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This thesis analyses the difficulties encountered in the promotion of usability, especially in relation to occupation health issues, when developing IT systems in a public authority. It examines what happens when User-Centred Systems Design (UCSD) approaches are introduced to organisations with in-house systems development for their employees. It studies how stakeholder values affect the outcomes in terms of usability, occupational health, and institutional acceptance. Moreover, new methods are examined and evaluated as potential tools for assisting the adoption of UCSD. These methods are for example Field studies for system developers, Usability coaching for stakeholders and Management views of usability.

A stated aim is to influence systems development in practice. Hence an action research paradigm has been employed, carrying out research and change in real life settings, gathering and analysing data using qualitative techniques.

This thesis is based on a constructivist perspective, where theories in the areas of learning and organisational change have been used in order to better understand the research questions.

The research demonstrates that most people are enthusiastic to, and interested in, UCSD with a focus on the computerised work environment. Many of the stakeholder groups, such as managers, users, project managers and system developers, changed their construct of identity as well as practice when UCSD was introduced.

However, this research shows that there are several values that affect systems development and hinder usability work. These include for example value of rationality and objectivity, and differing values and perspectives underpinning descriptions and discourse on work and systems development. Values such as automation, efficiency, and customer satisfaction shape the development of new technology, and ultimately the tasks, work practices integrated in IT systems.

Moreover, the results demonstrate that even though many consider usability as important, few take active responsibility for it, as the title of this thesis suggests.