Much current literature on management and strategy still describes strategy work as a linear, top-down, management-based, rational, logical, structured and planned change activity with clear and predictable goals. It is described as an activity in which individual managers are addressing key questions and implementing an important, management-based plan. By using the right tools and techniques, skilled managers can transform plans into reality through good leadership and systematic rollout. This way of thinking about leadership is based on an understanding of leaders as rather powerful, knowing, heroic individuals who can stand outside of their organization to plan an ideal future, and who are equipped to make employees follow their instructions in order to reach desired goals. In this thesis I research into my experiences of what is happening in an organization, taking seriously the experience of developing a new strategy. It is an organization working in the public sector in Denmark which is right now trying to find a strategy and its way through a series of 'wicked problems' not easily handled. Through the use of autobiographical narrative-based inquiry and a focus on everyday local interactions between people working together, I research into what is 'really' going on in strategy work. Drawing on the theory of complex responsive processes of relating and reflexivity, I describe and analyse the interactions in our leadership team's efforts to change the organization's strategy. In doing so themes of power, power games and power differentials, politicking and some of the paradoxes in management - such as inclusion/exclusion, local interaction and global patterning, unpredictable predictability, and conflict and cooperation - are investigated. The complex responsive process perspective views organizations as patterns of interaction and conversations between people working together. By analogy from complex adaptive systems models, sociology, psychology and philosophy, it argues that generalizable population-wide patterns emerge in unpredictable ways through exactly these local complex interaction and interplays of people's intentions, thoughts and actions. This leads me to propose generalizable new contributions to knowledge about strategy work. Examining my own experience, I problematize the 'heroic', individualistic, view of what leaders do when working with strategy, preferring to see strategy as a co-created activity that emerges in complex and paradoxical interactions between people in the organization, in the leadership team, in daily cooperation with employees, and through the interface with customers. The understanding of co-creation here being that together we co-create our social life and our social life is co-creating us, our selves, our personalities at the same time. This inseparable paradox of the individual and the group, of the one and the many is investigated. Finally, I suggest that strategy work is inseparable from the everyday messy conflictual power games of organizational life, and that leaders - through actively engaging in ongoing conversations and co-creating meaning - participate in developing new understandings of identity and culture. In talking with one another about what it is we are doing, in influencing and being influenced, and reflecting on this, we are already changing what is going on; this itself is strategy work. The narratives show that to work with strategy effectively, we need to negotiate our intentions in convincing ways through forming strong power alliances. Taking experience seriously also demonstrates a close connection between power, ethics and action, and that it is impossible to decide the 'good' thing to do before acting. Developing reflexivity, both as an individual and in collaborative work, is a prerequisite for working in an ethical way, aware of our mutual interdependence. Finally, the thesis describes some of the consequences of taking experience seriously as a strategy. It has changed the way our staff understand what they are doing, and is beginning to change the kind of assignments we take on, and how we deal with them. One spin-off has been producing two books (with more to come). We also have new and more reflexive contacts in business and knowledge-creating environments, such as universities and business schools. The thesis shows a number of results from working with strategy in this way. This indicates that the act of taking your experience seriously in itself implies a kind of transforming causality, and hereby a strategy of change.

