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Still ‘skiing their own race’ on New Public Management implementation? Patient choice and policy change in the Finnish and Swedish health-care systems

Smith, Christopher J. and Rauhut, Daniel LU (2019) In International Review of Administrative Sciences 85(1).
Abstract
This article applies an agenda-setting approach to the impact of New Public Management on health-care reform in Sweden and Finland (1993–2016). A system-level view of agenda setting and New Public Management implementation is used to order the historical data derived from literature reviews of each health reform process. New Public Management is viewed as a hybrid concept rooted in the search for efficiency gains and cost containment but, here, generating system preservation and system change strategies, characterised as ‘public competition’ and ‘choice and marketisation’. Sweden and Finland are viewed as ‘pragmatic modernisers’ in the public management literature. Health-care system reform in each country was based on similar problems and... (More)
This article applies an agenda-setting approach to the impact of New Public Management on health-care reform in Sweden and Finland (1993–2016). A system-level view of agenda setting and New Public Management implementation is used to order the historical data derived from literature reviews of each health reform process. New Public Management is viewed as a hybrid concept rooted in the search for efficiency gains and cost containment but, here, generating system preservation and system change strategies, characterised as ‘public competition’ and ‘choice and marketisation’. Sweden and Finland are viewed as ‘pragmatic modernisers’ in the public management literature. Health-care system reform in each country was based on similar problems and similar policy ‘solutions’, and was promoted by similar actors, while the implementation of choice and marketisation again saw windows of opportunity open in a similar manner in each. Policy divergence nevertheless occurred. We identify three key reasons for this, relating to the site and pervasiveness of conflict, the impact of party systems, and administrative openness to outside ideas. Sweden’s conflictual politics produced stalemate while consensual Finland produced radical policy change. (Less)
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type
Contribution to journal
publication status
published
subject
in
International Review of Administrative Sciences
volume
85
issue
1
publisher
SAGE Publications
external identifiers
  • scopus:85060727062
ISSN
1461-7226
DOI
10.1177/0020852318801498
language
English
LU publication?
no
id
cb4fdb05-17d3-4c0c-9786-0d93f7b61897
date added to LUP
2024-03-07 12:36:26
date last changed
2024-03-08 04:07:29
@article{cb4fdb05-17d3-4c0c-9786-0d93f7b61897,
  abstract     = {{This article applies an agenda-setting approach to the impact of New Public Management on health-care reform in Sweden and Finland (1993–2016). A system-level view of agenda setting and New Public Management implementation is used to order the historical data derived from literature reviews of each health reform process. New Public Management is viewed as a hybrid concept rooted in the search for efficiency gains and cost containment but, here, generating system preservation and system change strategies, characterised as ‘public competition’ and ‘choice and marketisation’. Sweden and Finland are viewed as ‘pragmatic modernisers’ in the public management literature. Health-care system reform in each country was based on similar problems and similar policy ‘solutions’, and was promoted by similar actors, while the implementation of choice and marketisation again saw windows of opportunity open in a similar manner in each. Policy divergence nevertheless occurred. We identify three key reasons for this, relating to the site and pervasiveness of conflict, the impact of party systems, and administrative openness to outside ideas. Sweden’s conflictual politics produced stalemate while consensual Finland produced radical policy change.}},
  author       = {{Smith, Christopher J. and Rauhut, Daniel}},
  issn         = {{1461-7226}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{SAGE Publications}},
  series       = {{International Review of Administrative Sciences}},
  title        = {{Still ‘skiing their own race’ on New Public Management implementation? Patient choice and policy change in the Finnish and Swedish health-care systems}},
  url          = {{http://dx.doi.org/10.1177/0020852318801498}},
  doi          = {{10.1177/0020852318801498}},
  volume       = {{85}},
  year         = {{2019}},
}