The Norwegian Substance Treatment Reform: Between New Public Management and conditions for good practice

摘要

■ BACKGROUNDIn 2004, the responsibilities for all substance abuse treatment and rehabilitation services in Norway were transferred from the county level to the state owned regional healthcare enterprises.■ AIMThis reform, as many other European health reforms, was inspired by the same ideological and expert policy prescriptions for organizing public services. The aim of this paper is to analyze how these organizational principles influence the probability of services meeting the conditions of recognized prerequisites for a high quality of care.■ DATAThe paper builds on data from one national and two regional evaluations of the reform.■ RESULTSThe new organization principles have created a system of fragmented, linear transfer of responsibilities from one agency to the next, preventing the realization of fundamental preconditions for effective treatments of substance abuse. Initiatives of bottom-up organization are seen as attempts to counteract these consequences.■ CONCLUSIONSThere seems to be an inherent...