The purpose of this thesis is to explicate and explain deficiencies in the health care system in Sweden, leading to inefficiency amongst the medical doctors. The health care system is mostly financed by the public (i.e., taxes). In order to reach conclusions we conducted a three-step empirical approach in the publicly financed health care system. The study uses a theoretical analytical lens strongly supported by previous research, which is supposed to help explain the results of the empirical studies. Study 1 consisted of semi-structured interviews. Study 2 was based on register data and examined if we could confirm that there is a correlation between administration and number of patients. Study 3 is a post-hoc analysis based on survey data from a total of 124 respondents. By using three different research methods, the study offer a more complete and holistic view of the medical doctors’ situation and the aspects of control within Swedish health care. The results confirm earlier findings in previous studies is somewhat consistent across the three separate studies (Study 1-3) that Swedish medical doctors meet very few patients. The study further identify variation among medical doctors meeting patients is very high. While some meet only one patient per day other meet up to 25 patients in a day. We could not find significant differences between doctors meeting few from those meeting many patients. Furthermore, no difference come in terms of administration between routine patient meetings or returning patients. The post-hoc analysis in part explains that management control system is poorly developed. Our result implies administrative work is not correlated to patient visits. Medical doctors themselves means that the reason to why many doctors not have a large number of patient visits is due to more administrative work. Data from patient record systems does not verify their statements. The correlation is thus opposite. The more patient visits the more administrative work. Additionally, the study implies that predetermined times modules for patient visits complicates measurements of doctors’ performances. We hope the thesis will attract attention amongst the citizens in Sweden but also amongst Swedish agencies that leads to further examinations and improvements of the publicly financed health care system. / Sverige har femte flest läkare inom EU. Ändå växer vårdköerna och det talas om läkarbrist. Är det verkligen problemet eller bottnar det i en ineffektivitet? Syftet med examensarbetet är att förklara situationen inom den offentliga svenska hälso- och sjukvården med avseende på läkarnas effektivitet och vilken roll styrningen har för prestationen. För att uppfylla syftet och besvara forskningsfrågan kommer studien att utgå från Sveriges landsting och regioner med fokus på situationen för läkarna och med tonvikt på styrningen inom landstingen. Examensarbetet använder en teoretisk analys som bygger på tidigare forskning som stöd till förståelse och förklaringar av resultaten. Examensarbetet har tre olika delstudier. I studie ett (1) genomfördes semistrukturerade djupintervjuer inom samma landsting med ett antal personer med olika befattningar för att spegla olika värdeperspektiv. I studie två (2) tog vi del av intern registerdata på en klinik för att påvisa ett eventuellt samband mellan antal fysiska patientmöten och administrativt patientarbete. Studie tre (3) var en post-hoc analys där vi diskuterar kring samband och förklaringar i utfall från studie 1 och 2. I post-hoc analysen undersöktes Sveriges samtliga landsting och regioner genom enkätundersökningen där totalt 124 läkare runtom i Sverige deltog. Resultatet visar att det är många olika faktorer som spelar in avseende läkarnas effektivitet och den situation som råder inom svensk offentlig hälso- och sjukvård idag. Bilden att svenska läkare generellt tar emot färre patienter jämfört andra europeiska länder bekräftas samtidigt som vi kan påvisa stora variationer. Ett argument som ofta framförs är att svenska doktorer arbetar med patienten administrativt och att detta arbete inte återspeglas när man mäter antal fysiska möten. Genom journalstudier kan vi inte bekräfta detta samband. Våra resultat visar att rent administrativt patientarbete korrelerar till antal fysiska möten mellan läkare och patient. Vi ser också att styrning genom exempelvis förutbestämda tidsmoduler gör att prestationer verkar bli svårare att följa upp. Vår förhoppning med examensarbetet är att väcka ett större intresse hos allmänheten och myndigheter för dessa frågor vilka kan leda till granskning och förbättring av den offentliga svenska sjukvården.

Over the last two decades the impact of power in communicative planning has gained prominence in discussions about meaningful planning, i.e. planning that achieves the goals as set out in the plan and also has wider socially desirable environmental, social and economic outcomes. This study aims to examine the influence of power on communication in the compilation of municipal Integrated Development Planning in South Africa, specifically as it affects intra- and intergovernmental relations in the IDP preparation process in local municipalities. This dissertation is the result of a historical study into the 2000/2001 and 2001/2002 Integrated Development Plan process in the local governments of Kungwini Local Municipality, and Klerksdorp Local Municipality as study areas. The time lapse between the events that took place in these municipalities and the completion of this study assists in providing a more objective view of the power relations at play. Throughout the study emphasis is placed on certain concepts that influence the outcome of planning processes and the planning processes itself, as summarised in the final chapter. They are: <ul> <li> The quality of inter- and intra-governmental relationships;</li> <li> The awareness and use of power in planning;</li> <li> The concept and nature of “meaningful communication”; and</li> <li> The role and impact of power on such communication.</li> </ul> As an exploratory historical study into the power interface in IDP, it provides an interesting perspective on the dynamics of compiling an IDP and opens up the opportunity for more such studies in other local governments in South Africa with the influence of power on communication in intergovernmental planning processes (specifically IDP in local municipalities) and general studies regarding the effect of power in communicative planning as focus. This study also provides an indication of the pressures planners face in the pursuit of meaningful/useful planning results. / Dissertation (MT&RP)--University of Pretoria, 2009. / Town and Regional Planning / unrestricted

