Marta SzebehelyProfessor emeritus i socialt arbete med inriktning mot äldre
Marta Szebehely är professor emeritus i socialt arbete med inriktning mot äldre vid Stockholms universitet. Hon har forskat om äldreomsorg och andra omsorgsfrågor ur vardags-, genus- och socialpolitiska perspektiv sedan mitten av 1980-talet.
Fram till slutet av 2019 var hon ansvarig för forskningsprogrammet Individanpassad omsorg och generell välfärd: dilemman i marknadiseringens tid; ett forskningsprogram med finansiering (3 miljoner per år) från Forte 2014-2019. Se slutrapport och förteckning över publikationer från programmet här.
Hon är en av medlemmarna i det nordiska forskningsprojektet Social Inequalities in Ageing, finansierad av Nordforsk, och är ansvarig för ett nätverk för arbetslivsinriktad omsorgsforskning, finansierat av Forte 2019-2022.
Tidigare har hon ansvarat för Normacare, ett nordiskt forskarnätverk om marknadisering inom äldreomsorgen (finansierat av Forte och NordForsk), samt de svenska grenarna av två komparativa projekt om äldreboenden i olika länder Re-imagining Long-term Care Residential Care och Healthy Ageing in Residential Places- HARP.
Under 2007-2013 var hon ansvarig för ett sexårigt forskningsprogram finansierat av Forte: Omsorg i omvandling: Vardagsliv, organisering och välfärdspolitik. Under samma period var hon också ansvarig för temat 'Care in ageing and diversifying societies' i det nordiska excellenscentret REASSESS (Reassessing the Nordic Welfare Model).
Hon är även huvudansvarig för den nordiska komparativa enkätsttudien Nordcare som har undersökt den nordiska omsorgspersonalens arbetsvillkor 2005 och 2015.
2021 tilldelades hon det nordiska gerontologipriset (the Sohlberg Prize), se prisföreläsningen "Care work and care services under pressure". 2019 tilldelades hon det svenska Stora Gerontologipriset av Sveriges Gerontologiska Sällskap, se prisföreläsning här och 2016 fick hon Svensk Socialpolitisk förenings hederspris
Aktuellt med anledning av Covid-19:
Marta Szebehely Äldreomsorgen och Coronakrisen. Seminarium, Arena Idé 20 jan 2021
Presentation av rapporten Internationella erfarenheter av covid-19 i äldreboenden: https://www.sns.se/artiklar/coronakommissionen-presenterar-delrapport-om-aldreomsorgen-2/ 16 dec 2020
Internationella erfarenheter av covid-19 i äldreboenden. Underlagsrapport för Coronakommissionen: https://coronakommissionen.com/ 15 dec 2020
Covid-19 i svenska äldreboenden – insatser, utmaningar och konsekvenser, Presentation vid webbinarium arrangerat av KI: Äldres hälsa under covid: https://ki.se/nvs/aldres-halsa-under-covid-19, 10 nov 2020.
The impact of COVID-19 on long-term care in Sweden. En rapport publicerad 22 juli 2020 av LTCcovid, ett internationellt forskarnätverk kopplat till London School of Economic and Political Science
Marta Szebehely: Corona-pandemin, en vändpunkt för äldreomsorgen? Akademikerförbundet SSR, Socialtjänstpodden, 26 maj 2020
Marta Szebehely, Rebecka Strandell, Anneli Stranz: Äldreomsorgens låga status öppnar för smittan, Debattartikel i Kommunalarbetaren 24 april 2020
I urval från Stockholms universitets publikationsdatabas
En värdig äldreomsorg kräver värdiga arbetsvillkor
2017. Marta Szebehely, Anneli Stranz, Rebecka Strandell.Artikel
Genus i omsorgens vardag
2017. Evy Gunnarsson, Marta Szebehely.Bok (red)
Komplexiteter och utmaningar i omsorgens vardag
2017. Evy Gunnarsson, Marta Szebehely. Genus i omsorgens vardag, 13-28Kapitel
Marketization in Long-Term Care
2017. Charlene Harrington (et al.).Artikel
This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability.
