Room for Action? How Service Managers in Three Scandinavian Cities Experience their Possibilities to Develop their Services

Abstract

Background The study is based on the ongoing public debate concerning a limited scope for local service development in alcohol and drug treatment-related services - and that the main cause of local “paralysis” is to be found in health policy micromanagement of these services. It is argued that business management models place too much emphasis on financial control and performance measurement and that this leads to less interest in quality improvement in the provision of services. Design 23 interviews with service managers in three Nordic urban municipalities, Stavanger, Umeå and Aarhus. Results The article documents comprehensive local service development, demonstrating that the main conditions for innovation are management commitment and interdisciplinary co-operation in the practice field. Conclusions In all three municipalities the services develop in a hybrid innovation model that combines New Public Management-inspired solutions with technical co-operation in horizontal networks. Results show that NPM-inspired solutions to alcohol and drug treatment services do not necessarily hinder the consideration of local professionalism and flexibility in the development.