Privatizing the care for elderly: public and private home care services in the West Gothenburg Region, 2013

This paper is a reaction to a number of critical articles in Gothenburg’s media about privatized care services for elderly, which were published in the last year. Home services for elderly are seldom studied separately. Nonetheless they deserve researchers’ attention since the Swedish authority perceive home services as the best solution for older people according to Ädelreform of 1992, secured by the Social Service Act of 1980: 620 (Socialtjänstlag 1980: 620), 19§ and 20§ and its following adjustments that did not changed the first law in this regard (e.g., Socialtjänstlag 1997: 313; 1998: 384), and since especially knowledge about differences between public and private agencies providing home care services for the elderly is severely lacking (Öppna jämförelser: vård och omsorg om äldre, 2012). Hence, in this paper I ask: What have the public and private home care providers in common? What differences can be observed in their understanding of home care services for elderly and working methods? What lessons can be learned from the implementation of the state delegation of home care services for elderly to the municipal authorities? The purpose of this study is to compare and evaluate the public and private home care services for elderly given economic limitations after delegating them to municipality in the Gothenburg Region. The additional aim is to make politicians conscious about this development. The theoretical model of delegation and decentralization by Cristiano Castelfranchi and Rino Falcone (1998) and the Resource Dependency Theory by Pfeffer and Salancik (1978) constitute the theoretical reference frame. The study is based on an analysis of state regulation, policy documents and semi-structured interviews with the chief responsible for public and private home care services for elderly at the municipal level. This study reveals that the delegation of care for elderly to the municipalities faced some serious problems not be solved until 2013 and surprisingly that these problems are especially seen where the recipients of such care don’t have a choice on their service provider. The lesson drawn from the research is that if politicians or other authorities take away the right from people to make their own decisions about their own lives this inevitably results in dissatisfaction and subsequent reforms.

Celem artykułu jest porównanie i ocena publicznych i prywatnych domowych usług opiekuńczych dla ludzi starszych w regionie Goeteborg w Szwecji po przekazaniu przez władze centralne odpowiedzialności za te usługi na poziom samorządowy. Artykuł oparty jest na analizie legislacji, dokumentów urzędowych oraz wywiadów z kierownikami instytucji samorządowych odpowiedzialnymi za usługi opiekuńcze dla ludzi starszych w miejscu zamieszkania.