2017. Marta Szebehely, Gabrielle Meagher. Journal of European Social PolicyArtikel
This paper builds on recent research on the fortunes of universalism in European social policy by tracing the development of eldercare policy in four Nordic countries: Denmark, Finland, Norway and Sweden. Six dimensions of universalism are used to assess whether and how eldercare has been universalised or de-universalised in each country in recent decades and the consequences of the trends thereby identified. We find that de-universalisation has occurred in all four countries, but more so in Finland and Sweden than in Denmark and Norway. Available data show an increase in for-profit provision of publicly funded care services (via policies promoting service marketisation), and an increase of family care (re-familialisation) as well of services, paid out-of-pocket (privatisation). These changes have occurred without an explicit attack on universalism or retrenchment of formal rights but are threatening the class- and gender-equalising potential of Nordic welfare states.
Omsorgsmönster bland kvinnor och män
2017. Marta Szebehely. Genus i omsorgens vardag, 29-48Kapitel
Vad kan Finland lära av Sveriges erfarenheter av vinst i välfärden?
2017. Marta Szebehely.Artikel
Vem ska arbeta i framtidens äldreomsorg?
2017. Marta Szebehely, Anneli Stranz, Rebecka Strandell.Rapport
Working longer, caring harder – the impact of ‘ageing-in-place’ policies on working carers in the UK and Sweden
2017. Madeleine Starr, Marta Szebehely.Artikel
Most developed countries have introduced significant changes in housing and longterm care policies for older people. Simultaneously, there is increasing policy and economic emphasis on extending working lives and on changes to pension schemes. These changes have combined to have negative consequences for working-age family carers. In this contribution, Madeleine Starr MBE, Director of Business Development and Innovation at Carers UK, and Marta Szebehely, Professor of Social Work at Stockholm University, Sweden, discuss the situations in the UK and Sweden – two countries with different policy traditions but facing similar challenges.
How institutions matter for job characteristics, quality and experiences
2016. Gabrielle Meagher, Marta Szebehely, Jane Mears. Work, Employment and Society 30 (5), 731-749Artikel
This article seeks to understand a puzzling finding: that workers in publicly-funded home care for older people in Australia, compared to those in Sweden, feel that they are better able to meet their clients’ needs, that their workplaces are less pressed, and that their work is less burdensome and more compatible with their family and social commitments. This finding seems to challenge expectations fostered by comparative sociological research that job quality and care services are inferior in Australia compared to Sweden. Informed by comparative institutionalist theory and care research, the structures and dynamics of the care systems in the two countries are analyzed, along with findings from the NORDCARE survey of home care workers conducted in Sweden in 2005 (n=166) and Australia in 2010 (n=318). Differences in the work and working conditions in the two countries are explained by the dynamic interaction of national institutional and highly gendered sector-level effects.
Mapping Nursing Home Inspections and Audits in Six Countries
2016. Jacqueline A. Choiniere (et al.). Ageing International 41 (1), 40-61Artikel
International quality concerns regarding long-term residential care, home to many of the most vulnerable among us, prompted our examination of the audit and inspection processes in six different countries. Drawing on Donabedian’s (Evaluation & Health Professions, 6(3), 363–375, 1983) categorization of quality criteria into structural, process and outcome indicators, this paper compares how quality is understood and regulated in six countries occupying different categories according to Esping Andersen’s (1990) typology: Canada, England, and the United States (liberal welfare regimes); Germany (conservative welfare regime); Norway, and Sweden (social democratic welfare regimes). In general, our review finds that countries with higher rates of privatization (mostly the liberal welfare regimes) have more standardized, complex and deterrence-based regulatory approaches. We identify that even countries with the lowest rates of for profit ownership and more compliance-based regulatory approaches (Norway and Sweden) are witnessing an increased involvement of for-profit agencies in managing care in this sector. Our analysis suggests there is widespread concern about the incursion of market forces and logic into this sector, and about the persistent failure to regulate structural quality indicators, which in turn have important implications for process and outcome quality indicators.