La Réussite éducative est un dispositif mis en place en 2005 visant à aider les enfants en « fragilité » de deux à seize ans scolarisés ou domiciliés dans les territoires en Politique de la Ville. Loin d’être seulement un dispositif d’aide éducative, la Réussite éducative est aussi un instrument de réforme. Cette thèse répond à deux questions : comment un dispositif extérieur à l’Éducation nationale réforme la politique éducative et quelles sont les implications de la réforme portée par la Réussite éducative.Nous mobilisons dans un premier temps la sociologie des instruments de l’action publique et nous présentons notamment les ambiguïtés de la Réussite éducative, son déploiement et sa carrière. Il s’agit alors de comprendre comment ce dispositif est devenu à la fois un instrument éducatif et un instrument de réforme, comme celui-ci s’implante localement, et comment il évolue selon les différents contextes.La Réussite éducative porte une recomposition de la politique éducative accordant une place accrue aux associations et aux collectivités territoriales. Cette recomposition implique des changements dans les modalités d’emploi et de travail dans la politique éducative que nous étudions en mobilisant les analyses sur les processus d’invisibilisation du travail.Au carrefour d’une sociologie de l’action publique et de ses instruments, du travail et du monde associatif, cette thèse aspire à être une contribution à l’analyse de la Nouvelle Gestion Publique dans le secteur éducatif. / "Educational Success" is a political device that was set up in 2005. It aims at helping children between two and sixteen years who are labelled as "weak" in the local territories where urban policies are set up. Far from being only a help to the children’s education, it is also a tool of reform. This thesis answers two questions: how does a device that is external to the national system of education reform the politics of education, and what are the implications of the reform it implements. Through a sociology of the instruments of public action, we will present the ambiguities of "Educational Success", its expansion, and its career. We will explain how this tool of reform was established locally and how it evolved according to various elements of context. Educational Success reconfigures educational policies through an approach based on local authorities and associative organisations. This implies changes in the terms of employment of its actors and, namely, a process of making their work "invisible". At the crossroad between public action sociology, sociology of work and sociology of associations, this thesis contributes to the analysis of the New Public Management in the educative field.

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Statistik från Socialstyrelsen (2019) visar att en stor mängd av den äldre befolkningen besväras av sin ensamhet i dagens Sverige. Äldre personer som bor på äldreboenden tycks besväras i större utsträckning av ensamhet. Folkhälsomyndigheten (2019) menar att det finns tydliga kopplingar mellan ensamhet och psykisk ohälsa och där depression bland äldre är så pass vanlig att det idag klassas som ett folkhälsoproblem i Sverige.  Regeringskansliet (2018) skriver i sin handlingsplan utifrån Agenda 2030 att de ska arbeta förebyggande för att minska den psykiska ohälsan tillsammans med Sveriges Kommuner och Landsting. Därför fokuserar den här studien på hur enhetschefer inom kommunala äldreboenden arbetar förebyggande genom att minska den ensamheten som bidrar till psykisk ohälsa bland äldre. Studiens syfte var att genom forskningsintervjuer undersöka hur enhetschefernas förebyggande arbete för att minska äldres ensamhet på kommunala äldreboenden kan influeras av enhetschefens syn på ensamhet bland äldre och den organisatoriska strukturen. I undersökningen användes socialkonstruktivismen som teori för att analysera enhetschefernas konstruktion av ensamhet bland äldre. New Public Management, individualisering, destabilisering samt medmänsklighet och empati är andra teorier som användes för att se analysera hur organisatoriska förutsättningar kunde influera det förebyggande arbetet för att minska äldres ensamhet. I undersökningen intervjuades fem enhetschefer och resultatet visade att det inte finns någon nationell överenskommelse för hur enhetschefer ska driva ett förebyggande arbete för att minska ensamheten bland äldre. Det finns ingen gemensam överenskommelse för vad ensamhet är och därför konstrueras äldres ensamhet olika beroende på individuellt intresse vilket leder till olika möjligheter för de boende. Även enhetschefernas specifika arbetsuppgifter som sker i uppdrag från kommunpolitiker, deras närvaro i verksamheten och andra aktörer påverkade konstruktionen av ensamhet som influerar det förebyggande arbetet för att minska ensamhet bland äldre.

Sweden is a country with a relatively high level of trust, both between citizens and towards the public sector and its institutions. During the corona epidemic of 2020, a large amount of responsibility to avoid spreading the virus has been placed on the people. The last three decades there have been a number of reforms applied to the public sector in Sweden. These reforms, which fall under the blanket name of New Public Management, have the purpose of making the public sphere more like the private one. The purpose of this study is to, through a use of statistical method, examine how the level of trust between the residents of Sweden has changed since the implementation of NPM-policies began at the end of the 80’s. This is done by using a theoretical framework of the concept of social trust. The results show that although the trust between residents continue to be strong, it has gone down from 2006 to 2011, which may be a cause for concern.

