begun to establish in the public management. Region Skåne adopt care choices into more and more areas of care. The tour has now reached the addiction treatment and at the moment it decides on the introduction of care choice in LARO, medication-assisted treatment for opioid addiction. The debate is going on with ideological arguments between politicians. In this work, the question is what impact the professionals in the City of Malmö and Region Skåne see for the patients with the introduction of care choice in LARO. The question is how they who actually work with LARO are arguing about a care choice. To study this, a discourse analysis has been made with a theoretical basis of new public management. The results showed that the discourse held by the interviewees speak well about a care choice. The main argument is that the reform gives patients more influence and that competition improves the quality of care. There is a fear in the discourse about reduced restrictiveness but the profits of the reform are deemed worthy of the risk.Keywords: care choice, discourse analysis, LARO, medication-assisted treatment, new public management, opiate addiction

This essay is the result of a case study. The aim of this study has been to gain an understanding of government employee’s opportunity to be involved in and contribute to the processes tied to organizational development. The case study is based on the perspective of the government employees and their experience and thoughts regarding their opportunity to be a part of the organizational development. The empirical data that was generated by the case study has been analysed with New Public Management and Sense Of Coherence as a theoretical point of view. The case study has shown that government employee’s experience of being a part of the organizational development is very shifting depending on several influencing factors such as political control, governing within the organization and the employee’s own will and capacity to contribute to the organizational development. The case study has also shown the need to adapt the structure and governing of the organisation in order to be able use the full capacity of the government employees connected to organizational development.

Denna studie undersöker vilka strategier fyra organisationer från den ideella sektorn använder sig av för att hantera sitt samarbete med staten. Studien tar sitt avstamp i Staffan Johanssons teori om hur påtvingar ideell sektorn ett homogeniseringstryck. Genom att undersöka olika egenskaper hos den ideella sektorn, såsom ideologi, ekonomiska förutsättningar och möjligheten att vara me och påverka undersöks hur organisationerna uppfattar sin roll i samarbetet. Studien visar att ideologin och de ekonomiska förutsättningarna spelar avgörande roll för hur organisationerna kan strukturera både sig själva som organisation liksom deras arbete. I relationen till staten framstår det som viktigt att resursberoendet inte är allt för ensidigt för att organisationerna skall kunna hålla på sin särart och styra sin organisation i en självvald riktning. / This study examines the strategies four organizations from the voluntary sector uses to manage its cooperation with the State. The study takes its starting point in Staffan Johansson's theory of how imposing a non-profit sector with a homogenization pressure. By investigating various characteristics of the voluntary sector, such as ideology, economic conditions and the possibility of criticism, explores how organizations perceive their role in co-operation. The study shows that ideology and the economic environment plays key role in how organizations can structure themselves both as a organization and their work. In relation to the state, it seems important that resource dependence is not too one-sided for organizations to retain its character, ideology and control over their activities.

In this thesis I explore how design makes and unmakes citizenship through a collaborative independent project together with design student Théo Löfgren. I start out by looking at how the Swedish administrative levels of governance unmake citizenship by designing the Swedish citizens into customers. This has consequences since costumers have no obligations towards the collective, thus affecting sustainability on all levels (social, cultural, economical and ecological). Through my collaborative independent project I wanted to use design to critique that citizens are being designed into customers, as well as to create a design that promotes a citizenship of rights and obligations by co-creation. The result is a prototype of an interactive space called the Citizen Lab in which we (me and Théo Löfgren) use provotypes to create a discussion about the ‘customer citizen’ and the approach of participatory design to engage citizens in co-creation. The Citizen Lab was staged at the city library of Malmö (‘Malmö Stadsbibliotek’). In collaboration with the library and The Enforcement Authority (‘Kronofogden’) participants of the lab got to speculate about the future connected to problems and possibilities suggested by the collaborators. In the end the Citizen Lab proved to be a space in which participants could engage in co-creation as well as a place for us to try out our design and methods which were iterated on during the staging.

This thesis examines how New public management has affected the governance of elderly care in Swedish municipalities.  In recent years, the Swedish media, unions for people working in elderly care and other societal actors, have reported on flaws in both the working environment for the people working in elderly care and in the care that is provided to the elders. This thesis examines how the ideas behind the term New public management are implemented in a public organization that is facing a lot of challenges and therefore is struggling to deliver good quality services to the residents. This is done by an in depth analysis of the governance of the elderly care in a single Swedish municipality, Arvika kommun. This analysis also aims to explore the relationship between the challenges that the Swedish elderly care is facing and the implementation of reforms that are associated with the term New public management.  The analysis is based on a model for ideal type analysis and the material that is analyzed consist of a policy document that describes the elderly care in Arvika kommun and transcribed interviews with four informants who are working as managers in the elderly care in Arvika kommun. The ideal types that have been constructed are based on the doctrines that Christopher Hood formulated as the content of the term New public management.  The results from the analysis shows that the ideas behind the term New public management are implemented in the governing of the elderly care in Arvika kommun in a large number of ways. For example in the use of explicit standards and measures of performance, private sector styles of management and the disaggregation of units. The most prominent way in which the ideas behind the term New public management are implemented in the governing of the elderly care is in the focus on discipline and parsimony in resource use which is something that affects the whole organization.  Like some of the previous studies that examine New public management in relation to Swedish elderly care, this thesis also presents the result that there is a connection between the challenges that the elderly care is facing and the implementation of reforms associated with New public management. New public managements focus on making everything more time- and cost effective gives the staff working in elderly care a more stressful working environment. The stressful working environment leads to people resigning and a staff shortage which in turn leads to a lower quality in the care that is provided to the elders.

