Changing accountability regimes in hospital governance

Denmark and Norway compared

Authors

  • Haldor Byrkjeflot Department of Sociology at University of Oslo
  • Simon Neby Uni Stein Rokkan Centre for Social Studies, Norway
  • Karsten Vrangbæk Danish Institute of Governmental Research

DOI:

https://doi.org/10.58235/sjpa.v15i4.16153

Keywords:

Accountability, Reform, Hospitals, Governance, Democracy

Abstract

As modern welfare states are reforming, relationships and processes of accountability in public sector systems are transforming. This transformation has consequences for the relationship between the public, political and administrative institutions as well as service production, and ultimately concerns democratic legitimacy. In this article we focus on the hospital systems in Norway and Denmark, and explore the changes in accountability relationships that have come about in conjunction with reforms over the last 10-15 years. Departing from the theoretical idea that accountability serves several different functions and the empirical observation that recent reforms in the two systems are diverging as much as converging, we find that health care reforms provide fruitful cases for studying changing accountability relationships. We argue that the Norwegian and Danish hospital sectors, in spite of reform variation, are both moving from a situation characterized by democratic-administrative accountability mechanisms towards an increased focus on performance-oriented accountability mechanisms that combine and intersect with more traditional notions of democratic and administrative accountability. Finally, and based on this finding, we explore the implications for further research on accountability changes and reform.

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Author Biographies

Haldor Byrkjeflot, Department of Sociology at University of Oslo

Haldor Byrkjeflot, Dr.polit, is professor at the Department of Sociology and Human Geography, University of Oslo and is also associated with Uni Stein Rokkan Centre for Social Studies. He has ample research experience within management in several areas, and has worked extensively with themes such as reform, governance and reputation management within the hospital sectors.

Simon Neby, Uni Stein Rokkan Centre for Social Studies, Norway

Simon Neby, PhD, is senior researcher at Uni Research, the Stein Rokkan Centre for Social Studies. He has worked with questions concerning reforms and governance of Scandinavian hospital systems and healthcare, but also has experience from research on other areas of the welfare state and governance in general.

Karsten Vrangbæk, Danish Institute of Governmental Research

Karsten Vrangbæk, PhD, is director of research at the Danish Institute for Governmental research. He has worked with reforms and management in areas crossing municipalities, regions and the state, not least healthcare systems. He has also worked with public sector values and public management.

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Published

2011-12-15

How to Cite

Byrkjeflot, H., Neby, S., & Vrangbæk, K. (2011). Changing accountability regimes in hospital governance: Denmark and Norway compared. Scandinavian Journal of Public Administration, 15(4), 3–23. https://doi.org/10.58235/sjpa.v15i4.16153

Issue

Section

Original Articles

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