The Organisation of Welfare Services on Quasi-Markets - a Study of Elderly Care in Sweden

This paper examines how a Scandinavian country organises elderly care as a welfare service on a quasi-market. More specifically, it deals with how public officers work with meeting citizens’ need and demand, while at the same time struggle with political decrees, changes in the political climate, as well as the whims of the market. Swedish elderly care is used as an example of how a welfare service is organised on a market in which care needs and state financed subsidies intersect with private and public actors. The Swedish welfare regime traditionally seeks to de-familiarise welfare services and de-commodify citizens.The aim is to unburden families of unpaid welfare service work and secure individual welfare from market failures. Since the end of 1900, however, the model has been reformed in terms of opening up the market for private actors to organise and deliver elderly care.

The study is based on three different empirical sources. First, a survey was conducted on elderly people living in a mid-sized Swedish city and who applied for a retirement home in 2014. Second, qualitative interviews was conducted with public officers responsible for the placement of elderly. Third, a text analysis was made on significant policy documents that frame the practice of the public officers.

The findings suggests that the conditions for the organisation of elderly care have changed, the welfare regime’s original aims are contested, and that family relationships is the main determinant for explaining differences in elderly people’s attitudes to living in a retirement home in the future. In addition, the findings reveal the complex tactics that the public officers developed in order to handle the needs and demands of elderly citizens in relation to new ways of governing elderly care.