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Political strategies in difficult times - The "backstage" experience of Swedish politicians on formal priority setting in healthcare
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. (Prioriteringscentrum)ORCID iD: 0000-0002-3300-5516
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life. (Prioriteringscentrum)ORCID iD: 0000-0003-0204-4536
2016 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 163, 63-70 p.Article in journal (Refereed) Published
Abstract [en]

This paper contributes to the knowledge on the governing of healthcare in a democratic context in times of austerity. Resource allocation in healthcare is a highly political issue but the political nature of healthcare is not always made clear and the role of politicians is often obscure. The absence of politicians in rationing/disinvestment arrangements is usually explained with blame-shifting arguments; they prefer to delegate "the burden of responsibility" to administrative agencies or professionals. Drawing on a case where Swedish regional politicians involved themselves in setting priorities at a more detailed level than previously, the findings suggest that the subject of "blame avoidance" is more complicated than usually assumed. A qualitative case study was designed, involving semi-structured interviews with 14 regionally elected politicians in one Swedish health authority, conducted in June 2011. The interviews were analysed through a thematic analysis in accordance with the "framework approach" by Ritchie and Lewis. Findings show that an overarching strategy among the politicians was to appear united and to suppress conflict, which served to underpin the vital strategy of bringing the medical profession into the process. A key finding is the importance that politicians, when appearing "backstage", attach to the prevention of blame from the medical profession. This case illustrates that one has to take into account that priority settings requires various types of skills and knowledges - not only technical but also political and social. Another important lesson points toward the need to broaden the political leadership repertoire, as leadership in the case of priority setting is not about politicians being all in or all out. The results suggest that in a priority-setting process it is of importance to have politics on-board at an early stage to secure loyalty to the process, although not necessarily being involved in all details.

Place, publisher, year, edition, pages
Saunders Elsevier, 2016. Vol. 163, 63-70 p.
Keyword [en]
Blame avoidance; Healthcare; Interview; Leadership; Legitimacy; Political strategies; Priority setting; Sweden
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-130800DOI: 10.1016/j.socscimed.2016.06.046PubMedID: 27404909OAI: oai:DiVA.org:liu-130800DiVA: diva2:955108
Available from: 2016-08-24 Created: 2016-08-24 Last updated: 2016-09-14

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The full text will be freely available from 2019-06-28 09:45
Available from 2019-06-28 09:45

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Garpenby, PeterNedlund, Ann-Charlotte
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Division of Health Care AnalysisFaculty of Medicine and Health SciencesNISAL - National Institute for the Study of Ageing and Later Life
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Social Science and Medicine
Health Care Service and Management, Health Policy and Services and Health Economy

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