Residential Care for Older People
2016. Marta Szebehely. Journal of Canadian studies 50 (2), 499-507Artikel
Based on a qualitative rapid ethnography study, this article analyzes everyday care work in nursing homes in Ontario and Sweden. The comparison is linked to the broader socio-political and organizational contexts in the two jurisdictions. Policy documents in both locations stress that care services should be of high quality and individually adapted. The organizational preconditions to provide such care were better in the Swedish care homes because of higher staffing ratios, fewer routines, and more time for collegial support. The workers therefore had more opportunities to adapt their efforts to meet residents' different and changing needs. In both jurisdictions, however, the care workers' own needs were often disregarded, and their health and well-being were at risk.
From the state to the family or to the market?
2015. Petra Ulmanen, Marta Szebehely. International Journal of Social Welfare 24 (1), 81-92Artikel
This article analyses the changing roles of the state, family and market in providing care for older people in Sweden, in relation to Scandinavian welfare ideals of universalism and de-familisation. Since 2000 every fourth residential care bed has disappeared and the increase in homecare services has not compensated for the decline. Instead family care (defined here as help from adult children and other non-cohabiting family or friends) has increased in all social groups: help by daughters mainly among older people with shorter education and help by sons among those highly educated. Use of privately purchased services has also increased but continues to play a marginal role. Family care remains more common among older people with less education whereas privately purchased services are more common among those with higher education. This dualisation of care challenges universalism, and working-class daughters continue to be most affected by eldercare cutbacks.
Att ge omsorg mitt i livet
2014. Marta Szebehely, Petra Ulmanen, Ann-Britt Sand.Rapport
Ett körverk om omsorg
2014. Marta Szebehely. Alltid någon annan som väntar, 165-178Kapitel
Hur mycket självbestämmande ryms det i skälig levnadsnivå?
2014. Marta Szebehely, Gun-Britt Trydegård. Tre decennier med socialtjänstlagen, 103-126Kapitel
It’s a scandal! Comparing the causes and consequences of nursing home media scandals in five countries
2014. Liz Lloyd (et al.). International journal of sociology and social policy 34 (1/2), 2-18Artikel
Purpose – This study aims to explore the causes and consequences of media scandals involving nursing homes for older persons in Canada, Norway, Sweden, the UK and the USA.
Design/methodology/approach – This study uses a descriptive case-study methodology which provides an in-depth, focused, qualitative analysis of one selected nursing home scandal in each jurisdiction. Scandals were selected on the basis of being substantive enough to potentially affect policy. An international comparative perspective was adopted to consider whether and how different social, political and economic contexts might shape scandals and their consequences.
Findings – This study found that for-profit residential care provision as well as international trends in the ownership and financing of nursing homes were factors in the emergence of all media scandals, as was investigative reporting and a lack of consensus around the role of the state in the delivery of residential care. All scandals resulted in government action but such action generally avoided addressing underlying structural conditions.
Research limitations/implications – This study examines only the short-term effects of five media scandals.
Originality/value – While there has been longstanding recognition of the importance of scandals to the development of residential care policy, there have been few studies that have systematically examined the causes and consequences of such scandals. This paper contributes to a research agenda that more fully considers the media's role in the development of residential care policy, attending to both its promises and shortcomings.
Ny studie: Högt pris för att ge anhörigomsorg
2014. Marta Szebehely, Petra Ulmanen, Ann-Britt Sand. Dagens samhälle (7 januari)Artikel
Vinstsyfte i äldreomsorgen
2014. Marta Szebehely. Alla dessa marknader, 129-141Kapitel
Ekonomer tenderar att vara mer positiva än omsorgsforskare till vinstdrivande välfärdsföretag. De förra ser höjd kvalitet och effektivitet, de senare risk för ökad ojämlikhet.
