Welfare mix and active citizenship in Scandinavian schools and nursing homes

• In Event: What happened to the Scandinavian, social-democratic welfare model?

Abstract

The public can provide welfare services in-house or leave it to a nonprofit organization or a for-profit company. The Scandinavian welfare societies have a number of similarities, but over the last 20 years Sweden has seen rapid growth in for-profit provision, Denmark has kept its relatively high non-profit share in welfare, and in Norway public in-house provision dominates (Sivesind, 2013). These changes invite to studies of how the use of public, non-profit and for-profit providers contribute differently to the experience of the users of the services (Phillips & Smith, 2011; Smith & Grønbjerg, 2006 p. 224). An important approach to this issue is to look at the active citizenship of users and how the autonomy of the user is preserved in the meeting with public services, depending on the economic sector of the provider (Andersen & Rossteutscher, 2007; Rothstein, 1998). This way, changes in division of labor, responsibility and influence allows us to evaluate the different providers in the welfare mix from the users point of view (Boje & Potucek, 2011; Jensen & Pfau-Effinger, 2005).
To explore this I use data from comparative case studies at the municipal level – where many of these policies are implemented. We selected six municipalities – two in each country. Researchers from Norway, Sweden and Denmark conducted the fieldwork in their respective countries. In each municipality, one municipal and one non-municipal service provider within both schools and nursing homes were selected. The data comes from three types of sources: 113 interviews with users, staff, and leaders at the institutions, and the political and administrative leadership in the municipalities; local user surveys; and local strategic documents. I use three dimensions of active citizenship to analyze differences in the room for active citizenship for users of public, nonprofit, and for-profit welfare services and their next of kin: choice, empowerment, and participation.
I find greatest variation in active citizenship between the different service areas. Users of schools have more room for active citizenship than users of nursing home services. Differences between providers belonging to the public, nonprofit, and for-profit sector are more evident in the school than the nursing home sector. This implies that the potential differences depend on contextual factors such as regulation, financing and steering. An overall result is that public authorities to a certain extent can use the welfare mix as a tool for promoting active citizenship, but changes in the welfare mix cannot alone produce wanted aspects of active citizenship. User choice is decisive for the possibility to establish distinctiveness for the non-profit, for-profit, and public institutions. This distinctiveness is an important factor in its own right, but allowing for institutional distinctiveness has further implications. Institutional arrangements that allow for diversity are more flexible in how they are run. The potential for obtaining real changes through arenas for empowerment is therefore greater. Interestingly, there seem to be a tradeoff where users who experience local empowerment at the institutions participate less in local policymaking.

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Author

• Hakon Dalby Traetteberg, Institute of Social Research