Resarchers have come together in Normacare to examine how marketisation – the emergence and growth of market ideas, practices and organisations – is shaping and reshaping eldercare services in the Nordic countries.
Comparative research is essential to Normacare’s work, not least because marketisation is unevenly developed in the study countries. In Finland and Sweden, for example, for-profit provision has grown significantly in tax-financed eldercare, while in Denmark and Norway, the development of a for-profit private sector in eldercare has been much slower. Although the pace of privatisation differs between the Nordic countries, market-inspired steering principles have been introduced in all of them.
Interdisciplinary research is also essential to Normacare’s work, because of the complex array of changes and challenges marketisation involves. For example, with marketisation, care users are increasingly regarded as customers and care services, whether provided by public or private providers, are increasingly expected to be individualised and personalised. Across the region, these developments have altered relationships between citizens and the state, and between citizens and the organisations and professionals that they interact with in the eldercare system.
Marketisation, then, raises a range of important questions that are best answered by collaborative comparative research across the social science, social welfare and business disciplines:
– When and how have market reforms in eldercare services been introduced in the Nordic countries?
– What role, if any, has policy learning between the Nordic countries played in the evolution of marketisation and privatisation in eldercare?
– Which policy instruments (such as fee controls, contracting out, tax rebates, vouchers, customer choice) have facilitated or inhibited the growth of private provision in each country?
– What is the current scope and extent of for-profit and not-for-profit providers in eldercare in each country?
– What kinds of regulation are private providers subject to? Are they regulated by the same or different instruments as public providers?
– Marketisation has been framed as a solution to a range of problems including worries about public spending, the quality of care and empowerment of users. What evidence is there that these problems have been solved? Have new problems emerged?
– At the level of policy discourse, marketisation is represented as empowering consumers: is that what happens in practice? What actually changes (from the client perspective) in the process of getting services when market models and/or private providers come in? Are there new benefits, new problems? How does marketisation affect family members and informal carers?
-How does marketisation affect care workers? When private providers enter the field, do differences in employment conditions between public and private eldercare services emerge? What is the interplay between the tax-funded homecare market and the household service market (in the formal or informal economy)?
– Does privatisation change the use/distribution of services between different social groups of clients/service users (e.g. increased or decreased inequality)?
– Has the emergence of for-profit providers affected the democratic steering of social care services, in the political process at national and municipal levels and within organisations, by workers and service users?
Normacare’s activities include regular network meetings to discuss work in progress and project ideas. Normacare participants also present their studies to wider audiences at conferences and at open seminars linked to network meetings. Information about research on marketisation published by Normacare participants is available here.
The network will build an e-database of policy documents, statistics and business reports as well as a bibliography of published research. The e-database is designed to serve as a resource for Nordic students and scholars – within and outside the network – who seek to study the trend towards marketisation and privatisation in eldercare and other social services.
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