Arbeitsbedingungen in der Altenpflege
2013. Hildegard Theobald, Marta Szebehely, Maren Preuss.Bok
Durch die demographische Entwicklung wird der Bedarf an Pflegekräften für die professionelle Versorgung in der Altenhilfe zunehmen das ist ebenso unbezweifelbar wie die Vorhersage, dass es zum Problem werden wird, den Bedarf zu decken. Es könnte ein Beitrag zur Lösung dieses Problems sein, wenn Pflegekräfte ihre Tätigkeit weniger oft unterbrechen oder in andere Positionen wechseln, als das in Deutschland gegenwärtig der Fall ist. Der Vergleich mit Schweden, wo Pflegekräfte viel länger und kontinuierlicher tätig sind, verspricht hier interessante Aufschlüsse. Das Forschungsprojekt, über das in diesem Buch berichtet wird, hat mit jeweils 600 Pflegekräften in der ambulanten und stationären Altenpflege in beiden Ländern untersucht, wovon der Verbleib im Beruf abhängt. Vor dem Hintergrund von Pflegepolitiken, Organisation und Professionalisierung der Pflege wurden Anstellungs- und Arbeitssituation, Berufsverlauf und Vereinbarkeit von Beruf und Familie verglichen. Die Ergebnisse zeigen unter anderem: Die Qualifikation der Beschäftigten spielt eine große Rolle, ebenso die Ausgestaltung und Familienfreundlichkeit der Beschäftigungsverhältnisse sowie die Arbeitsbelastungen und die Ressourcen zu deren Bewältigung.
Care workers and New Public Management: A comparison of long-term care reforms and their effects on care workers in Sweden and Germany
2013. Hildegard Theobald, Marta Szebehely.Konferens
Family rediscovered? Working carers of older people in Finland and Sweden
2013. Outi Jolanki, Marta Szebehely, Kaisa Kauppinen. Combining paid work and family careKapitel
The chapter addresses the characteristics and situations of working carers of older people in Finland and Sweden. It draws together knowledge on employment legislation, public policy and payments to working carers with studies on family care of older people. The central questions addressed are: Who are the carers? What kind of support is available for them? Are their working lives affected by caring responsibilities? And how do they perceive their everyday lives? The chapter shows that in both countries, family carers, the majority of whom are working women, have a major role in older people’s care. It argues that restructuring older people’s public care services has implicitly increased the expectation that family members will provide care, and notes that, while in the 2000s family care and working carers of older people have risen up the political agenda, legislation and practical actions to support them are still largely absent.
Long-term care in Sweden
2013. Gabrielle Meagher, Marta Szebehely. Reforms in long-term care policies in Europe, 55-78Kapitel
Sweden constitutes a traditionally well-developed system of long-term care, based on tax-funded, mainly publicly provided services. This system has changed significantly in recent decades. There has been some retrenchment in eldercare evident in falling coverage and stronger targeting of people with higher levels of need. This development has led to the informalization of care for some groups of older people. In disability care, there has been a considerable expansion of services, perhaps most notably in the introduction of a personal assistance scheme for people with severe disabilities. These divergent trends in services for older people and people with disabilities have coincided with a convergent development across both care fields: the marketization of services and the emergence of large, corporate, for-profit providers. This chapter explains how and why these changes have happened, and their consequences for service users and for the possible future of social care in Sweden. In addition to the dynamic interaction of state-steering and municipal response that are typically important in explaining change in patterns of social service in countries with multilevel government, “invasive displacement” and “layering” are identified as processes transforming the institutions that directly and indirectly organize care service provision.
Marketisation in Nordic eldercare:
2013. Gabrielle Meagher, Marta Szebehely.Bok (red)
Marketising trends in Swedish eldercare: competition, choice and calls for stricter regulation
2013. Sara Erlandsson (et al.). Marketisation in Nordic eldercare, 23-84Kapitel
A caring state for all older people?
