Marketization in Long-Term Care and Growing Inequality within Care Workforce: A Comparison of Sweden and Germany

Since the 1990s, two distinct processes of marketization in long-term care provision can be found in Sweden and Germany. First, professional long-term care services were restructured inspired by ideas oriented towards New Public Management. Second, tax deduction policies were established to create a new mix of (ir)regular domestic and professional care services. Despite the international character of the development, the existing structure of professional and (ir)regular domestic services at the beginning and the approaches selected, their effects on the infrastructure and on the situation of care (and domestic) workers differ significantly between both countries. In both countries, research findings indicate – however country-specific - patterns of a worsening of working- and employment conditions of care workers embedded in distinct processes of hierarchisation among care workers. The paper aims to compare pre-existing service structures, policy approaches, their effects on service restructurings and the situation of care workers. Based on a comparison, it will reveal and explain the effects of country-specific policies and restructurings on processes of hierarchisation among care workers.  

Conceptually, the paper combines international comparative research on care policies and marketization and intersectional approaches developed within sociology to relate the effects of marketization to the emerging patterns of inequalities within the care work force based on gender, social class (training levels and positions) and ethnicity. Empirically, it will include documents and laws, literature review and representative statistics to analyze policy changes and existing- and changing infrastructure. Findings of a German-Swedish research project on the situation of professional carers with approx. 600 care workers in each country, will be used to reveal the country-specific restructurings and processes of hierarchisation within formal care provision, which is complemented by research on the developments within domestic service provision.