Valfrihet I Arvika Kommun

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Valfrihet I Arvika Kommun Fakulteten för samhälls- och livsvetenskaper Brith Marie Johansson Margaretha Lundberg Eva Nilsson Valfrihet i Arvika kommun En studie av medborgarnas inställning till valfrihet Freedom of choice in Arvika municipality A studie of citizens settings to freedom of choice Masteruppsats Vårterminen 2011 Datum/Termin: 2011-05-13 Handledare: P O Norell Examinator: Alf Sundin Karlstads universitet 651 88 Karlstad Tfn 054-700 10 00 Fax 054-700 14 60 [email protected] www.kau.se Abstract Society is developing into having an increasingly individualistic approach and the freedom of choice has come as a reform to strengthen the individual's opportunities for involvement, influence and power in society. We found it interesting to go into the question and examine how the reform affects the municipality. The politicians in Arvika municipality have decided to exposure for competition the service area within elderly care under The Act on System of Choice in the Public Sector (LOV). Neoliberalism and New Public Management have contributed to that we have gone from a collectivist approach to an increasingly individualistic. We have chosen to describe how the influences of these movements have affected the society and its organization. Democracy is significant because all people have equal dignity and equal rights. The right to influence and to take part in decisions are the important parts of democracy. The purpose of this study is to describe the settings of the residents of Arvika municipality for municipal and private providers within elderly care and if there are any differences in settings between specific groups of age. The research question we ask ourselves is if the residents settings varies between the age groups 35, 50, 65 and 80 years, registered in Arvika municipality. Keywords in the paper is Setting, Choice and Neoliberalism / NPM / Privatization. A main study in the form of a survey forms the basis of our study. To get a better range and more angles, we have supplemented with sub-studies where we have examined the experiences of other municipalities, how the market is and what is the views of the key actors in Arvika municipality. The results shows that the citizens who took part in the study have a negative attitude to increased competition and privatization, and to pay for private services in elderly care. They are more sympathetic to the situations of choice they face in society and want to select providers if they have been granted a service in elderly care. ii Sammanfattning Samhället utvecklas till ett alltmer individualistiskt synsätt och valfrihet har kommit som en reform för att förstärka den enskilde individens möjlighet till delaktighet, påverkan och makt i samhället. Vi fann det därför intressant att studera närmare hur reformen påverkar den kommun där vi arbetar i vård och omsorgsverksamheten. De ansvariga politikerna i Arvika kommun har beslutat att konkurrenspröva serviceområdet inom hemtjänsten enligt lagen om valfrihetssystem (LOV). Nyliberalismen och New Public Management rörelsen har bidragit till att vi har gått från en kollektivistisk syn till en allt mer individualistisk. Vi har valt att beskriva de påverkningar dessa rörelser har resulterat i när det gäller samhället och dess organisation. Demokrati har en viktig aspekt eftersom det bland annat handlar om att alla människor har lika värde och samma rättigheter. Rätten att påverka och att vara med och bestämma är betydelsefulla delar inom demokratin. Syftet med studien är att vi vill främst beskriva Arvika kommuns invånares inställning till kommunala och privata utförare inom äldreomsorgen bland särskilda kategorier av åldersgrupper för att se om det finns variationer i inställningen till valfrihet. Forskningsfrågan vi ställer oss är om inställningen varierar till valfrihetssystem för servicetjänster inom äldreomsorgens hemtjänst bland medborgare inom åldersgrupperna 35, 50, 65 och 80 år, folkbokförda Arvika kommun? Centrala begrepp i uppsatsen är Inställning, Valfrihet och Nyliberalism/NPM/Privatisering. En huvudstudie i form av en enkätundersökning utgör basen i vår studie. För att få en större bredd och fler infallsvinklar har vi kompletterat med delstudier där vi undersökt erfarenheter från andra kommuner, hur marknaden ser ut och vilka synpunkter aktörerna i Arvika har. Resultatet tyder på att medborgarna i studien har en negativ inställning till ökad konkurrensutsättning och privatisering samt till att betala för privata tjänster inom vård och omsorg. De är istället positivare till de valsituationer man ställs inför i samhället och vill vara med och välja utförare om de har fått en beviljad servicetjänst inom hemtjänsten. iii Förord Master of Public Administration (MPA) är utbildningen vi har ägnat oss åt de sista tre åren, sedan 2008, samtidigt