2012. Mia Vabø, Marta Szebehely. Welfare State, Universalism and Diversity, 121-143Kapitel
Changing policies, changing patterns of care
2012. Tine Rostgaard, Marta Szebehely. European Journal of Ageing 9 (2), 101-109Artikel
Despite pursuing the policy of ageing in place, the two Nordic countries of Denmark and Sweden have taken diverse roads in regard to the provision of formal, public tax-financed home care for older people. Whilst Sweden has cut down home care and targeted services for the most needy, Denmark has continued the generous provision of home care. This article focuses on the implication of such diverse policies for the provision and combination of formal and informal care resources for older people. Using data from Level of Living surveys (based on interviews with a total of 1,158 individuals aged 67-87 in need of practical help), the article investigates the consequences of the two policy approaches for older people of different needs and socio-economic backgrounds and evaluates how the development corresponds with ideals of universalism in the Nordic welfare model. Our findings show that in both countries tax-funded home care is used across social groups but targeting of resources at the most needy in Sweden creates other inequalities: Older people with shorter education are left with no one to resort to but the family, whilst those with higher education purchase help from market providers. Not only does this leave some older people more at risk, it also questions the degree of de-familialisation which is otherwise often proclaimed to be a main characteristic of the Nordic welfare model.
Equality in the social service state
2012. Gabrielle Meagher, Marta Szebehely. Changing Social Inequality, 89-118Kapitel
Home care for older people in Sweden
2012. Marta Szebehely, Gun-Britt Trydegård. Health & Social Care in the Community 20 (3), 300-309Artikel
One aspect of universalism in Swedish eldercare services is that publicly financed and publicly provided services have been both affordable for the poor and attractive enough to be preferred by the middle class. This article identifies two trends in home care for older people in Sweden: a decline in the coverage of publicly funded services and their increasing marketisation. We explore the mechanisms behind these trends by reviewing policy documents and official reports, and discuss the distributional consequences of the changes by analysing two data sets from Statistics Sweden: the Swedish Level of Living surveys from 1988 ⁄ 1989 and 2004 ⁄ 2005 and a database on all users of tax deductions on household and care services in 2009. The analysis shows that the decline of tax-funded home care is not the result of changing eldercare legislation and was not intended by national policy-makers. Rather the decline was caused by a complex interplay of decision-making at central and local levels, resulting in stricter municipal targeting. The trend towards marketisation has been more clearly intended by national policy-makers.
Legislative changes have opened up tax-funded services to private provision, and a customer-choice (voucher) model and a tax deduction for household- and care services have been introduced. As a result of declining tax-funded home-care services, older persons with lower education increasingly receive family care, while those with higher education are more likely to buy private services. The combination of income-related user fees, customer-choice models and the tax deduction has created an incentive for high-income older persons to turn to the market instead of using public home-care services. Thus, Swedish home care, as a universal welfare service, is now under threat and may become increasingly dominated by groups with less education and lower income which, in turn, could jeopardise the quality of care.
Konkurrens som drivkraft i välfärden – debatten som väckte Sverige
2012. Marta Szebehely. Tidsskrift for velferdsforskning 15 (2), 134-139Artikel
Nursing Home Staffing Standards and Staffing Levels in Six Countries
2012. Charlene Harrington (et al.). Journal of Nursing Scholarship 44 (1), 88-98Artikel
Purpose: This study was designed to collect and compare nurse staffing standards and staffing levels in six counties: the United States, Canada, England, Germany, Norway, and Sweden. Design: The study used descriptive information on staffing regulations and policies as well as actual staffing levels for registered nurses, licensed nurses, and nursing assistants across states, provinces, regions, and countries. Methods: Data were collected from Internet searches of staffing regulations and policies along with statistical data on actual staffing from reports and documents. Staffing data were converted to hours per resident day to facilitate comparisons across countries. Findings: We found wide variations in both nurse staffing standards and actual staffing levels within and across countries, although comparisons were difficult to make due to differences in measuring staffing, the vagueness of standards, and limited availability of actual staffing data. Both the standards and levels in most countries ( except Norway and Sweden) were lower than the recommended levels by experts. Conclusions: Our findings demonstrate the need for further attention to nurse staffing standards and levels in order to assure the quality of nursing home care.
