1. Demarcation or assimilation? Hospital social workers (HSWers) jurisdictional work in Sweden and Germany 2012-07-11 Manuela Sjöström, PhD student, Gothenburg university, Sweden

2. HSW – conditions Frequently uttered claims: Frequently uttered claims: -Work tasks in health care are unclear -Professional discretion often disregarded -Health care policy makers have unclear expectations on HSWers contributions Limited research on HSW & its professionalization Limited research on HSW & its professionalization Cross-national research on professionalization is unusual Cross-national research on professionalization is unusual 2012-07-11 Manuela Sjöström, PhD student, Gothenburg university, Sweden

3. Jurisdictional work 2012-07-11 Manuela Sjöström, PhD student, Gothenburg university, Sweden Professionalization = a context bound individually, but predominantly collectively pursued attempt to gain jurisdictional control over a professional sub- groups work tasks & fields. Professionalization = a context bound individually, but predominantly collectively pursued attempt to gain jurisdictional control over a professional sub- groups work tasks & fields. Jurisdictional work = Use of specific internal and external activities & strategies in order to protect jurisdiction in a variety of arenas (work place, professional group, public & policy making. Jurisdictional work = Use of specific internal and external activities & strategies in order to protect jurisdiction in a variety of arenas (work place, professional group, public & policy making.

4. Aim, Theory, Method Aim: Describing, analysing, comparing HSWers performance of jurisdictional work during the period 1989-2008; predominantly on the associational level, but also on the work place level & state level Aim: Describing, analysing, comparing HSWers performance of jurisdictional work during the period 1989-2008; predominantly on the associational level, but also on the work place level & state level Theory: Predominantly Theory of professions (Abbott 1988 & 2005); Theory on social identity (Jenkins 2003), Theory on organisational compliance (Etzioni 1961), symbolic interactionism (Mead 1962) Argumentation analysis (Karlsen 2012) Theory: Predominantly Theory of professions (Abbott 1988 & 2005); Theory on social identity (Jenkins 2003), Theory on organisational compliance (Etzioni 1961), symbolic interactionism (Mead 1962) Argumentation analysis (Karlsen 2012) Method: Case study including approx. 450 documents from HSWers’ professional bodies (predominantly 2 associations) in Sweden and Germany; 2 focus group interviews (associational boards); 11 interviews with HSWers in Germany (5) and Sweden (6) Method: Case study including approx. 450 documents from HSWers’ professional bodies (predominantly 2 associations) in Sweden and Germany; 2 focus group interviews (associational boards); 11 interviews with HSWers in Germany (5) and Sweden (6) 2012-07-11 Manuela Sjöström, PhD student, Gothenburg university, Sweden

5. Background 1989-2008 Different welfare state regimes (Esping-Andersen 1990): Sweden = Social democratic welfare state, Germany = corporative welfare state regime Different welfare state regimes (Esping-Andersen 1990): Sweden = Social democratic welfare state, Germany = corporative welfare state regime Sweden, legislative reforms: Sweden, legislative reforms:  Abolishing overlap between counties’ and municipalities’ responsibilities concerning health care/social welfare services ( esp. elderly care/psychiatric care reforms)  Efforts to introduce private caregivers Germany, legislative reforms: Germany, legislative reforms:  Formal integration of legislation concerning social welfare/health care in one legislative framework (SGB)  Efforts to increase involvement of other than historically established corporative actors in policy making (esp. patients) (GMG) 2012-07-11 Manuela Sjöström, PhD student, Gothenburg university, Sweden

6. Results: Internal jurisdictional work Developing a collective professional identity Collectively describing the profession’s past and presence (incl. perceived lack of control) Collectively defining work task, competence requirements, professional standards Embedding HSW in a primary disciplinary context Controlling and expanding compliance to collective definitions 2012-07-11 Manuela Sjöström, PhD student, Gothenburg university, Sweden

7. Results: External jurisdictional work I Strategies and activities to transfer into formal jurisdiction (Legislature, public regulations, work place level) Showing presence in these arenas Informing on associational stances Cooperating & negotiating over professional boarders Lobbying 2012-07-11 Manuela Sjöström, PhD student, Gothenburg university, Sweden

8. External jurisdictional work II Paving the way for formal jurisdiction (Labour unions, university departments/research, (patient) organisations, other professions, local actors, media) Building coalitions NegotiatingCooperating 2012-07-11 Manuela Sjöström, PhD student, Gothenburg university, Sweden

9. Collective claims-making HSW is especially suitable to fill this function; it has a specific and genuine set of competences/skills Health care organisations/policy makers tend to fail filling these functions HSW is necessary in health care to bridge gaps between health care/social welfare; and to represent patient interests in health care 2012-07-11 Manuela Sjöström, PhD student, Gothenburg university, Sweden