Konkurrenceudsættelse af velfærdsydelser: Et studie i ældreplejen i Høje‐Taastrup Kommune

Abstract

New regulations on ”free choice of supplier” have made it interesting as well as possible for municipalities to pool together various elements of services of eldercare and to make a comprehensive supply of these services. To combine the operations of a residential home with services related to home care increases the certainty regarding the amount of work for a future supplier since citizens who live in residential homes will not be able to choose their own supplier. Consequently, a supplier is guaranteed a certain amount of work, which also helps the municipality achieve a better price. However, for employees in the eldercare sector this provides a new situation. Due to the transfer of the job to a private supplier, it is no longer the citizen’s own choice whether or not the assistance comes from a private or public organization. The employees were very resistant regarding the preparation of this invitation to tender. However, the participation of employees is a prerequisite in order to prepare the contractual terms since the employees are the ones with the knowledge of the pitfalls. Based on this, I have worked with the following problem: “How does the invitation to tender of welfare services affect the motivation of employees in the eldercare in Høje‐Taastrup Municipality?” In order to be able to answer this problem, I have researched what motivates employees in the eldercare sector, and thereafter how these factors are affected by the invitation to tender. By using theories of motivation, from Maslow’s Hierarchy of Needs and Herzberg’s Two‐Factor theory to theories that include Public Service Motivation, I have come to the conclusion that employees are partially driven by an altruistic desire to do something for others or contribute to the public value, and partially driven by their self‐interests with regards to monetary rewards, work conditions, possibility of acknowledgement, and enjoyment of the job. Interviews with selected employees have confirmed this picture, but also contributed to the creation of a more complex picture of what really motivates employees. They do not show demotivation as the classical theories of motivation prescribe when they are not provided with the desired framework. They fight for what they believe in, and respond by fighting even harder. The fact that someone profits monetarily from helping others is not compatible with the professional stance concerning the delivery of welfare services. The employees in the eldercare sector in Høje‐Taastrup Municipality are in many ways very similar to the professional employee. They are highly driven by the goal of doing work in the best interest of the citizen. This means that they do not always react as expected when it comes to demotivation in case the framework does not give them the opportunity to work in a client‐centric manner. In these situations they accept the battle against the system and embrace the role as the citizen’s advocate. It is no longer their specific work area that is important. Instead it is more important to stand up for the citizen and enhance the possibility of winning against the system. In special situations where the employees put all their energy into helping the citizens in the best possible way, they experience a kick when they are successful. This occurs in situations when they are helping a dying citizen or his or her relatives. Or it can happen, as mentioned above, when they pull off a victory against the system. Those are the situations in which they truly enjoy their work. These situations compensate for a large part of their other assignments which can be seen as trivial and rather unchallenging. The employees experience these kicks in situations where they have been given the freedom and acceptance from management/colleagues to spend the amount of time they find necessary. As a consequence, it happens in situations where they are either given or take the freedom to solely let their knowledge decide without being subject to management criteria such as quality standards or time pressure due to tight schedules. The freedom that the employees experience in the way they organize their work is a substantial part of what they fear they might lose if they are to be transferred to a corporation that also has a goal of maximizing its profit. Depriving them of this freedom will be considered an attack to their professional identity. Therefore, the employees fear that a transfer of the organization to a private supplier will result in a more strict management relative to what they experience today. They regard this freedom as a prerequisite to delivering a technically sound quality for the citizens that depend on their assistance. Thus, to engage employees in such a change requires that there are incorporated demands that secure this freedom when preparing specific requirements for a coming invitation to tender. Only by doing this can it be made certain that the competition takes place on a level playing field.