”Det går meget bedre nu…”: Om inkonsistens og paradokser i samarbejdet mellem kommunal sundhed og beskæftigelse

Dorrit Guttman

Student thesis: Master executive thesis


“It all goes better now…” Inconsistencies and paradoxes in collaboration between municipal health and employment. The thesis seeks to explore the fundamental contradictions of the attempt of an integrative collaboration between municipal health‐ and employment sectors. The reform of disability pension and flexi‐job, that came into force in 2013, ensured a solid framework for collaboration in the form of interdisciplinary local rehabilitation teams. Political and administrative leaders have had great confidence, that these teams would be the ultimate way of overcoming former collaboration difficulties. But the work of rehabilitation teams is marked by an increasing ambivalence including a risk of demotivation among staff. Thus, the field calls for a renewed management focus: The analysis rests on institutional theory, which emphasizes rational myths, isomorphism, and legitimacy ‐ and describes how meaning is created, diffused, adopted, and adapted over space and time. The collaboration is analyzed through four institutional theoretical perspectives:  A historical‐institutional perspective (Carsten Greve 2102), describing how reform ideas embed differently in the development tracks of the two sectors  A translation perspective (Kjell Arne Røvik 2009), which demonstrates how employees in both disciplines translate reform content through contextualization  An exploration of the collaboration as a loosely coupled system (Orton & Weick 1990)  A detection of the organizational hypocrisy (Nils Brunsson 2003) that occurs in the tension between ideology and practice of the rehabilitation team The study, primarily based on qualitative interviews, shows that interdisciplinary collaboration in rehabilitation teams actually works in spite of countless contradictions. But, simultaneously, new paradoxes emerge, that might reinforce ambivalence. Among the most striking is the close coupling between the employees mention of an improving team spirit and the actual experience of powerlessness when facing the citizen.

EducationsMaster of Public Governance, (Executive Master Programme) Final Thesis
Publication date2015
Number of pages56