Structural violence in long-term residential care for older people: Comparing Canada and Scandinavia
2012. Albert Banerjee (et al.). Social Science and Medicine 74 (3), 390-398Artikel
Canadian frontline careworkers are six times more likely to experience daily physical violence than their Scandinavian counterparts. This paper draws on a comparative survey of residential careworkers serving older people across three Canadian provinces (Manitoba, Nova Scotia, Ontario) and four countries that follow a Scandinavian model of social care (Denmark, Finland, Norway, Sweden) conducted between 2005 and 2006. Ninety percent of Canadian frontline careworkers experienced physical violence from residents or their relatives and 43 percent reported physical violence on a daily basis. Canadian focus groups conducted in 2007 reveal violence was often normalized as an inevitable part of elder-care. We use the concept of “structural violence”(Galtung, 1969) to raise questions about the role that systemic and organizational factors play in setting the context for violence. Structural violence refers to indirect forms of violence that are built into social structures and that prevent people from meeting their basic needs or fulfilling their potential. We applied the concept to long-term residential care and found that the poor quality of the working conditions and inadequate levels of support experienced by Canadian careworkers constitute a form of structural violence.Working conditions are detrimental to careworker's physical and mental health, and prevent careworkers from providing the quality of care they are capable of providing and understand to be part of their job. These conditions may also contribute to the violence workers experience, and further investigation is warranted.
The marketisation of care
2012. Deborah Brennan (et al.). Journal of European Social Policy 22 (4), 377-391Artikel
The use of markets and market mechanisms to deliver care services is growing in both liberal and social democratic welfare states. This article examines debates and policies concerning the marketisation of eldercare and childcare in Sweden, England and Australia. It shows how market discourses and practices intersect with, reinforce or challenge traditions and existing policies and examines whether care markets deliver user empowerment and greater efficiency. Markets for eldercare and childcare have developed in uneven and context specific ways with varying consequences. Both politics and policy history help to shape market outcomes.
Unheard voices, unmapped terrain
2012. Tamara Daly, Marta Szebehely. International Journal of Social Welfare 21 (2), 139-148Artikel
This article aims to contribute to comparative welfare state research by analysing the everyday work life of long-term care facility workers in Canadaand Sweden. The study’s empirical base was a survey of fixed and open-ended questions. The article presents results from a subset of respondents (care aides and assistant nurses) working in facilities in three Canadian provinces (n = 557) and across Sweden (n = 292). The workers’ experiences were linked to the broader economic and organisational contexts of residential care in the two jurisdictions.We found a high degree of country-specific differentiation of work organisation:Canada follows a model of highly differentiated task-oriented work, whereasSweden represents an integrated relational care work model. Reflecting differences in the vertical division of labour, the Canadian care aides had more demanding working conditions than their Swedish colleagues. The consequences of these models for care workers, for older people and for their families are discussed.
Universell eller skiktad äldreomsorg – vem vinner och vem förlorar?
2012. Marta Szebehely. Jämlik ålderdom?Kapitel
2012. Marta Szebehely, Petra Ulmanen.Rapport
Rapporten undersöker hur den svenska äldreomsorgen har förändrats över tid. Hur har förändringarna påverkat de äldre, och hur har de påverkat deras anhörigas förvärvsarbete? Vi bygger på nya analyser av SCB:s stora intervjustudier av befolkningens levnadsförhållanden (ULF), samt tidigare svensk och internationell forskning. Vi jämför förändringarna under 1980- och 1990-talen med förändringarna under 2000-talet.
Insatser för äldre och funktionshindrade i privat regi
2011. Marta Szebehely. Konkurrensens konsekvenser, 215-257Kapitel
Lifting the Violence Veil
2011. Tamara Daly (et al.). Canadian Journal on Aging 30 (2), 271-284Artikel
We conducted a mixed-methods study – the focus of this article – to understand how workers in long-term care facilities experienced working conditions. We surveyed unionized care workers in Ontario (n = 917); we also surveyed workers in three Canadian provinces (n = 948) and four Scandinavian countries (n = 1,625). In post-survey focus groups, we presented respondents with survey questions and descriptive statistical fi ndings, and asked them: “Does this reflect your experience?” Workers reported time pressures and the frequency of experiences of physical violence and unwanted sexual attention, as we explain. We discuss how iteratively mixing qualitative and quantitative methods to triangulate survey and focus group results led to expected data convergence and to unexpected data divergence that revealed a normalized culture of structural violence in long-term care facilities. We discuss how the finding of structural violence emerged and also the deeper meaning, context, and insights resulting from our combined methods.
