Client Focus, Cooperation, and Coherence: (Re)professionalising Processes for Elderly Care

• Author: Niklas Wällstedt
• Date: 01 February 2017
• DOI: http://doi.org/10.1111/faam.12103
• Published date: 01 February 2017

Financial Accountability & Management, 33(1), February 2017, 0267-4424

Client Focus, Cooperation, and

Coherence: (Re)professionalising

Processes for Elderly Care

NIKLAS W¨

ALLSTEDT∗

Abstract: This paper suggests the study of professionalism and the profess-

ionalising processes within public sector organisations. Sociologists propose that

professionalism is changing into a new variant developing under the premise

of organisational management and control. This paper disputes the perspective

that the use of management control leads to deprofessionalisation in terms of

the routinisation of reflective professional tasks or weakened professional values.

This paper proposes that, with client focus, professionals and accountants can

cooperate and create coherence between management control system elements and

professional values. This dynamic contributes to the retention of professional values

and more reflective work procedures.

Keywords: professionalising processes, organisational management, management

control systems, deprofessionalisation

INTRODUCTION

Management control and accounting practices diffuse into the public sector

(Jackson and Lapsley, 2003), and evaluation of performance increasingly takes

place through auditable criteria (Lapsley, 2009; Power, 1997; Vedung, 2010)

because of new public management (NPM). Several studies have addressed

how public sector professionals handle these practices. Studies have shown

that professions become hybridised when professionals adopt management

∗The author is from Stockholm Business School, Stockholm University, Sweden. He would

like to thank the following people for comments on earlier drafts: the two anonymous

reviewers, Roland Almqvist, Charlotta Bay, Bino Catas´

us, Jan Greve, Karin Jonnerg˚

ard,

Andreas Sundstr¨

om, Fredrik Sv¨

ardsten, the participants at the 7th International Conference

on Accounting, Auditing and Management in Public Sector Reforms, and the members of the

MUSICA research group at Stockholm Business School.

Address for correspondence: Niklas W¨

allstedt, Stockholm Business School, Stockholm

University, Sweden.

e-mail: nw@sbs.su.se

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4W¨

ALLSTEDT

accounting techniques (Kurunm¨

aki, 2004), or polarised because some groups

within the profession refuse this (Jacobs, 2005). Other studies address iden-

tity problems that stem from the adoption of techniques by professionals

aspiring to management positions (Skærbæk and Thorbjørnsen, 2007), or how

nursing professionals become ordered into administrative and caring expertise

(Blomgren, 2003) by the introduction of new administrative routines. These

papers all address the effect of management control techniques on the profession.

However, because ‘organisational techniques for controlling employees have

affected the work of practitioners in professional organisations’ (Evetts, 2011,

p. 415) resulting in a ‘type of professionalism developed in NPM which qualifies

it as a new, distinctive variant’ (Evetts, 2009, p. 255), the present paper suggests

a development towards the study of professionalism and professionalising processes

within public sector organisations.

Professions are often considered bounded entities with their own interests and

languages. This prompted Lapsley (2008) to propose that NPM in the form of

management control cannot penetrate professional boundaries: the design and

configuration of management control systems (MCS) may have little effect on

organisational outcomes by changing the behaviour of organisational members

(Malmi and Brown, 2008). However, the studies of hybridisation, polarisation,

identity work, and ordering show that MCS-based rules and routines (Burns

and Scapens, 2000), management accounting techniques (Kurunm¨

aki, 2004),

and stipulations and rationalities of means-ends relationships (Broadbent and

Laughlin, 2009; Kurunm¨

aki et al., 2011; Rose and Miller, 1992) have penetrated

professional boundaries. The introduction of MCS has changed the way profess-

ionals conduct their work and, as Evetts (2006) shows, moved professionalising

processes within the borders of the organisation, which concerns both the

manager and ‘the managed’.

A perspective exists, however, that as organisational MCS is adopted by

professionals, the formal nature of MCS may lead to deprofessionalisation

because reflective professional tasks are routinised (Abbott, 1988) or professional

values are rendered subordinate to financial and administrative tasks (Adcroft

and Willis, 2005; Skærbæk and Thorbjørnsen, 2007). Despite this perspective,

MCS elements are useful to professionals in conducting tasks (Ahrens and

Chapman, 2007; Conrad and Guven Uslu, 2011). When professions become

hybridised (Kurunm¨

aki, 2004), management and professionals find it easier to

cooperate (Reay and Hinings, 2009) in attaining common objectives. Moreover,

management accounting calculations can be used to translate between strategic

and operational objectives (Mouritsen et al., 2009), requiring professionals to

master the art of accounting. Professionals that fail to make use of accounting

may be unable to demonstrate their accomplishments and justify their need for

resources (Ferri and Zan, 2014).

The use of accounting-based MCS in public sector organisations is multi-

faceted. The effects can be both deprofessionalisation and professionalisation.

Hence, professionals must carefully choose how to conduct professional tasks

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2017 John Wiley & Sons Ltd