Towards a More Diversified Supply of Welfare Services? Marketisation and the Local Governing of Nursing Homes in Scandinavian Countries

2022

NAT

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Drygt hälften av de svenska kommunerna har infört valfrihet inom hemtjänst baserat på lagen om valfrihetssystem (LOV). Detta valfrihetssystem mynnar ut i en ”välfärdsmix” i kommunerna, där offentliga och privata utförare konkurrerar med varandra. I artikeln undersöks hur den offentliga utföraren av hemtjänst, i en kontext av LOV, presenterar sin verksamhet. Tillämpas härvidlag tillvägagångssätt mot ”konvergens” eller ”divergens” i förhållande till privata utförare? Med ”konvergens” avses att den offentliga utföraren försöker efterlikna privata utförare i presentationen av sin verksamhet, medan ”divergens” istället avser att den offentliga utföraren för fram skillnader gentemot privata utförare. Den empiriska studien består av en riktad innehållsanalys och omfattar LOV-kommuner som presenterat den offentliga utföraren på kommunens hemsida (N=107). Studiens övergripande slutsats är att det dominerande tillvägagångssättet handlar om divergens, kryddat med inslag av konvergens. I den offentliga utförarens presentationer betonas exempelvis det kommunala ägandet samt kommunernas erfarenhet av att bedriva hemtjänst. Samtidigt förekommer företagsinspirerade inslag som användandet av begreppet ”kund”. Studiens resultat placeras in i en övergripande diskussion om hur offentliga utförare utvecklas i en kontext av marknadisering. Att offentlig verksamhet okritiskt ”importerar” tillvägagångssätt från vinstdrivande företag kan utmana centrala värden i förvaltningen, som öppenhet, saklighet och följsamhet till den demokratiska styrningskedjan.

Section: Marknadisering Och Välfärdsmixunclassified

”Kunden i fokus!” – Om den kommunala hemtjänstens presentation av verksamheten i en marknadiserad äldreomsorg

Feltenius¹,

2022

NAT

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“…In this model, the contract is awarded to the actor with the most attractive bid in terms of the quality descriptions or cost of services -or both (Segaard and Saglie 2017). In Sweden, this model has been applied, for instance, in the procurement of nursing home services for elderly persons (Feltenius 2017;Broms, Dahlström, and Nistotskaya 2020).…”

Section: Marketizationmentioning

confidence: 99%

“…In fact, all welfare providers that meet the specified criteria in the tender document (förfrågningsunderlag) stipulated by each municipality are given permission to offer services (Government Bill 2008/09:29). Service providers who gain permission then become an option that an individual can choose from in the system (Jordahl 2013;Feltenius andWide 2015, 2019;Wide and Feltenius 2016). However, in the case of home care services, the elderly must first have been granted this particular service, a decision made formally by a responsible care manager of the municipality.…”

Section: Marketizationmentioning

confidence: 99%

“…The practice of LOV has been most evident in home-care services (Feltenius andWide 2015, 2019), which has resulted in different types of providers that include for-profit, nonprofit and public. It is notably in the context of LOV that the size of different types of providers depends on the choice made by the elderly individual.…”

Section: Providers Of Home-care Servicesmentioning

confidence: 99%

See 1 more Smart Citation

Conservation or disappearance? The public provider of home care services in a system of choice

Feltenius

Public Management Review

2021

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This article aims to analyse the position of the public provider (i.e. share of recipients) of home-care services in Swedish municipalities with marketization: a system of choice. Following the literature, an assumption is that the public provider has difficulties in surviving the competition with private home-care providers. In addition, the relevancy of this assumption could differ between different municipal settings. To test this assumption, we use statistical analysis. The main result is that the public provider is a 'strong player' in most municipalities experiencing marketization. However, there exists a variation in this respect -the position varies between municipalities.

“…However, these changes do not mainly concern the actual provision of welfare services nor the main rationale behind it, such as a universalism (Beland et al 2014). Sweden is still considered to have a universal and generous welfare state, where welfare is broadly distributed to its citizens (Feltenius 2017;Lindbom 2001). Instead, the changes mainly concern the actual governing of important welfare tasks at the local level, summarized in terms of 'marketization' (Petersen & Hjelmar 2013;Pierre 1995;Salamon 1993), which means 'the penetration of essentially market-type relationships into the social welfare arena' (Salamon 1993: 17).…”

Section: The Welfare State In Transitionmentioning

confidence: 99%

Business as usual? Civil society organizations in a marketized Swedish welfare state

Feltenius

Journal of Civil Society

2019

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This article aims to examine the participation of pensioners' organizations in a context of marketization within local elderly care. The literature on New Public Management (NPM) points out different views on the effects of marketization on the participation of civil society organizations within the decision-making process. One view states marketization implies less of participation by civil society organizations since this stands in conflict with inherent values of NPM, such as efficiency and the citizen as customer on a market. An opposite view states that marketization does not cause this effect, i.e., civil society organizations participate in the same manner as before. The empirical investigation consists of results from a questionnaire sent out to pensioners' organizations in Swedish municipalities with a marketized elderly care. The main result is that marketization does not cause any major crowding out effect on civil society organizations from the decision-making process. However, according to the survey, there exists a variation in this respectparticipation varies between municipalities.