Eva Bejerot

Multilevel analyses of organizational change and working conditions in public and private sector

The aim was to investigate organizational impact on working conditions and to explore the associations between sector, different types of organizational change, and working conditions. A strategic selection was made of representative staff members from 72 work sites. Data pertaining to organizational factors were collected from managers, and to working conditions from employees. Multilevel analyses were performed, with 10 aspects of self-reported and expert assessed psychosocial and ergonomic/physical working conditions as the dependent variables, and patterns of organizational change and sector as the explanatory variables. The results showed that the variance in working conditions was significantly attributed to organizational level (16 – 65% of the variance), and that both the pattern of change and the sector were important. Organizations that had not undergone change provided the best work conditions. The “standardizing” and “market-adjusting” patterns of change had deleterious effects, while the “lean” and “centralizing” patterns led to dual outcomes. Organizational change was perceived as having more negative consequences in the public sector than in the private sector. The results indicate that organizational change contributes to increased differentiation of working conditions, as different types of changes congregate in specific areas of the labour market and affect groups of employees differently.

Combining professional work with family responsibilities: a burden or a blessing?

This paper investigates job-related distress and satisfaction with the work--family interface in various combinations of professional work and family responsibilities in Sweden. The study is based on the self-reports of 1,764 male and female university graduates in paid employment and with children at home. For both women and men, conditions at work seem to be most important. However, the division of responsibilities between partners was also found to have an impact, but in different ways for women and men. Only in families where both partners are gainfully employed and share the domestic work and financial responsibilities, was the psychological well-being and the work--family interface satisfactory for both women and men. In other families, negative effects for either women or men are noticed. The conclusion is that multiple roles and shared responsibilities and demands in the private sphere promote health among both women and men.

Webs of Knowledge and Circuits of Communication : Constructing Rationalized Agency in Swedish Health Care

In this article we analyse an institutional transformation of Swedish health care that is underway. We combine the recent work from the ‘Governmentality’-tradition with contributions by John Meyer and associates. The latter is used to explain how these changes are rendered as necessary and natural. The main part of our analysis concerns how the institutional construction of rationalized agency is instrumented. To accomplish that, Dean’s (1999) categories technologies of agency and technologies of performance are used to conceptualize some of the means and principles mobilized in the ongoing institutional transformation of Swedish health care. Firstly, we display the emergence of a complex landscape of new actors, arenas and new practices that regulate and coordinate medical practice. Secondly, various attempts to imbue agency into the patients are analysed as an example of a technology of agency put to use. The conclusions present a more comprehensive picture of governing through new forms of agency. Technologies of agency are closely intertwined with appeals to common goods, the formation of new arenas and forms of expertise.

Forms of Intervention in Public Sector Organizations: Generic Traits in Public Sector Reforms

The present paper argues that recent research on public sector reforms offers few contributions to the body of knowledge on this topic because it adds little to the conclusions drawn during the first generation of research in this area. Although these later studies have often been context-specific and have explored the details of the process of change in some depth, it is rather difficult to compare their results or to make reasoned judgements of the comprehensiveness and centrality of the analysed change. Although most public sector reforms that affect hospitals, schools or social services are initiated and designed by national governments, individual case studies of local administrations often fail to capture the generic traits of nationwide reforms. However, public sector change cannot be approached as if it comprises collections of nominally independent local events. The present paper argues for two new approaches to the study of public sector change: (i) the systematic categorization of the different forms of governmental intervention under study and (ii) analysis of the ways in which these forms of intervention are linked and interact. Based on extensive empirical research, this paper suggests a generic classification of these forms of intervention that can be used in empirical research on comprehensive public sector change. Consequently, five interventions in public sector organizations are suggested, namely political intervention, intervention by laws and regulations, intervention by audit and inspection, intervention by management and intervention by rationalizing professional practice. The model is particularly well suited to the longitudinal analysis of complex public sector reforms. This approach provides a conceptual tool to distinguish between interventions based on different forms of knowledge and to investigate how they are linked to each other vertically and horizontally. We demonstrate the usefulness of the model by analysing two empirical examples of reforms in which a variety of interventions were imposed at the local level, through legislation as well as a spectrum of voluntary measures proposed by government agencies, by national associations for local and regional councils and by other national or regional actors.

