In Sweden, performance-based pay has gone furthest in the public sector. This development has placed demands on employers to have a transparent and salient salary review process with which to evaluate employees uniformly and fair – and to act in a unitary manner, as one employer. Pay policies aim to coordinate salary reviews in organizations. However, the transfer of policy to practice is not easy and research has shown a gap between intended and implemented policies. Drawing on a case study in a municipality, this article expands knowledge on policy transfer by exploring and describing how HR, unions, managers and employees perceive implementation and integration of the pay policies, and to what extent the municipality succeeds in a one-employer approach. The findings suggest that the municipality fails to act as one employer and that the units that are most successful in implementing the policy are those closer to top management.
This article examines the development of diverse quality systems in the otherwise quite similar Danish and Swedish public health sectors. After decades of numerous piecemeal medical and managerial quality development programs in both countries, a nationwide mandatory accreditation system was introduced in the Danish health services in 2009. Nationwide quality indicator projects are also found in Sweden, but there has been political attempt to introduce a compulsory system. This article seeks to explain this difference. It argues, first, that resistance from the medical professions blocked the introduction of compulsory, nationwide quality systems in both countries for decades. Second, the implementation of the Danish accreditation system was triggered by a combination of unintended policy learning produced by local reforms in two counties and of the Ministry of Health’s carefully orchestrated policy process that served to co-opt critical voices in the medical profession.