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Collaboration between handicap organizations and the health care sector (poster presentation)

Christina Fleetwood, Nordic School of Public Health


User involvement has a long tradition in Sweden. The Organization for the Deaf started in 1868, long before the Social Democratic party. During the last war the Handicap Organiza-tions became part of `The Commission for Partially Able-bodied´, which lasted until 1949. Sweden, which considered itself to be at the forefront in this area, laid a proposal to create special forums where representatives from the handicap movements and the politicians from the county or municipal boards could meet in the form of committees for `consultation and contact´ (SOU 1970:64). These committees have continued over the years and are still in function. In the new Health Care Act (1981/82:97; revised 1994:1099) the new concept of 'collaboration' was launched for the health care sector, expanding the formerly used concept of `consultation´. `Collaboration' is the concept still used today. It is one of the more popular concepts in the society at large and the question is to what degree it actually functions be-tween the Handicap Organizations and the Health Care sector. The structure of the Handicap Organizations follows the Swedish political structure. On the national level the communication relates to governmental issues. On the county level (cur-rently 21 counties) the main issues are health care and public transportation and on commu-nity level (municipalities, boroughs) social care, local area development and education up to high school level. This Research Project focuses on collaboration between county level health care administration and the handicap organizations on the same level. One of these handicap organizations is an umbrella organization representing 40 different diagnoses. This particular study is directed to the collaboration in Stockholm County over a 12 year period (1996-2008). This case study uses three different approaches. The first is based on an interview study that was made in 1989 with focus on expectations/attitudes around a formal system of collabo-ration. The next is a review of minutes and agendas of ongoing meetings between the Handi-cap organizations and the Health Administration over 12 years and several different formal agreements as well as changes in political majority. The third approach is a review of three evaluations done on the ongoing so called collaboration process. The first one was done by an outsource company, brought in by the County Administration. The next two were reviews of a two year trial of a formal model decided by the County Council. These reviews were made separately by the handicap organizations and the County administration. Research methods for this case study are both qualitative, using content analyses and quantitative, organizing the content of the minutes in separate categories. The three approaches are then combined in tri-angulation, thus gaining further knowledge about user involvement. What can be seen thus far is that despite the extensive Swedish tradition of participation in organizations and interest groups, effective collaboration is limited in this specific county. Unclear definitions, diffuse goals and unrealistic demands on the participating representatives from all bodies in this process can explain why the resulting activity seems to be characterized by "information" rather than "collaboration".

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