When ‘Choice’ and ‘Choice’ Are not the Same: Institutional Frameworks of Choice in the German Welfare System

Blank, Florian

doi:10.1002/9781444324341.ch4

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…In German healthcare, policy discussions have increasingly focused on enabling patients in sharing their views on care quality (Blank, 2009; Ewert, 2011; Köppe et al., 2016; Newman & Kuhlmann, 2007). This shift is reflected in hospital management rhetoric as well, where one of the most prominent buzzwords has become “value‐based healthcare” (Porter & Guth, 2012), an approach to internal control that seeks to make patient experiences part of quality measurement.…”

Section: Methodsmentioning

confidence: 99%

Making the user useful? How translation processes managerialize voice in public organizations

2020

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One of the most pervasive topics in public management discussions in recent decades is the notion of user orientation. More than ever, external stakeholders expect public organizations to "get closer" to users and to treat citizens as knowledgeable consumers of public services with a view and a voice. Existing literature highlights how, through a wide range of calculative practices, information gathered from and about public service users is assembled into descriptions of organizational activity that are useful for managers in addressing issues of surveillance and internal control as well as legitimation. In our multiple case study of hospitals and prisons in Germany, we introduce a two-step model of translation for explaining how user voice is transformed into management objects, which are then further translated into organizationally "useful" information. In doing so, we make three contributions to further our understanding of how user views are formatted to organizational activity and put to use by managers in the public sector. First, we developed a model of translation that highlights how user voices and the prospect of user orientation are enacted across diverse organizational contexts. Second, we found that different types of organizations deploy distinct methods of accounting, which nevertheless make user feedback useful in similar ways: to develop information that helps construct an image of performance, gain financial leverage, and enact compliance. Third, we found that in addition to quantitative forms of accounting, narrative accounting techniques played important roles in making users "useful" in public organizations.

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Section: Methodsmentioning

confidence: 99%

Making the user useful? How translation processes managerialize voice in public organizations

2020

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“…Choice-based environments. In countries throughout Europe but also in the United States one can see vouchers or even budgets being granted to individual citizens, as novel ways of public services delivery (Gilbert and Gilbert 1989;Savas 2000;Blank 2009;Greve 2011;Loeb, Valant and Kasman 2011). On the supply-side these so-called 'choice-based services' enable policy-makers to differentiate between target groups and to offer varying schemes of choice.…”

Section: A Civic Turn: Citizens and Public Administrationmentioning

confidence: 99%

The public encounter as object of scholarly inquiry

2022

The Politics of the Public Encounter

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“…User choice has been examined at a policy level, mostly as a welfare state ideology connected to welfare consumerism, welfare markets, neo‐liberalist ideas and New Public Management (e.g. Blomqvist ; Glendinning ; Blank ). Its implementation in procedures like direct payments, personal budgets and service vouchers has been studied (e.g.…”

Section: Studying Choices In Interactions Between Service Users and Pmentioning

confidence: 99%

Accepting and Negotiating Service Users' Choices in Mental Health Transition Meetings

et al. 2014

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Across Western welfare regimes, policies emphasize that service users should have more choices regarding their services. This article examines how service choices are presented, responded to and decided in interactions between service users and professionals in mental health transition meetings. Choice is often associated with consumerist user involvement ideas, but in mental health choice also relates to democratic user involvement approach and to shared decision making between professionals and service users. The results of the study show that professionals construct service users as consumers by offering service options in choice making sequences, expecting users to make appropriate choices. Service users mostly act like consumers by responding to these choice options. However, the study also demonstrates that the professionals do not always accept the user' first choice but respond to them as non-preferred. Sometimes they also suggest choices on behalf of the users. In these 'non-accepting' sequences choices are negotiated in interaction between the parties, rather than users acting as autonomous choice makers. The sequences are based on two kinds of professional reasoning: first the professional-led needs assessment and second the structure of the service package that the user is being offered. This negotiation has elements of shared decision making and the 'logic of care'. But it also has elements of paternalist control which 2 challenge both consumerist and democratic service user involvement and suggests consideration of more collectively oriented service user actions.

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When ‘Choice’ and ‘Choice’ Are not the Same: Institutional Frameworks of Choice in the German Welfare System

Cited by 3 publications

References 20 publications

Making the user useful? How translation processes managerialize voice in public organizations

Making the user useful? How translation processes managerialize voice in public organizations

The public encounter as object of scholarly inquiry

Accepting and Negotiating Service Users' Choices in Mental Health Transition Meetings

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