Is nordic eldercare facing a (new) collaborative turn?

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The aim was to discover whether Nordic elderly care policy is nudging municipalities towards the adoption of new public governance approaches and how they may be best motivated to do so.

Scholars do not see the new public governance as a unified or new administrative paradigm, but it does have some features in common (Greve et al. 2020; Osborne 2010; Torfing et al., 2020; Torfing & Triantafillou 2013).

Collaboration, inclusion and co-production as communal elements

Based on previous research, this study utilised three key community elements of the new public governance (Osborne 2010; Torfing et al. 2020) to analyse the content of the data.

The first is cooperation between different administrative levels (vertical) or content sectors (horizontal). The integration of services, for example between specialist care and home care, is one example of this (Goodwin 2016). Another element of the new public governance is the integration of customers and patients into service production (Needham & Carr 2009; Ansell & Torfing 2021). The third can be called co-production, usually in collaboration between a public sector actor and a private sector actor, for example with companies or organisations (Ansell & Torfing 2021).

The analysis focused on 20 key laws and 42 policy documents from the 2010s onwards. It shows that new public governance is visible in Nordic care policy and that states guide executive actors, municipalities and regions, to work in that direction. Project funding, following good practices and guiding information through various networks are all used here as motivating means. Countries often learn from each other in terms of legislation and policy, promoting policy transfer.

Policy guidance for the elderly care according to the new public governance

The following is a list of examples of policy guidance for care for the elderly under the new public administration.

1. Vertical and horizontal collaboration and service integration are reflected, among other things, in customer and patient service plans that are being implemented in all countries. In addition, the data mentioned care paths or chains, service chains, service guidance, multi-professional teams and reablement which has spread from Denmark to the other Nordic countries. It is a multi-professional home rehabilitation approach that supports the ability to act on one’s own in your own habitat.
2. Involving customers and patients in service production was highlighted in policy documents through, among other things, the terms active ageing, self-care and customer orientation. Emphasis is placed on the activity, inclusion and hearing of clients and patients and, for example, on technological applications which often seek to promote self-care and self-reliance rather than reliance on services. The emphasis on family care is also inclusive and the Finnish Family Care Act (263/2015) directs caring responsibilities away from public services.
3. Co-production in the new public governance is different from that in the market-oriented New Public Management approach, as it is not based on market creation and competition, but on cooperation. In Finland, this is reflected, among other things, in the fact that while the task of the new welfare areas is soon to provide services, municipalities and other organisations are responsible for promoting well-being and health. Denmark has its own programme for strengthening civil society as part of service development

New research on elderly care policy in the Nordic countries 

This is one of the first studies in the field of care for the elderly showing how the new public governance approach is presented in Nordic care policy documents. This may be due to the marketisation of care policy that began in the 1990s which widened the range of care producers and made the system more complex. The overarching policy imperative of cost containment and the need to effectively husband scarce resources also has a role to play here. In the new public governance, the aim is to bring together the resources of all actors so that ageing at home is possible.

References

Ansell, C., & Torfing, J. (2021). Co-creation: The new kid on the block in public governance. Policy & Politics, 49(2), 211–230.

Goodwin, N. (2016). Understanding integrated care. International Journal of Integrated Care, 16(4), 1–4.

Greve, C., Ejersbo, N., Lægreid, P., & Rykkja, L. H. (2020). Unpacking Nordic administrative reforms: Agile and adaptive governments. International Journal of Public Administration, 43(8), 697–710.

Needham, C., & Carr, S. (2009). Co-production: An emerging evidence base for adult social care transformation. SCIE research briefing 31. Social Care Institute for Excellence.

Osborne, S. P. (2010). Introduction. The (new) public governance: A suitable case for treatment? In S. P. Osborne (Ed.), The new public governance? Emerging perspectives on the theory and practice of public governance (pp. 1–16). Routledge.

Perhehoitolaki (263/2015).

Torfing, J., Andersen, L. B., Greve, C., & Klausen, K. K. (2020). Public governance paradigms: Competing and co-existing. Edward Elgar Publishing.

Torfing, J., & Triantafillou, P. (2013). What’s in a name? Grasping new public governance as a political-administrative system. International Review of Public Administration, 18(2), 9–25.

The article

Vabø, Mia, Zechner, Minna, Stranz, Anneli, Graff, Lea & Sigurðardóttir, Sigurveig H. (2022) Is Nordic eldercare facing a (new) collaborative turn? Social Policy & Administration https://doi.org/10.1111/spol.12805