Big Business in a Thin Market: Understanding the Privatization of Residential Care for Children and Youth in Sweden

Abstract

This article analyzes the transformation of Swedish residential care for children from a regionally coordinated, public social service system into a thin, but highly profitable, national spot market in which large corporations have a growing presence. Marketization and privatization are theorized as complex processes, through which the institutional structure and logics of this small, but significant, social policy field changed profoundly. Using official documents, register data, media reports and existing research, three consecutive phases in the development of the children's home market are identified since the early 1980s. Change was driven on one hand by policies inspired by New Public Management, which shifted public authority horizontally to the private sector, and vertically to local authorities (funding) and to the state (regulation). On the other hand were the responses of local authorities and private actors to the changing incentives that policy shifts entailed. During the first two phases, both the proportion and size of for‐profit providers increased, and the model of family‐like care was replaced by a professional model. Cutting across the trend of privatization in the third phase was establishment of a parallel system of homes for unaccompanied refugee children – mostly in public ownership. Similarities with privatization in the English system of children's care homes are noted. By showing how the Swedish market for residential care has been created by policy and by actors’ responses to those reforms, the article provides a foundation for thinking through how the predictable, significant and well‐documented problems of such care markets might be addressed.

Social services in post-industrial Europe: an incomplete success story and its tragic moments

“…Polacek et al (2011) report a growing reliance on these providers in numerous countries. This trend is prominent in childcare and child protection (see Lloyd and Penn, 2012;Jones, 2015;Meagher et al, 2015, for the case of Sweden and England) as well as for organised work integration and services to older people. In these areas, commercial enterprises have often replaced public service units, but also non-profit providers (Damm, 2014, dealing with England;Puthenparambil and Kröger, 2016, concerning Finland).…”

Adjusting to standards: reflections from ‘auditees’ at residential homes for children in Sweden

“…Residential care is a heterogeneous field in terms of the type of care (secure units, treatment institutions and supported accommodation) as well as target groups (children with behavioural problems, unaccompanied refugee minors, and children and their families) (Sallnäs 2012). Influenced by the New Public Management reforms that were launched in the 1980s, there has been a steady growth of private providers (currently 50-70% of all institutions) (Meagher et al 2015). From being a field that comprised many small-scale businesses, larger firms have increased their market shares.…”

“…The increased importance assigned to inspections is not unique to Sweden, rather it is part of an international trend in which more and more resources are invested in monitoring the outcomes of welfare services (Hood et al 1999;Power 1999;Johansson and Lindgren 2013). In the case of Swedish residential care in particular, the driving forces have been a rapid privatisation of the services (Meagher et al 2015) paired with concerns about the quality of care (NAO (National Audit Office) 2002). This culminated in the 'Inquiry into Abuse and Neglect' that revealed a series of cases of maltreatment in the past (SOU 2009:99).…”

“…Pålsson 2015;Meagher et al 2015;Sallnäs & Wiklund 2015a;Sallnäs & Wiklund 2015b). In the article, I explore how inspections are perceived from the point of view of representatives of residential homes.…”

Stability and change in the field of residential care for children. On ownership structure, treatment ideas and institutional logics

“…This sector has indeed been subjected to numerous changes both in a long term and in a short-term perspective. In line with New Public Management ideals (NPM), there has been a high influx of for-profit providers and the composition of the field in terms of ownership structures has thus undergone substantial change (Meagher et al 2016). Parallel to the reshaping of the field, changes with regard to treatment ideas and methods linked to social work in general and residential care for children in particular, have taken place.…”