I shouldn't have to do this: Illegitimate tasks as a stressor in relation to organizational control and resource deficits

Abstract The performance of tasks that are perceived as unnecessary or unreasonable – illegitimate tasks – represents a new stressor concept that refers to assignments that violate the norms associated with the role requirements of professional work. Research has shown that illegitimate tasks are associated with stress and counterproductive work behaviour. The purpose of this study was to provide insight into the contribution of characteristics of the organization on the prevalence of illegitimate tasks in the work of frontline and middle managers. Using the Bern Illegitimate Task Scale (BITS) in a sample of 440 local government operations managers in 28 different organizations in Sweden, this study supports the theoretical assumptions that illegitimate tasks are positively related to stress and negatively related to satisfaction with work performance. Results further show that 10% of the variance in illegitimate tasks can be attributed to the organization where the managers work. Multilevel referential analysis showed that the more the organization was characterized by competition for resources between units, unfair and arbitrary resource allocation and obscure decisional structure, the more illegitimate tasks managers reported. These results should be valuable for strategic-level management since they indicate that illegitimate tasks can be counteracted by means of the organization of work.

Healthy Work: Ideal and Reality among Public and Private Employed Academics in Sweden

In what does healthy work for persons with an academic background consist, and how great is the perceived gulf between actual work and healthy work? A random sample of 5,700 members of the Swedish Confederation of Professional Associations (SACO) was taken in order to investigate their images of healthy work (in a very broad sense). Two groupings of work aspects emerged as particularly important. The first can be designated as work intellectuality—that work provides intellectual stimulation and is performed freely and independently, that innovative thinking and initiative-taking are appreciated, and that personal qualities can be utilized constructively. Great discrepancies between ideal and reality were evident in the latter two aspects. The second significant set of aspects was the value of work—benefit of the work to society and the extent to which it accorded with personal values. Here, the correspondence between ideal and actual work was relatively high. Lowest ranked of the twelve aspects which were judged to constitute healthy work were being well paid and having opportunities for career advancement. Rank orders and discrepancies are analyzed for seven occupational groups: physicians, dentists, teachers, engineers, university teachers, lawyers and economists. Comparisons are made by gender, age, employer, and position.

CHANGES IN CONTROL SYSTEMS ASSESSED BY PUBLICLY EMPLOYED DENTISTS IN COMPARISON WITH OTHER PROFESSIONALS

In the public service sector in Sweden, including dentistry, changes in management control systems have occurred. The extent and content of such self-assessed changes are described and analyzed for dentists in relation to other academicians. A questionnaire was answered by 306 dentists in the Public Dental Health Service and 3600 other academicians in Sweden. The response rate was 67%-77%. Three areas of change were found in factor analysis: management by objectives, by dialogue, and by hierarchy. In logistic regression models, dentists reported fivefold increases in management by objectives as compared with other academicians. Reported increases in management by dialogue were less for dentists. Having a female supervisor was related to increase of management by hierarchy. It is concluded that clear changes in management style have occurred and that dentists are notable for increase of management by objectives.

Performative policy: the case of Swedish healthcare reforms

ABSTRACT In this article we analyze public sector change as a profoundly constructed phenomenon – as performative reforms. Public sector reforms, of which policy processes are an integral part, are constituted and realized through long chains of interventions. Communicative–discursive interventions posit and constitute problems as real and important, while technocratic interventions, such as plans, analyses, and schemes construct new imagined worlds for possible and attractive instrumental solutions. Our empirical results display circular movements of three modes of change, making up a continuous policy cycle in the transformation of Swedish health, reiterated on different levels of the system, in different scales, and with different actors involved. The continuity of the reforms is to a large extent the result of a successful institutionalization of the policy cycle and its content. It is stabilized as a set of discourse and social technologies, distributed throughout the entire healthcare system and almost impossible to question.

ENCLOSURE IN HUMAN SERVICES: The Panopticon of Dentistry

There are a number of indicators of increased work-environment problems within human services. The trend in the dental profession provides one example of this. The objectives of this study were to find indicators of differences between ideal and reality in dentists work in the Swedish Public Dental Health Service (PDHS). 160 dentists in the PDHS answered an openended question. Textual analysis was conducted in the form of line-by-line categorization, searching for sensitizing concepts. Enclosure and visibility emerged as two such concepts. The results were interpreted in Foucauldian terms, in particular through the metaphor of the Panopticon, the perfect prison of the 18th century. The work of Hirschman offers a path to a broader understanding of dentists’ work situation. Individuals’ reactions to negative circumstances may be to leave their organization (exit), to protest (voice), or to do neither (loyalty). Operationalization of enclosure within Hirschman’s framework shows that in the case of dentists only the loyalty option remains available.