(Mis)taking social responsibility? Implementing welfare state reform by private and non-profit organizations

ABSTRACT

This article relates institutional theory to the concept of organizational legitimacy with cognitive, moral, and pragmatic dimensions, to analyse how a Dutch national policy reform – aimed at expanding the social responsibility for sick leave and disability toward non-state organizations – is understood and enacted locally. Based on interviews in 52 organizations, the study highlights that implementing welfare state reform is predominantly based on pragmatic reasoning, and justified by specific moral and cognitive interpretations. The findings reveal that implementing reform is active institutional work by – paradoxically – restricted local agency, with disciplinary effects on a narrow range of actors.

KEYWORDS:

• Welfare state reform
• institutional theory
• organizational legitimacy
• social responsibility
• sick leave policy

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Nicolette Gestel

Nicolette van Gestel is Professor of New Modes of Governance, and Academic Director of the Executive Master in Public and Non-profit Management at TIAS School for Business and Society, Tilburg University, The Netherlands. She is an academic member of the Social and Economic Council of the Dutch government, and visiting professor at Oslo Metropolitan University. Her research interests include public sector reform, decision-making in plural (network) settings, and the changing role and position of professionals in the welfare state. She currently works on the EU Horizon2020 project Co Production and Co Governance: Strategic Management, Public Value and Co creation in the Renewal of Public Agencies across Europe (COGOV). Recent papers have been published in Public Administration, Organization Studies, Human Resource Management, Personnel Review, BMC Health Services Research, Public Money & Management, European Journal of Social Work, Public Management Review, Scandinavian Journal of Management, and Perspectives on Public Management and Governance.

Susanne Boch Waldorff

Susanne Boch Waldorff is Associate Professor at the Department of Organization, Copenhagen Business School, Denmark, Program Manager of the Master of Public Governance, and Director of the Center for Health Management at CBS. She is member of the Center for Public Organization, Value and Innovation (POVI), and visiting scholar at TIAS School for Business and Society, Tilburg University, The Netherlands. Her research interests include the translation of reform and policy into organizational practices, public sector management, innovation, and professions. Drawing on institutional theory and organizational analysis, she published in the Academy of Management Journal, Scandinavian Journal of Management, Research in the Sociology of Organizations, Journal of Change Management, The Innovation Journal: The Public Sector Innovation Journal, BMC Health Services Research, and Critical Public Health.

Jean-Louis Denis

Jean-Louis Denis is Professor of Health Policy and Management at the School of Public Health, Université de Montréal and holds the Canada Research Chair on health system design and adaptation. He is senior scientist at the Research Center of the CHUM (CRCHUM) and visiting professor at the Department of Management, King’s College London. His current research focus on the role of medical doctors in health system change and improvement, on transformative capacities of health systems in Canada and in Europe, and on the development of learning health systems in academic health centers. Recent papers have been published in the Journal of Health Politics, Policy and Law, Organization Science, Academy of Management Annals, Milbank Quarterly, Administration and Society, Implementation Science, Journal of Public Administration Research and Theory and Perspectives on Public Management and Governance. He is co-editor of the Palgrave series on Organizational Behaviours in Health Care, and Associate Editor of BMC Health Services Research.