Search results

New Public Management (NPM) has increased fragmentation in municipal health and social care organizations. In response, post-NPM reforms aim to enhance integration through service integration. Integration of municipal services is important for people with complex health and social challenges, such as concurrent substance abuse and mental health problems. This article explores the conditions for service integration in municipal health and social services by studying how public management values influence organizational and financial structures and professional practices.

This is a case study with three Norwegian municipalities as case organizations. The study draws on observations of interprofessional and interagency meetings and in-depth interviews with professionals and managers. The empirical field is municipal services for people with concurrent substance abuse and mental health challenges. The data were analyzed both inductively and deductively.

The study reveals that opportunities to assess, allocate and deliver integrated services were limited due to organizational and financial structures as the most important aim was to meet the financial goals. The authors also find that economic and frugal values in NPM doctrines impede service integration. Municipalities with integrative values in organizational and financial structures and in professional approaches have greater opportunities to succeed in integrating services.

Applying a public management value perspective, this study finds that the values on which organizational and financial structures and professional practices are based are decisive in enabling and constraining service integration.

The purpose of this paper is to discuss how and to what extent users can become involved in the process of selecting and implementing telecare and telehealth technologies in local health care services.

The discussion is based on data from a project in one local authority in Norway. About 100 persons have participated in focus group interviews where issues regarding new telecare and telehealth technologies for the elderly were discussed. The focus groups involved different groups of product users and stakeholder groups, i.e. “older senior users” (over 65 years), “younger senior users” (55-65 years), relatives, health care professionals and general practitioners (GPs).

Different user groups have different stakes in the technology. It is difficult to involve “older senior users” in the selection process due to their lack of information about potential solutions, while “younger senior users” are more informed and positive towards the introduction of telecare and telehealth technologies. The results also indicate that professionals are ambiguous towards new technologies; on the one hand they expect services to be better, but on the other they are concerned about ethical and working life issues that have not been fully explored as yet.

This paper provides an understanding of how different groups of product users and stakeholder groups relate to and can be involved in an expanded implementation process of telecare and telehealth technology which allow older people to remain in their homes for longer.