Genus i omsorgens vardag
2009. Evy Gunnarsson, Marta Szebehely.Bok (red)
The growth of the for-profit nursing home sector in Norway and Sweden
2020. Gudmund Ågotnes, Frode Jacobsen, Marta Szebehely. The Privatization of Care, 38-50Kapitel
The impact of COVID-19 on long-term care in Sweden
2020. Marta Szebehely.Rapport
The politics of profit in Swedish welfare services
2019. Gabrielle Meagher, Marta Szebehely. Critical Social Policy 39 (3), 455-476Artikel
The Social Democratic architects of the Swedish welfare state considered public provision as well as public funding of welfare services essential to realising their egalitarian ambitions. However, since the early 1990s, a highly concentrated, for-profit sector has emerged in welfare service provision. We analyse how the Swedish Social Democrats have discussed privatisation and the profit motive in welfare services from the 1980s to the present. We find that Social Democratic governments have defended public provision weakly across the period. The driving factors include the eclipse of the egalitarian ideal in favour of ideals of choice and diversity, internal disunity within the party on the profit question, and change in the political power order in Sweden, such that private welfare companies and their interest organisations have gained and now wield significant influence over welfare service policy.
Job Autonomy of Long-Term Residential Care Assistive Personnel
2018. Frode F. Jacobsen (et al.). Ageing International 43 (1), 4-19Artikel
Assistive personnel are the primary caregivers in long term residential care (LTRC) and their job autonomy is a major social determinant of health. Our goal is to explore experiences of assistive personnel in six industrialized countries (Canada, Germany, Norway, Sweden, England, and the U.S.), and consider innovations in the LTRC setting that might influence their job autonomy. The methodology is based on on-site observations at nursing homes and interviews with assistive personnel and other relevant LTRC staff in selected nursing homes in all six countries. Previously published statistical material from the study on staff characteristics like pay, formal education, unionization, employment-related benefits and extent of part-time work is employed as relevant context for discussing job autonomy. Our results show that assistive personnel are highly supportive of job autonomy though they interpret autonomy differently and report widely varying levels of job autonomy. Those LTRC organizations that have a reputation for encouraging autonomy of assistive personal, report recruiting is far easier even where there is a shortage. In some countries we were told that “resident-centered” (“person-centered”) care and a leveling of the division of labor, understood as more equal and horizontal division of labor, was on the rise and this could affect autonomy. Job autonomy is welcomed by assistive personnel. The wide variation in job autonomy across nursing homes and across countries is surprising. Within nursing homes variation may reflect imperfect or incomplete implementation of autonomy policies, or differential application of policies. The resident-centered philosophy and the leveling of the division of labor could make for greater autonomy for assistive personnel. These workplace innovations are not universal in all countries and they could be more difficult to apply where resources and commitment are lacking. The increasingly frail population of LTRC facilities and the general trend toward growth of specialized medical treatment within LTRC in some of the countries may support an argument for some limitations to job autonomy in assistive personnel. Autonomy is favored by assistive personnel though not all have it. The workplace innovations of resident-centered care and a leveling of the division of labor in LTRC, could make for a greater degree of autonomy for assistive personnel in the future, while increased demand for highly skilled care could work in the other direction.
Generell välfärd och lokalt självstyre
2018. Marta Szebehely, Gun-Britt Trydegård. Äldreomsorger i Sverige, 21-42Kapitel
Organizational trends impacting on everyday realities
2018. Anneli Stranz, Marta Szebehely. The Routledge Handbook of Social Care Around the World, 45-57Kapitel
Äldreomsorger i Sverige
2018. Håkan Jönson, Marta Szebehely.Bok (red)