Multi‐level governance in Norway: universalism in elderly and mental health care services

Abstract

Abstract Purpose – Based on a case study of Norway, the purpose of this paper is twofold: to present recent trends in the development of the multi‐level governance of the care services for the elderly and people with mental illness towards what we call the cooperative turn; and to discuss the implications of this trend for universalism in service provision. Design/methodology/approach – The paper is a study of documents and the recent research literature. Findings – A shift towards the cooperative turn can be identified as a change from command‐and‐control instruments to soft regulation mechanisms. Regulations and economic means are increasingly complemented by informational means. Soft versions of the steering instruments are used to target the results and processes of local policies. Hard instruments do not disappear, and a mixture of all the abovementioned instruments governs the two policy fields. This has implications for universalism defined as territorial uniformity, accessibility and coverage as user groups are competing for scarce resources, professionals are gaining autonomy in decision making and users are involved in service provision. Originality/value – The originality of this paper is the discussion of the development of multi‐level governance towards a cooperative turn and the implications of this for universalism in service provision.

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