University of Agder, Department of Political Science and Management, Norway.
University of Agder, Department of Political Science and Management, Norway.
Soc Sci Med. 2021 Jan;269:113588. doi: 10.1016/j.socscimed.2020.113588. Epub 2020 Dec 13.
Taking popular protest as a common reaction to changes in hospital services as its point of departure, this paper explores how a social movement has taken on the issue of the hospital as an institution. In the wake of the transformation of Norwegian public hospitals into health enterprises (trusts), this paper explores community resistance to the proposals and plans of decision-makers to restructure hospitals. The study is based on a qualitative and quantitative analysis of the website/blog for the local hospital movement's activities from 2007 until 2017 and of its involvement and resistance in respect of three instances of proposed change to the hospital structure during this period. The study reveals that the health enterprises and the managerialism they represent pose a threat to individual safety and sense of belonging, and to the preservation and identity of the local community. Moreover, the framing of the cause of the local hospital movement illuminates how the institutional identity of the hospital is highly contested between the institutional categories of 'public administration' on the one hand, and 'the company' on the other. The impact of the local hospital movement has proven modest in terms of influencing and reversing decisions to restructure hospitals, but it has been considerable in terms of cultural support for its concepts and values, not just concerning hospitals and health care services, but also with regard to democratic governance.
本文以大众对医院服务变化的普遍抗议为出发点，探讨了一场社会运动如何将医院作为一个机构问题提上日程。在挪威公立医院向卫生企业（信托）转型之后，本文探讨了社区对决策者提出的医院结构重组建议和计划的抵制。本研究基于对当地医院运动活动网站/博客 2007 年至 2017 年的定性和定量分析，以及该运动在该期间三个医院结构变革建议中的参与和抵制情况。研究表明，卫生企业及其代表的管理主义对个人安全和归属感，以及对当地社区的保护和认同构成了威胁。此外，当地医院运动原因的构建阐明了医院的机构身份在“公共行政”和“公司”这两个机构类别之间是如何受到高度争议的。当地医院运动在影响和扭转医院结构重组决策方面的效果有限，但在为其概念和价值观提供文化支持方面却产生了相当大的影响，这不仅涉及医院和医疗保健服务，还涉及民主治理。