Profound changes in higher education induced by the reforms of the New Public Management (NPM) have led to administrative growth, professionalism, managerialism, and higher relevance of the economic principle. As a further consequence, the importance of the organizational perspective has increased. Thus, questions about effective organizational structures and their design frameworks have become more crucial. The contingency approach provides insights into these questions because it investigates the effectiveness of organizational structures in different situations. Based on expert interviews with faculty managers and subsequent qualitative content analysis, in-depth insights are gained regarding criteria of effectiveness of German faculties, dimensions of their organizational structure, and their contextual factors from their subjective perception. Furthermore, it is possible to renew the approach, to refute criticism, and to build a reference framework as a precursor for developing new theories.

This thesis evaluates the effects of the Swedish ordningsvakt system with regards to its contribution to public safety. Building on a body of critical research regarding the effects of outsourcing of public services and police forces in particular, it develops an insight into the driving factors and underlying causes of the expanding use of ordningsvakter. The effects of ordningsvakt use in 17 Swedish municipalities on violent crime, theft, and vandal-ism have been measured through a multivariate regression model. Over multiple specifications, it became apparent that a statistically significant effect can be observed for vandalism but not other types of crime.The thesis finds that ordningsvakter in public spaces provide at most a very modest contribution to public order and fail to achieve the core objective of reducing violent altercations. This may be either due to a general inade-quacy of the system, or due to displacement effects caused by the deployment of guards. The resulting policy recommendation is an exploration of alternative ways to enable public order and safety measures on the municipal level, particularly a reintroduction of municipal police forces.

New Public Management has been the prevailing governance model in public sector administration since the late 1980s. In 2005, OECD-DAC member states adopted the resultsbased management model ‘Paris Agenda for Aid Effectiveness’, building on new public management theory and values. The aim was to achieve more effective aid by coordinatingand harmonising donor efforts, aligning development interventions and funding, supporting national ownership and propelling a result- and accountability culture by demonstrating achievements.Despite its worthy ambitions the Aid Effectiveness Agenda has paradoxically failed todeliver on its own outcomes. The results-based management framework underpinning theagenda has proven to be highly complex in methodology, interpretation and application. The framework is laborious and burdensome, diverting time from ‘ordinary’ work and risking a bureaucratization of the development aid sector. The ‘measurement fever’ has grippeddonors and agencies alike, and is now mainly driven by donors’ domestic accountability concerns, rather than the real needs of developing countries. More alarmingly, it has not onlyhad numerous unintended consequences but also outright adverse effects. This in turnen dangers long-term human development.This study sets out to explore to what extent the results-based management framework, based on new public management theory, has been a suitable management model to achieve aid effectiveness in the development aid sector. It departs from the governance theories of Denhardt and Denhardt (2000) and assesses whether New Public Service couldbe a fitting alternative governance model. The study utilizes the realist review methodology,specifically the CMO-configuration, in order to explore how context and mechanisms interact and how this affects the outcome. This study has through its aggregative and configurativeambition explored 26 scholarly articles in the time frame of 2011 to 2021 in order to draw conclusions.The review has found that the results-based management framework does not support the underlying theory of change that is imperative to achieve the Aid Effectiveness Agenda.Contextual factors are found to impede implementation, although due to being under research edit is difficult to determine to what extent. Further, none of the five mechanisms ofthe Paris Declaration can neither fully nor partially be said to contribute to ‘aid effectiveness’as defined in the Aid Effectiveness Agenda. Rather, the review has found that the literatureall point to numerous adverse effects of its implementation.This study concludes that the New Public Service governance model, at least intheory, could prove to be a more suitable management model for the development aidsector. Since the sector is neither linear nor predictable as the business sector for whichthe framework was developed, it is not surprising that adverse effects abound. Especiallysince the development aid sector is highly complex with a multitude of actors, politicalincentives and not least challenging implementational environments. In contrast, New Public Service places the citizen at the centre and aspire at buildingdemocratic citizenship and community through citizen participation and dialogue. Such analternative governance model built on democratic theory and participative epistemologyhas the potential to democratize governance practices by replacing the vertical top-downprincipal-agent dynamics of new public management with more horizontal forms of citizeninvolvement, co-determination and mutual accountability. New Public Service stresses the‘serving not steering’ aspect of governance, which would open up for a more authenticdiscourse of recipients owning development in their own society and setting the direction.No systematic review has previously been carried out to assess governance models inrelation to achieving the Aid Effectiveness Agenda. In fact, there is very little research onwhat has worked or not regarding the agenda. This thesis sets out to fill this gap and tocontribute to the discussion of governance models on a theoretical level. It is also anempirical contribution to applied development management regarding insights about whatcontexts and mechanisms affect aid effectiveness.