Hälso- och sjukvården har sedan början av 1990-talet varit föremål för en rad olika marknadsstyrda reformer som saknar motstycke i svensk historia. Dessa härstammar från New Public Management idéer vars avsikt var att organisationen skulle effektiviseras. Emellertid verkar denna intention gett en motsatt effekt enligt vad som framkommit i samhällsdebatten det senaste decenniet vad gäller patientsäkerheten och sjukvårdpersonalens arbetsmiljö. Mot bakgrund av detta har syftet med denna studie varit att undersöka och förstå överläkarens psykosociala arbetsmiljö och yrkesroll i förhållande till dessa strukturella förändringar. Kvalitativa semistrukturerade intervjuer har genomförts för att analysera ämnet med stöd utav Jürgen Habermas teorier om kommunikativt handlande och system och livsvärld samt Robert Karasek och Töres Theorells krav, kontroll och stödmodell. Dessa teorier har därefter kopplats till begreppen avprofessionalisering, etisk stress och målförskjutning. Med hjälp utav dessa analytiska verktyg har en systemförändring i samhället kunnat identifieras. Detta tycks ha påverkat hälso- och sjukvården i den benämningen att det har orsakat en ökad administration och detaljstyrning i organisationen. Det empiriska materialet i uppsatsen visar att konsekvenserna har utmynnat i avprofessionalisering samt etisk stress för läkarens yrkesroll och psykosociala arbetsmiljö. Enligt informanternas utsagor tycks det saknas en vilja hos sjukvårdshuvudmännen att ta ett övergripande ansvar för alla problem som har uppstått i hälso- och sjukvården till följd av individualismen och New Public Management. Det medför i sin tur att flera av informanterna känner sig otillräckliga i sitt arbete samt ansvarsområde och att skulden för en dysfunktionell organisation drabbar läkare. En slimmad organisation kombinerat med individernas ökade krav på tillgänglighet och medverkan i sin sjukvård har sålunda ökat den sammanlagda belastningen på hälso- och sjukvården. Följaktligen är uppsatsens slutsats att marknadsstyrningar och slimmade organisationsmodeller i hälso- och sjukvården endast fungerar om tillgång och efterfrågan möts samt att organisationsbeslut bör helst fattas i nära samråd med professionen.

Ideas matter. Thus, approaching peacebuilding efforts from an ideational perspective can contribute to a deeper understanding of their meanings and legacies. Traditionally, the liberal peace paradigm has been prevalent in peacebuilding, translating into programs, projects, actions, and agreements that model liberal norms, values, and practices. Among these sets of ideas, it is possible to identify beliefs about New Public Management (NPM), which affect how instruments like peace agreements are designed and codified. However, this relationship has not been thoroughly explored in the peacebuilding and public management literature, although both strive to achieve efficient and effective governance and peace. In response to this gap, this thesis examines, through text analysis, the degree to which the normative and bureaucratic legacies of NPM are present in the design of a comprehensive peace agreement. This required the selection of an empirical case that could deepen the understanding of what kind of public management NPM ideas are embedded and to what extent, hence the selection of the Colombian Peace Agreement, an example of the golden standard in comprehensive arrangements. The study systematically reviewed and codified the text of the agreement –578 provisions or stipulations– based on the presence and specificity of NPM-related doc-trines. The findings show the pervasiveness of bureaucratic legacies associated with strategic planning, performance audit of provisions, decentralisation, and the appointment of managers and high-level bodies to administer the implementation. However, ideas associated with financial control, competition and flexibilization of the public sector, were less relevant. The analysis also identified other ideas, which expand on the civilian input in the main bureaucratic doctrines. Thus, it provides a new insight to understanding peace in bureaucratic terms as the strategic expansion of institutional infrastructure with strong oversight mechanisms within peace agreements. This calls for a more careful review of the bureaucratic legacies and understandings present in peacebuilding efforts and how they could relate to other sets of ideas already reviewed in the literature, which could lead to further research shaping our understanding of peace through time and across contexts.

