The Swedish Model in the Post-Financial Crisis Era
Edited by Christina Garsten, Jessica Lindvert and Renita Thedvall
Chapter 9: Home help work: balancing loyalties
In home help work, many things are as they have always been. The main work tasks of caring for people in need of support and assistance remain the same. Important parts of the work similarly continue to be people-to-people relationships with elements of both joy and difficulty. The home help services in Sweden are still publicly funded, financed by taxes and organized by local councils. Private and for-profit agencies are a growing industry in Sweden, but the municipal responsibility for home health and home care still dominates. But much has also changed, and working in home help services in the 2000s is different than in the past. The reorganization of municipal home help services that really took off in the 1980s has had considerable consequences, not only for those who use home help but also for the staff’s ability to perform their work. One of the arguments for the reorganization was based on economic considerations, where the vision was a welfare policy governed by an economic/instrumental rationality (see, for example, Drugge 2003; Eliasson 1992; Szebehely 1996). This has meant a rise in market thinking, where cost efficiency has been equated with care efficiency. This in turn has led to rationalization measures in the form of a downgrading of priorities and cuts to certain work tasks, above all household-related tasks such as cleaning. Another argument put forward was that it was a way to upgrade the value of home help work.
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