Green care governance: between market, policy and intersecting social worlds.
OBJECTIVE
Green care--the utilisation of farms as the basis for health services--is seen as a promising addition to other health services, and it is seen as a viable diversification strategy for many farm families. However, the number of such services is low both in Norway and in Europe in general. The development of green care seems to have stagnated. This paper seeks to analyze and discuss the case of Norwegian green care in order to reflect on the hindrances to the further development of a viable green care sector.


METHODS
The paper analyzes the green care market, green care policies and the interaction of social worlds that are necessary to make the green care sector function smoothly.


RESULTS
The conclusion is that there is a sound basis for a green care market and that there are sufficient political support and political engagement for the development of green care in Norway. The problem with the green care sector is the interaction between the "social worlds" involved in the sector--the suppliers/farmers, the users, and the (public sector) buyers. It is argued that the development of a green care market is hampered by the lack of an institutional framework and a set of market devices capable of bringing key actors together.


CONCLUSIONS
The paper presents an analysis of the Norwegian green care sector. It shows that there are substantial cross-national differences between health service systems, and therefore comparisons between nations are difficult. However, the principal challenges--diverse social groups, the lack of institutional frames, and immature markets--are shared. Therefore, the need for further research is evident and there are lessons to be learned from cross-national comparison and case studies.


CONCLUSIONS
Within the green care research field, there have been few social science studies that address organisational issues and the governance of this new and emerging business. Theoretically oriented and analytical contributions on organisational aspects of green care services are therefore timely. This paper is such a contribution.
Centre for Rural Research, Trondheim, Norway. jostein.vik@rural.no
Jostein
J
Vik
Maja
M
Farstad
D000383:Agriculture; D003153:Community Health Services / Q000379:methods* / Q000458:organization & administration; D003159:Community-Institutional Relations; D018166:Health Care Reform; D006291:Health Policy; D006293:Health Promotion / Q000379:methods* / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006801:Humans; D009664:Norway; D016730:Program Development; D012040:Regional Health Planning; D012936:Social Medicine