Tone Alm Andreassen

Asymmetric Mutuality: User Involvement as a Government—Voluntary Sector Relationship in Norway

User involvement (UI) has been introduced as a measure to ensure more focused, efficient, client-oriented, service-minded health and welfare services. User involvement as participation in planning and decision making requires collective action on behalf of more or less formally organized groups of people for whom welfare policy is targeted, for instance people with long-term somatic or mental health problems or impairments. User involvement is thus to be understood as a specific kind of government-voluntary relationship. By utilizing a combination of social movement perspectives and neoinstitutional perspectives, the article explores the conditions behind the growth of UI and the characteristics of the relationship of UI compared with other government-voluntary relationships in the field of health and welfare—philanthropy and corporatist relations.

The consumerism of ‘voice’ in Norwegian health policy and its dynamics in the transformation of health services

The policy of voice consumerism in Norwegian health policy has enabled patients to be involved in discussions about professional practice. Principles of openness have been successfully introduced in services bound by professional autonomy and discretion. This article demonstrates the influence that Norwegian patients and their representatives have been able to have on service provision in brain injury rehabilitation and mental healthcare.The policy of voice consumerism in Norwegian health policy has enabled patients to be involved in discussions about professional practice. Principles of openness have been successfully introduced in services bound by professional autonomy and discretion. This article demonstrates the influence that Norwegian patients and their representatives have been able to have on service provision in brain injury rehabilitation and mental healthcare.

Employment of disabled people in Norway and the United Kingdom. Comparing two welfare regimes and why this is difficult

Abstract The aim of this article is twofold. First, we explore the differences in employment of disabled people between Norway and the United Kingdom, and to what degree differences in employment rates are due to variation in definition and measures of disability. Secondly, we discuss the significance of the two countries belonging to different welfare regimes when it comes to disabled peoples relation to the labour market. Most of the data on disabled peoples labour market participation stems from the Labour Force Surveys in the two countries, and the 2005 figures are used as a basis. The results indicate that the employment rate of disabled people is higher in the UK than in Norway. The article argues that this is first and foremost due to different ways of defining and measuring disability. The article illustrates why comparing two welfare states can be difficult. Are different welfare regimes of any significance for disabled peoples engagement with the labour market? The results indicate that the u...

The making of ‘professional amateurs’ Professionalizing the voluntary work of service user representatives

The aim of this article is, through empirical material from Norway, to grasp a particular form of non-profit professionalization spurred by the incorporation of policies of service user involvement in health care and in social services. By drawing on perspectives from the research on professionalization, our ambition is to increase the understanding of the nature of this form of professionalization, how it differs from other kinds of professionalization in the non-profit sector and why it achieves its distinctive features. We denote the professionalization of service users’ work as representatives, as the making of ‘professional amateurs’ to capture its paradoxical nature – that while the process of professionalization resembles occupational professionalization, the voluntary workers who are becoming professionalized are still amateurs. It is professionalization in the form of increasing the competence of the voluntary workers, not professionalization through transforming voluntary work tasks into occupations and paid employment. It is a form of competence fundamentally resting on personal experience with the issues with which the work is concerned, not a competence to be achieved solely through education and professional training.

Reforming Social Services: The Institutional and Organizational Context of the HUSK Program

In this article the author provides an analysis of: (a) the institutional context that gave rise to the HUSK program, (b) the character of the HUSK program, and (c) the consequences of the reform of the organizational context in which the HUSK program was implemented—the fundamental reorganization of the labor and welfare services which occurred as a result of the “NAV reform.” Local social insurance services, employment services, and social welfare services were merged into one joint NAV office. While the NAV reform was focused on organizational restructuring and integration of three formerly separate services, the HUSK program was focused on development of the professional competence of social workers only and on extensive service user involvement. While HUSK, based on the logic of professionalism, could bypass organization, the NAV reform placed the logic of organization at the forefront. The NAV reform and the HUSK program became parallel developmental processes with weak ties.

From Democratic Consultation to User-employment: Shifting Institutional Embedding of Citizen Involvement in Health and Social Care

Policies of citizen involvement in health and social care have given rise to a variety of organisational forms, which address citizens in different capacities and differ in their demands as to the representativeness, performance and competence of those involved. Apparently, the policies draw on different institutional logics. Based on extant studies, partly the authors own research from Norway, this article sheds light on three purposefully selected cases of citizen involvement. Two models of democratic consultation encompass a dominant model of involvement in Norway (advisory bodies of service users) and a model more prevalent in UK (panels of the general public). These are both embedded within a logic of democracy. A third emergent model of involvement is one in which citizens with experience as service users are engaged as workers in service providing organisations. This model resembles an idea of co-production. However, when involvement is organised as user-employment and paid work, the model rather seems rooted within the logic of the market – the labour market of service workers. The rise of this model suggests a shift in institutional embedding of citizen involvement. The analysis of these models provides a framework of distinguishing dimensions between different models of involvement.

Modification of Public Policies by Street-Level Organisations: An Institutional Work Perspective

The literature on policy implementation is divided with regards to the impact of street-level bureaucrats on the implementation of public policies. In this paper, we aim to add to and nuance these debates by focusing on ‘institutional work’ – i.e. the creation, maintenance and disruption of institutions – undertaken by central authorities and street-level bureaucrats during public reform processes. On the basis of a case study of the organisational implementation of a retirement pension reform in the Norwegian Labor and Welfare Administration, we argue that institutional work is a useful heuristic device for conceptualising the variety of responses available to street-level bureaucrats during public reforms. We also argue that the responses demonstrate the impact of street-level bureaucrats in these reforms in the context of managerial control and regulation. Finally, we argue that the effectiveness of policy change is dependent on the institutional work of street-level bureaucrats and, in particular, on institutional work that supports the institutions created by politicians and public administrations.

Unemployable Workers? Comparing the Context and Contract in Voluntary Work and Regular Jobs

In welfare societies, disability pensions or incapacity benefits provide income security to people who, due to health problems or disability, are assessed as being unemployable. However, it is sometimes possible for people on disability pensions to work, for instance on a voluntary basis in and on behalf of associations of disabled people. This article applies perspectives on employability and discusses whether voluntary workers, like representatives of associations of disabled people, could have been employed in the ordinary labour market or whether there are definite characteristics of voluntary work which allow their capacity for work to be utilised.