CARING FOR PEOPLE OR CARING FOR PROXY CONSUMERS?

Mia Vabø

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Public Policy and Administration Research Social Policy and Reform Studies Healthcare innovation and challenges

Abstract

ABSTRACT Reforms that aim at empowering recipients as ‘consumers’ are often seen as self-evidently favourable and unavoidable. Current narratives on public-sector change describe the previous service regimes as rigid, uniform and inhumane, whereas reforms are regarded as offering a flexible and responsive future. Accordingly, consumerism has become a major driving force behind Nordic welfare reforms. This paper presents a more nuanced analysis of the suppositions about the past systems for home care services and offers a critical view on current reforms and the assumptions underlying them. Empirical examples are drawn from field research and personal interviews undertaken before (1995) and after (2000) the Norwegian home care service was caught in the wave of New Public Management reforms. The paper demonstrates how contractual arrangements implemented in the name of the consumer run counter to established practices based on personal trust and continuous dialogue on needs.

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References

1991A PUBLIC MANAGEMENT FOR ALL SEASONS?1996The New Public Management in Action 2006The Managerial State: Power, Politics and Ideology in the Remaking of Social Welfare 1998Reshaping the Democratic State: Swedish Experiences in a Comparative Perspective 2002HOW NEW PUBLIC MANAGEMENT REFORMS CHALLENGE THE ROLES OF PROFESSIONALS 1988CONSUMERISM AND THE PUBLIC SECTOR: HOW WELL DOES THE COAT FIT?

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