Gender and the Public Sector: Professionals and Managerial Change

By Jim Barry; Mike Dent et al. | Go to book overview

7

Plural frames of work in public sector organisations

Hans Hasselbladh and Martin Selander

Introduction

This chapter presents a study of the contested status of elderly people and professional work at two nursing homes in Gothenburg. Within Swedish health care, nursing homes have arrived at a crossroads and are confronted with conflicting frames of organisation. The status of professional work and of the elderly has become questioned - a consequence of the recent introduction of new public management (NPM) ideas, especially those relating to customer responsiveness. In 1992 a government reform was implemented, which explicitly defines the elderly living in nursing homes as 'customers', i.e. as consumers of a particular kind of housing and complementary services.

Our chapter raises three aspects of plural frames on the nursing homes. First, the identity of these sites is in flux, as a result of the government reform. Are nursing homes a kind of hospital, or sites for providing care for the very old, or a special kind of housing? Second, the status of the elderly is in a state of redefinition. Are they sick, and to be cured, or are they in a special stage of life with a special need for care, or are they tenants with unusual needs? Finally, the status of professional work is also in a state of change - is it nursing or medical work, or care of elderly people, or service for a particular type of customer? Work in nursing homes is also extremely gendered, as all employees are female. A complex pattern of relations between medicine, care and service as frames of action is presented in this chapter. The competing frames are restricted by an economic frame, which does not intervene in the practices as such but affects them indirectly. The pressure to cut the costs of running nursing homes - which has been very prevalent in the council of Gothenburg - has had an important influence on the emergence of a new balance between the frames of action at the nursing homes.

The chapter is organised as follows. The first section discusses how professions become involved in what we call plural framing - a redundancy of signification of professional work. The second section discusses the framing of professional identity and work and how rationalisation and NPM reforms may influence that. After that follows a background to our case, the reforms of the care for elderly people in Sweden. The frames identified in the case are

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Gender and the Public Sector: Professionals and Managerial Change
Table of contents

Table of contents

  • Title Page v
  • Contents vii
  • Acknowledgements xvi
  • Introduction 1
  • Part I - Contexts and Networks 13
  • 1 - New Labour, Governance and the Politics of Diversity 15
  • Notes 25
  • 2 - Gendered States, Critical Engagements 27
  • 3 - Managing Transformation? 44
  • 4 - Gender, Welfare Regimes and the Medical Profession in France and Greece 65
  • Notes 80
  • Part II - Managing Professional Work 83
  • 5 - Identifying the Professional 'Man'Ager 85
  • 6 - Women's Positioning in a Bureaucratic Environment 104
  • 7 - Plural Frames of Work in Public Sector Organisations 120
  • Note 133
  • 8 - On the Front Line 136
  • 9 - Hard Nosed or Pink and Fluffy? 154
  • References 168
  • 10 - Ministering Angels and the Virtuous Profession 170
  • References 184
  • Part III - Identity and Biography 187
  • 11 - Gendered Narratives of the Management of Residential Care Homes 189
  • 12 - The Problematic Professional 205
  • References 216
  • Index 218
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