Being bound and tied by the ropes of frugality: a case study on public management values and service integration

PurposeNew 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,...

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Veröffentlicht in:Journal of health organization and management 2022, Vol.36 (9), p.95-111
Hauptverfasser: Løken, Therese Dwyer, Helgesen, Marit Kristine, Vike, Halvard, Bjørkquist, Catharina
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container_end_page 111
container_issue 9
container_start_page 95
container_title Journal of health organization and management
container_volume 36
creator Løken, Therese Dwyer
Helgesen, Marit Kristine
Vike, Halvard
Bjørkquist, Catharina
description PurposeNew 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.Design/methodology/approachThis 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.FindingsThe 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.Originality/valueApplying 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.
doi_str_mv 10.1108/JHOM-10-2020-0401
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source MEDLINE; Sociological Abstracts; Applied Social Sciences Index & Abstracts (ASSIA); Standard: Emerald eJournal Premier Collection
subjects Case studies
Cities
Collaboration
Drug abuse
Health care management
Health problems
Humans
Integrated care
Interdisciplinary aspects
Management
Mental disorders
Mental health
Mental health services
Municipalities
New public management
Organizational structure
Professional practice
Professionals
Public administration
Public health
Public services
Research Paper
Segmentation
Service integration
Social services
Social Support
Social Work
Substance abuse
Value
title Being bound and tied by the ropes of frugality: a case study on public management values and service integration
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