Efficient og forsyningssikker styring på hjemmeplejeområdet

Cecilia Loftager Larsen

Studenteropgave: Speciale

Abstrakt

This master thesis explores the challenges presented, when a public institution must decide which policies a task should be subjugated. Should the task be carried out by private or public companies – or perhaps both? And how should an efficient and supply-secure governance structure be organised?

The Danish legislation for the home care area was revised in 2013, which meant that the municipalities now had an incentive to use a model where the task was exposed to competition. However, many municipalities chose to keep the municipal supplier out of competition. In this master thesis, it is analysed how this particular organisation of the governance structure poses challenges for efficiency and supply security. The thesis is based on a case study of the governance structure for the tasks ‘personal care’ and ‘practical assistance’ in the municipality of Egedal.

The case study is based on a mix of quantitative and qualitative methods, which are essential in order to answer the research question: Taking the supply security into consideration, how is the most efficient governance structure of the tasks ‘personal care’ and ‘practical help’ in the municipality of Egedal designed?

The thesis is divided into three sub-questions. The first sub-question is an introduction to the governance structure under which the tasks ‘personal care’ and ‘practical assistance’ in the municipality of Egedal are organised. The following questions are of analytical nature and involve the theoretical traditions, which the thesis is focusing on. The first part of the analysis examines the primary data with a governance structure perspective. Then, the ideal market theory, including market failures and dimensions of the transactions cost theory, contributes to the explanation of the challenges with homecare in the municipality of Egedal. The analysis is based on a policy analysis of the governance structure with focus on external and internal policies which the municipal of Egedal is to influence or change. The second analysis is based on the same theoretical traditions as the first part, the focus, however, is to determine alternative models to handle the challenges. The purpose of the models is to improve efficiency while ensuring supply security.

The master thesis concludes that there are overall three efficiency challenges associated with the chosen governance structure. The first challenge occurs because the governance structure generates a dual market, where the municipal supplier is subjected to a different set of rules than the private supplier. The different set of rules make it possible for the municipal supplier to influence the size of the tariff. The second challenge occurs because the citizens, due to insecurity caused by bankruptcies, chose the municipal supplier, which gives this supplier a significant market share. Finally, the third challenge occurs because the governance structure assumes that the suppliers can act fully rationally.

In addition to the current model, two alternative models have been presented: the tender model and the contract tender model. In the tender model, the municipal supplier is subject to the same competitive terms as the private suppliers. But even though the tender model handles the challenges better than the current model, it is unable to ensure supply security on the same level. Therefore, the tender model is less efficient than the current model. The second alternative model, the contract tender model, is the most efficient model. This model handles the challenges with specify rules and divide rules in order to organise the governance structure into a more efficient and supply security structure. Also, the contract tender model is more efficient because it handles the challenges while time ensuring supply security at the same level as the current model at the same time.

Overall, the challenges and the contract tender model are based on an assumed goal of efficiency (politically determined service level for the lowest possible price) and supply security. The master thesis has limitations as it only explains the phenomenon of "governance structure in home care" through a single case study with a narrowed theoretical perspective. Furthermore, only one consideration is included in the analysis. In practice, it may be relevant to include other considerations. Also, it could be argued, that the research literature is not sufficient enough, because of how difficult it is to quantify the impact of outsourcing. The thesis supports the literature, by explaining why the municipalities cannot achieve the full effect of outsourcing, by indicating which concrete policy challenge the municipalities are facing in the design of their governance structure.

UddannelserForvaltning, (Bachelor/kandidatuddannelse) Kandidat
SprogDansk
Udgivelsesdato4 aug. 2018
Antal sider79
VejlederePeter Triantafillou

Emneord

  • Efficiens
  • Styring
  • Forsyningssikkerhed
  • Udlicitering
  • Timepriser
  • Hjemmepleje
  • Offentlig