NPM resistance: A political intervention

• Author: Kari Nyland,Per Christian Ahlgren,Irvine Lapsley
• Date: 01 November 2020
• DOI: http://doi.org/10.1111/faam.12247
• Published date: 01 November 2020

Received: 1 March 2019 Revised: 31 January 2020 Accepted: 11 February2020

DOI: 10.1111/faam.12247

RESEARCH ARTICLE

NPM resistance: A political intervention

Kari Nyland1Per Christian Ahlgren1Irvine Lapsley2

1NTNU Business School, Trondheim,Norway

2University of Edinburgh Business School,

Edinburgh, Scotland

Correspondence

KariNyland, NTNU Business School, 7491 Trond-

heim,Norway.

Email:Kari.Nyland@NTNU.no

Abstract

This paper offers a unique perspective on NPM enactment. NPM is

the key means by which neoliberal policies penetrate society and

there is now a considerable literature on NPM in many economies.

The influence of NPM tends to be depicted as significant, embedded,

andirreversible. This study offers findings of resistance and rejection

of NPM by a cadre of politicians who did not accept the trappings

of NPM. The importance of accounting and metrics was rejected by

politicians in this study. These actions also influenced the actions of

professionals in health care organizations.

KEYWORDS

health care, neoliberal, NPM, politicians, resistance

1INTRODUCTION

This study examines a case of resistance in a world of NPM practices (Hyndman & Lapsley,2016; Lapsley & Schofield,

2009) where the calculative practices of new managerialism dominate the landscape of public services (Kurunmäki,

Mennicken, & Miller, 2016; Shore & Wright, 2015). Our case revolves around a large Norwegian Health Author-

ity in which ambulance services had been outsourced for an extended period of time, as a prevalent feature of a

neoliberal NPM agenda. In 2011, politicians as representatives on the board of directors decided that all ambu-

lance services should be reintegrated as part of public health services. The decision to insource was politically

motivated and the process of promoting this agenda of change was driven by a tactic where accounting numbers

were deliberately disconnected from the decision-making process and disregarded. This case shows a story of how

a political intervention successfully challenged the neoliberal thinking that underpins NPM. Although accounting

and its calculative practices have been demonstrated as a central feature of NPM enactment, this case illustrates

how the tactical use and nonuse of accounting became a strategy for the successful rejection of core features

of NPM.

This paper contributes to the existing literature on NPM research by its study of the significance of accounting,

metrics, and measurement in the management of health care in Norway. This focus addresses gaps in the existing

accounting literature investigating how health care professionals use or reject accounting information in the man-

agement of a major health care organization. Although there is a significant literature on NPM, Malmmose (2019),

in a review of health care research in leading accounting journals, identified a gap in our knowledge related to the

influence and actions of politicians. Prior research has looked generally at politicians and their use of accounting

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2020 John Wiley & Sons Ltd wileyonlinelibrary.com/journal/faam FinancialAcc & Man. 2020;36:376–400.

NYLAND ET AL.377

information, but this study focuses on politicians’ tactical use (and nonuse) of accounting information in promoting

politically motivated agendas and ultimately organizational change. In the context of political action, this paper also

contributes to the literature concerned with the proliferation of calculative practice in all walks of life and its impact

on democratic accountability (Behn, 1998; Kurunmäki et al., 2016).

The complexity of social phenomena requires more than one theoretical lens to explore, understand, and explain

their implications (Jacobs, 2012; 2016). This advocacy of theoretical pluralism (Lowe, Magala, &Hwang, 2012) is par-

ticularly pertinent to the focus of this study. Our study is informed by wide streams of literature concerned with

the impact of neoliberal policies on public sector services. This includes literature on NPM and democracy, NPM

and instrumentality (through the lens of accountingization) (cf. Lapsley, 1998; Power & Laughlin, 1992), as well as

NPM and legitimation (cf.Kurunmäki, Lapsley, & Melia, 2003). This distinguishes this study from extant literature and

enables novel understandings of the contextual enactment of NPM. Moving from pre-NPM to an NPM era, precon-

ceptions of the organization of professions have been fundamentally challenged. Research has suggested that in an

NPM world, professionals can, at best, resist change (Lapsley,2008). Yet, the extant literature is divided. There is evi-

dence that politicians, managers, and professionals comply with NPM implementation, without great protest. How-

ever, others, such as Bezes et al. (2012), have highlighted the prospect of professions not acquiescing in the face of

reform elements. In their view, professionals may assert themselves and their values by occupying influential posi-

tions in their organizations. In this paper, we explore the ability of politicians, and related health care profession-

als, as agents of change resisting what is depicted in the extant literature as the overpowering force of the NPM

agenda.

This paper contributes to the continuing debate over NPM in two specific ways.In the first instance, the paper pro-

vides an empirical account of acts of resistance where the calculative practices of NPM are not merely the immutable

vehicles of the NPM bandwagon, but may become tactically sidelined by keyactors promoting an alternative political

agenda. In this manner,the paper contributes to answering the research question of whether NPM undermines demo-

cratic accountability,a thesis first articulated by Behn (1998).

The second strand of debates over NPM in this paper concerns the impact of accounting practices on profession-

als. There is an existing literature suggesting that accounting practices and information have major adverseimpacts

on professional autonomy. This paper addresses the alternative contention by Bezes et al. (2012) that professionals

working in public services are articulate and influential and may challenge NPM practices.In this paper, we explore how

the engagement of politicians and their use (and nonuse) of accounting information in turn shapes the actions of pro-

fessionals, and their use of accounting information. Our second research question is thus; what is the significance of

accounting practices for politicians and professionals?

The paper examines the extentto which the Health Authority and its board of directors gave primacy to quantifica-

tionand financial outcomes. The findings reveal, contrary to the existing literature, that politicians successfully rejected

continued outsourcing as a feature of NPM. This rejection was made possible by the deliberate rejection of account-

ing numbers and imperatives. This rejection cascaded down to professionals within the Health Authority.The nature

and emergence of this contested new world for academic accountants, practitioners, and policy makers is discussed

below.

This paper is organized into six sections: first, we discuss prior research on the use of accounting information by

politicians and professionals and prior studies of resistance to public sector reforms; second, the research context of

NPM reforms in Norway is explained; third, the theoretical framework is explained,with reference to NPM reforms;

fourth, there is an explanation of research method; and in the following section, we present research results. These

reveal the depth of penetration of NPM in the Norwegian public sector,particularly its health sector, and the case of

rejection of accounting information by politicians, a resistance that was embracedby professional health care workers.

Finally,there is a discussion and conclusion that provides an overview of this project’s research findings and a research

agenda.