som vi utfört våra yrkesuppgifter inom verksamheten vård och omsorg i Arvika kommun. Utbildningen är ett samverkansprojekt mellan Universitetet i Karlstad, Högskolan i Falun samt Norska Høgskolen i Hedmark. Vi är nu i den avslutande delen av utbildningen som består av att leverera denna uppsats. Valet av ämne vi belyser föll på plats relativt snart då vi såg möjlighet att använda oss av vårt uppsatsämne i utvecklingsarbetet med att ta fram strategier inför en reformförändring i den verksamhet vi arbetar i. Reformen innebär i ett första steg för Arvika kommun att införa valfrihetssystem på vissa delar inom verksamheten vård och omsorgs hemvård. I samband med att vi skulle skriva master uppsats fann vi det intressant att fokusera på ämnet valfrihet. Vi känner att det är viktigt att studera området närmare vad det gäller vilken inställning medborgaren inom olika åldersgrupper i Arvika har omkring ökad konkurrens och privatisering, samt inställning till möjlighet att själv kunna välja utförare när man har fått en beviljad servicetjänst. Det skulle vara en vinning för oss att få underlag till det strategiska arbete som vi inom vård och omsorg bedriver med anledning av den nya reformens införande samtidigt som det bidrar till uppsatsarbetet i vår sista del av utbildningen. Arbetet med uppsatsen har vi fördelat mellan oss. Vi har namngett våra insatser genom att skriva namn på de olika kapitel vi har huvudansvar för. Sammantaget sett ansvarar vi givetvis för hela uppsatsen tillsammans. Här är det dags att rikta våra stora tacksalvor till er som bidragit på olika vis till att vi blivit färdiga med uppsatsen och kunna fylla den med innehåll och slutföra vår utbildning. Vi vill särskilt tacka vår handledare P-O Norell för hans råd och vägledning samt alla ni som bidragit med material till vår uppsats. Vi vill också tacka alla som bidragit till vår resa vi gjort de sista tre åren med MPA. Ingen nämnd, ingen glömd! Arvika, maj 2011 Eva Nilsson Margaretha Lundberg Brith-Marie Johansson iv Innehållsförteckning 1. DISPOSITION ................................................................................................................. 1 1.1 Inledning ..................................................................................................................... 1 2. BAKGRUND .................................................................................................................... 4 2.1 Allmän bakgrund ........................................................................................................ 4 2.1.1 Nyliberalism .................................................................................................................... 7 2.1.2 NPM - New Public Management, en reformrörelse ..................................................... 8 2.1.2.1 NPM och rollen som tjänsteman............................................................................. 10 2.1.2.2 NPM och rollen som politiker ................................................................................ 10 2.1.2.3 NPM och rollen som medborgare ........................................................................... 10 2.1.2.4 NPM och rollen som anställd samt de fackligas syn .............................................. 11 2.1.3 Demokrati ............................................................................................................. 14 2.1.3.1 Demokrati och rollen som politiker ........................................................................ 16 2.1.3.2 Demokrati och rollen som tjänsteman .................................................................... 18 2.1.3.3 Demokrati och rollen som medborgare/brukare ..................................................... 19 2.1.3.4 Demokrati och rollen som anställd samt de fackligas syn ...................................... 22 2.1.4 Lagstiftning ................................................................................................................... 24 2.1.4.1 Socialtjänstlagen SoL ............................................................................................. 24 2.1.4.2 Lagen om valfrihetssystem LOV ............................................................................ 25 2.1.5 Offentliga sektorns nya form ....................................................................................... 26 2.1.5.1 Privatisering ............................................................................................................ 26 2.1.6 Litteraturstudier ........................................................................................................... 28 Summering allmän bakgrund.............................................................................................. 33 2.2 Empirisk bakgrund ..................................................................................................
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