Since New Public Management's alteration of the public administration during the 1980s and 1990s, the role of the state has shifted from producing the welfare services itself to instead taking a regulatory position. The shift towards an increasingly decentralized welfare has resulted in an increasingly extensive public audit, and a contradiction within the public administration has been made visible: the relationship between control and trust.The purpose of this study is to contribute to a greater understanding of the relationship between public audit and professional autonomy; in this study, the Swedish School Inspectorate's quality inspections are a case of public audit, and teachers' discretion is a case of professional autonomy. By applying a qualitative content analysis this study investigates how the Swedish School Inspectorate's quality inspections have changed over time with regard to its possible impact on teachers' professional autonomy; whether the changes indicate a strengthened or weakened professional autonomy. The results of the study show that the quality inspections have become more comprehensive, and that the Swedish School Inspectorate has become more detailed in its definition of quality and more specific in its feedback to the schools. The combination of an increased external control and a more detailed and elaborate method could weaken professional autonomy. However, more research is needed in the area, partly to enable an explanation for the changes, partly to be able to gain more evidence that the professional autonomy has been weakened.

Drawing inspiration from the authors own term paper, this thesis examines the documentational and administrative workload of Swedish pre-school teachers. The focus being on its relationship with New Public Management, professionalization, deprofessionalization, and pre-school teachers' experiences of time constraints. The study itself consists of interviews with 15 individuals, thirteen of which are pre-school teachers, and 2 pre-school principals, most of whom work in the same municipality. These municipalities, as well as the true names and workplaces of the respondents, have been anonymized. The analysis centers around the respondents' perspectives on documentation, professionalization, deprofessionalization, and perceived lack of time. Findings indicate that respondents generally believed documentation to be pedagogically valuable for children's learning and progress, reflecting a perception of professionalization with occasional instances of deprofessionalization. However, the extent to which these scenarios represent pre-schools overall remains unclear. Notably, most respondents expressed a lack of time for their daily tasks, attributing it primarily to understaffing rather than the documentational and administrative workload itself. The study concludes that pre-school teachers find the documentational and administrative workload time-consuming and frustrating. It observes that documentation is perceived as an integral aspect of the pedagogical process. The emphasis on the pedagogic nature of pre-school reflects a continuous professionalization process and status elevation strategies employed by teachers, which has resulted in increased documentation. This insight may help explain the absence of negative experiences associated with the documentational workload. / Denna kandidatuppsats behandlar den dokumentations- och administrativa arbetsbelastningen som krävs av svenska förskollärare, och hur den relaterar till New Public Management, professionalisering och avprofessionalisering, samt förskollärares upplevelser av brist på tid för att utföra sitt arbete. Uppsatsen inspirerades till stor del av en B-uppsats skriven av författarna. Studien består av intervjuer med 15 personer, varav tretton är förskollärare och två är förskollerektorer, de flesta arbetar i samma kommun. Dessa kommuner, liksom de verkliga namnen och arbetsplatserna för respondenterna, har anonymiserats. Analysen baseras på respondenternas svar i förhållande till dokumentation, professionalisering, avprofessionalisering och upplevd tidsbrist. Resultaten indikerade att de flesta av respondenterna ansåg att dokumentationen hade ett tydligt pedagogiskt syfte i förhållande till barnens lärande och utveckling. Deras svar visade på en upplevd professionalisering snarare än avprofessionalisering, även om det finns vissa scenarion som skulle kunna indikera avprofessionalisering. Det är dock svårt att bedöma i vilken utsträckning dessa scenarier beskriver förskolor generellt. Slutligen drog vi slutsatsen att de flesta av respondenterna upplever brist av tid för att utföra sina arbetsuppgifter. Slutsatsen var att förskollärarna själva upplever att arbetsbelastningen relaterad till dokumentations- och administrationsarbetet är tidskrävande och en källa till frustration i samband med dess utförande under arbetets gång. Intressant nog tillskrivs den nästan allmänt upplevda tidsbristen bland respondenterna vanligtvis inte dokumentations- och administrationsarbetet, utan snarare personalbrist. Dokumentationen uppfattas som en integrerad del av den pedagogiska processen. Det pedagogiska arbetet i sig kan ses som en del av en kontinuerlig professionaliseringsprocessen och statushöjande strategier som används av förskollärare. Detta kan förklara bristen på negativa upplevelser av den dokumentationsbaserade arbetsbelastningen.

This study is about how trust-based management is being applied, used and how it works in asmaller municipality and with focus on the school organization within that municipality. Thestudy will also see if trust-based management can counteract the criticism New PublicManagement have endured the last decades. The purpose of the study is to create an understanding about how trust-based management canbe used in a municipality and within the school organization. The study will use themunicipality of Tomelilla and its school organization as a case and will use the methods ofqualitative interviews and text analysis. The interviews are made with a person in the centralmanagement of the school organizations and principals. The text analysis is focusing ondocuments such as organization plans, internal control plans, managing models and reportsfrom other organizations. To make the analysis of the material possible it will apply trustbasedmanagement and New Public Management as analytical framework on themunicipalities and school organizations managing functions. The result of the study shows thatthere’s both indicators of trust-based management and New Public Management within everymanaging function analyzed. The study also shows that in certain ways the trust-basedmanagement succeed to counteract the criticism of New Public Management.