Marketization, Managerialism and Welfare State Professionalism
Edited by Tanja Klenk and Emmanuele Pavolini
Chapter 6: New governance and professionalism
Professional services, also in care and welfare, face complex conditions. At first sight, this is a matter of rational, performance-based organizational and managerial pressures. Rational organizational systems and management control techniques are used to privilege outputs and outcomes, monitor production processes and hold employees, including professionals such as medical doctors and nurses, accountable. Products have to be delivered, preferably at competitive markets for services, and measurable results have to be booked. This has led to many comments upon and worries over the disciplining of professional practices and the de-professionalization of professional case treatment (Freidson 2001). Public professionalism has become pressured professionalism. On the side of professional groups, this has not only fueled commentaries and worries, but also tactical maneuvers and ‘micro resistance’ to neutralize management effects (Waring and Currie 2009; Thomas and Davies 2005) as well as to coping behavior in order to deal with difficult and ‘downgrading’ effects (Halliday et al. 2009; Hupe and Van der Krogt 2013). At second sight, these basic analyses and worries are too simple. When we dive more deeply into the dynamics of professional services, also in domains like care and welfare, we encounter more complex governance circumstances. Instead of mere managerialization and marketization, we find political and other pressures that embody ambivalent longings and conflicting logics (Thornton, Jones, and Kury 2005; Reay and Hinings 2005, 2009; Besharov and Smith 2014).
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