Central versus Local Service Regulation: Accounting for Diverging Old‐age Care Developments in Sweden and Denmark, 1980–2000

Abstract

In Sweden and Denmark, the development of old-age care has followed markedly divergent paths over the past 20 years. In both countries, the level of old-age care universalism was exceptionally high in the early 1980 s. Since then it has dropped sharply in Sweden, while remaining constantly high in Denmark. These divergent trends are clearly irreconcilable with the common image of a coherent Scandinavian welfare state model, and they seem hard to explain with reference to traditional approaches of comparative social policy. This article attempts to account for the divergent developments by focusing on the balance of old-age care regulation between central and local government. The main finding is that only in Sweden has the central regulation of old-age care been weak and unspecific. As a consequence, Swedish municipalities have enjoyed sufficient autonomous, regulatory competence to exercise certain local retrenchment measures in times of austerity, thereby eventually causing a nationwide weakening of old-age care universalism. By contrast, municipalities in Denmark have been much more tightly bound by central state regulations which have prevented them from imposing similar retrenchment measures in the old-age care sector; consequently, Denmark's level of old-age care universalism has remained comparatively high.

Los modelos territoriales de organización social del cuidado a personas mayores en los hogares

“…Exploran la gestión de la asistencia a partir de los programas de política social y visualizan las contradicciones existentes entre los principios nacionales que defi nen las políticas sociales de los Estados de bienestar y las distintas fórmulas que a nivel regional y local adquieren dichos programas (Trydegard y Thorslund, 2010;Rauch, 2008). Sin embargo, la organización social de los cuidados a escala regional abarca más que las políticas sociales y sus intervenciones.…”

“…They explore care management based on social policy programs and visualize existing contradictions between national principles defi ning social policies of welfare states and the distinct characteristics of said programs on a regional and local level (Trydegard and Thorslund, 2010;Rauch, 2008). However, social care organization on a regional scale encompasses more than mere social policies and their interventions.…”

The Fragmented Welfare State: Explaining Local Variations in Services for Older People

“…Most older adults not living alone live together with a partner; intergenerational cohabitation is atypical in Denmark, and family members (daughters, sons or other relatives) rarely provide personal care to frail older adults in Denmark (cf. Rauch, 2008;Rostgaard et al, 2011;Rostgaard and Szebehely, 2012). That is, the informal care sector is small relative to other countries with less developed formal care sectors.…”

Eldercare policies in Scandinavia between 1993 and 2014: Increased facilitation of family caregiving?

“…The wording of these supply-conditioned rights is different from the wording of the legal rights connected to short-term care obligations; instead of 'employee' and 'right', the words used are 'relative' and 'apply'. As a result, the availability of these schemes to carers is affected by other factors, such as municipal finances and the applicant's social network (Jakobsson, Kotsadam, Syse, & Øien, 2015;Rauch, 2007Rauch, , 2008. As of 2014, there are still few truly work-family facilitating schemes for eldercare provision in these countries.…”