Demarcation or assimilation?Hospital social workers (HSWers) jurisdictional work in Sweden and Germany

2012-07-11Manuela Sjöström, PhD student, Gothenburg university, Sweden

Manuela Sjöström, PhD student, Gothenburg university, Sweden

HSW – conditions

Frequently uttered claims: - Work tasks in health care are unclear- Professional discretion often disregarded- Health care policy makers have unclear

expectations on HSWers contributions

Limited research on HSW & its professionalization

Cross-national research on professionalization is unusual

2012-07-11

Manuela Sjöström, PhD student, Gothenburg university, Sweden

Jurisdictional work

2012-07-11

Professionalization = a context bound individually, but predominantly collectively pursued attempt to gain jurisdictional control over a professional sub-groups work tasks & fields.

Jurisdictional work = Use of specific internal and external activities & strategies in order to protect jurisdiction in a variety of arenas (work place, professional group, public & policy making.

Manuela Sjöström, PhD student, Gothenburg university, Sweden

Aim, Theory, Method

Aim: Describing, analysing, comparing HSWers performance of jurisdictional work during the period 1989-2008; predominantly on the associational level, but also on the work place level & state level

Theory: Predominantly Theory of professions (Abbott 1988 & 2005); Theory on social identity (Jenkins 2003), Theory on organisational compliance (Etzioni 1961), symbolic interactionism (Mead 1962) Argumentation analysis (Karlsen 2012)

Method: Case study including approx. 450 documents from HSWers’ professional bodies (predominantly 2 associations) in Sweden and Germany; 2 focus group interviews (associational boards); 11 interviews with HSWers in Germany (5) and Sweden (6)

2012-07-11

Manuela Sjöström, PhD student, Gothenburg university, Sweden

Background1989-2008

Different welfare state regimes (Esping-Andersen 1990): Sweden = Social democratic welfare state, Germany = corporative welfare state regime

Sweden, legislative reforms:

Abolishing overlap between counties’ and municipalities’ responsibilities concerning health care/social welfare services ( esp. elderly care/psychiatric care reforms)

Efforts to introduce private caregivers

Germany, legislative reforms:

Formal integration of legislation concerning social welfare/health care in one legislative framework (SGB)

Efforts to increase involvement of other than historically established corporative actors in policy making (esp. patients) (GMG)

2012-07-11

Manuela Sjöström, PhD student, Gothenburg university, Sweden

Results:Internal jurisdictional

workDeveloping a collective

professional identityCollectively describing

the profession’s

past and presence

(incl. perceived

lack of control)

Collectively defining

work task, competence requirement

s, professional standards

Embedding HSW in a primary

disciplinary context

Controlling and

expanding compliance to collective definitions

2012-07-11

Manuela Sjöström, PhD student, Gothenburg university, Sweden

Results:External jurisdictional work I

Strategies and activities to transfer into formal jurisdiction (Legislature, public

regulations, work place level)

Showing presence in

these arenas

Informing on

associational stances

Cooperating &

negotiating over

professional boarders

Lobbying

2012-07-11

Manuela Sjöström, PhD student, Gothenburg university, Sweden

External jurisdictional work II

Paving the way for formal jurisdiction (Labour unions, university departments/research, (patient) organisations, other professions,

local actors, media)

Building coalitions

Negotiating

Cooperating

2012-07-11

Manuela Sjöström, PhD student, Gothenburg university, Sweden

Collective claims-making

HSW is especially suitable to fill this function; it has a specific and genuine set of competences/skills

Health care organisations/policy makers tend to fail filling these functions

HSW is necessary in health careto bridge gaps between health

care/social welfare;and to represent patient interests in

health care

2012-07-11