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This article focuses on the new role of municipalities–as negotiators in multilevel governance of health services. The 2012 health care coordination reform in Norway involves a partnership between health services at the national and municipal levels. Negotiations in these regional partnerships result in regionally different solutions concerning the provision of health services. What does this new role of municipalities require with regards to political steering and administrative management? From interviews in nine municipalities and two regional health authorities, the authors find that the formal cooperation agreements have affected the interaction between municipalities and regional health authorities, with a shift from professional deliberation to strategic negotiations. The new negotiating role of the municipalities requires political will to clarify the room of maneuver for the negotiating actors and support the negotiating solutions when these are within the defined frames. The negotiations stimulate integration between management and professionals, in order to inform the chief executive officer, who is often the negotiator. The negotiators assume an essential role as bridge-builders between the political and professional world in the municipalities, and the professional world of the hospitals and regional health authorities.

The Municipality as Negotiator in Multilevel Governance of Health Care