How to sell controversial service to municipality? Stigma management as a professional strategy of the workers of the needle exchange services for intravenous drug users.

The paper explores current changes in the Finnish welfare society from the point of view of specialiazed drug treatment. I use new foucauldian theories about governmental power as a starting point to investigate relationships between service providers in the field of drug treatment and municipalities responsible of their funding in the era of new public management. Under the investigation is the concrete consequences that the idea of new public management has had on the everyday work of two drug treatment services locating in the Helsinki metropolitan area. The services in question are needle and syringe exchange programs - or health council services for intravenous drug users as they are called in Finland - which have existed in the area almost ten years. All this time the services funding has been temporary and this has meant constant re-assuring of different financial stakeholders - such as commune officials and EU -that the service is needed and that the work done in them is effective.

I explore how this kind of situation has moulded the concrete work done in the services. What are the measures that is needed when applying for funding or persuading the financiers to continue with the funding? How the ideology of new public health transforms the working methods and working enviroment of the counselling services?

On the focus of the attention in the paper is the strategies the employees of the health counselling services apply when negotiating of their status as a service provider. These strategies are very much concentrated on the need to reassure the financiers that the service is needed and that it doesn´t have undesirable effects. Health council services for intravenous drug users are still quite a disputed phenomenon in Finnish drug treatment system and there exists conflicting views about their status as services as well as about their working methods. This has resulted on part of the workers to a situation which I called the strategy of stigma management: the constant need to diminish the negative halo that the image of intravenous drug use has brought upon the services.

This kind of situation raises interesting questions about the nature of power in the era of new public management and how and by whom it is used. On the basis of my empirical foundings I argue that ideology of new public management opens up possiblities to governmental strategies applied by municipalities that use moralistic criterias, instead of for example knowledge based ones, as a tool to control the content of the services provided to the citizens. This makes the current funding system unstable and unreliable as for example the opinions and views of a few strong officials may have a great impact on whether certain service get their funding or not. Also the questions of health and social security are in danger to become political as for example the service providers with "right" views or "right" working methods are in strong position when talking about the competion between the services. At the light of this evidence it fair to ask whether municipalities have become “moral communities”, which decide what is right and wrong or desirable and undesirable in the field welfare services.

The presentation is based on ethnographic research conducted in two health counselling services located in Helsinki Metropolitan area and it is part of my doctoral thesis to the sociology department of the University of Helsinki.