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In the article we discuss the increased use of open tenders in the public procurement of welfare services in Norway in order to determine if this implies standardization, professionalization, and/ or innovation among civil sector providers and if this differs between welfare areas. The study is based on a review of public documents over the last 40 years and interviews with both purchasers and providers of welfare services in two welfare areas: SUD treatment and vocational rehabilitation. We emphasize the systemic and in part organizational levels, focusing on what the purchaser and management of the provider perceive as the result of these changes in the procurement regime. In light of neoinstitutional theory and theories on innovation, we find that the increased use of public procurement and tenders have professionalized and standardized non-profit organizations while also providing room for innovations, according to our informants. We find a kind of dual process, where organizations become more alike in structure, administration, andto some degreetreatment while also becoming more specialized and, in some cases, arriving at new and innovative solutions regarding content.

PurposeTrust plays an important role in the organisation of healthcare services. In Norway, the establishment of mandatory municipal acute wards with 24 h inpatient services introduces a new unit into the healthcare system. This article discusses how this new health care service succeeds in building trust with patients and among healthcare workers.Design/methodology/approachThe article is an in-depth case study of a single, exemplary inter-municipal acute ward. The study draws on interviews with COPD patients, the leader and doctors at the ward. The study also includes observations of daily work at the municipal acute ward. Moreover, administrators and healthcare workers at related healthcare institutions have been interviewed. Data were analysed using a qualitative method.FindingsThe study reveals that trust is built in complex relations and that it has both individual and systemic factors. The practices employed in the daily treatment and care of patients and in encounters between health care personnel and patients are important trust-building processes; however, these processes depend on structures and routines that promote efficient and adequate inter-organisational communication and patient-oriented procedures.Practical implicationsThe study provides insight into how trust dynamics work on multiple organisational levels and how they depend on both individual and systemic factors. Additionally, the study may provide a picture of the importance of trust in organising healthcare services in the future.Originality/valueLessons regarding trust building inspired by data from a case-study care institution can be applied in different care settings and countries.

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Artikkelen tar utgangspunkt i ei undersøking om arbeidsinnvandring til dei fire vestlandsfylka og om dette leier til behov for å utvikle eigne lokale politikkar for velferdstenester. Materialet er statistikk for regionen, dokument og nettsider, og intervju med tenesteytarar, arbeidsinnvandrarar og arbeidsgivararar i fylkeskommunane og åtte kommunar. Hovudfokus i artikkelen er kva politikk som kjem fram gjennom praksis. Funna viser at det er lagt liten vekt på arbeidsinnvandrarane sine saerskilte behov, at tenestetilbodet vektlegg det som er nødvendig der og då, og at det manglar tenesteutvikling for det framtidige og langsiktige. I artikkelen blir denne lokale politikken omtala som «reaktiv pluralisme» og det vert hevda at situasjonen kunne bli betre viss arbeidsinnvandrarane blei tatt meir på alvor som medborgarar og ved at kommunane la til rette for dei som om dei skulle bli verande i lengre tid.

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