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Professionalized through audit?: Care workers and the new audit regime in Sweden
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Government.ORCID iD: 0000-0001-5522-5344
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Government.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
(English)In: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515Article in journal (Other academic) Submitted
Abstract [en]

The objective of this article is to analyze whether the audit processes adopted in Swedish eldercare and childcare support or undermine the professionalization of the occupations working there, that is, nurses, nursing assistants, pre-school teachers and child minders. In particular we investigate whether the three main forms of audit; standard-setting, inspections and quality measurements, support or undermine the occupations’ ability to achieve professional closure and enhance their external and internal autonomy. The paper finds that the audit process adapted in eldercare is non-supportive of the professionalization of both nurses and nursing assistants. In childcare, however, it appears to support professional development, particularly for pre-school teachers. These findings suggest that audit processes do not have to be detrimental to professionalization. Instead, it appears that the state can design them in such a way that they make visible and close the work tasks of specific staff groups and thereby support, rather than undermine, their professional development

Keyword [en]
Professionalization, Audit, Social care, Eldercare, Child care
National Category
Social Sciences Public Administration Studies
Identifiers
URN: urn:nbn:se:uu:diva-319246OAI: oai:DiVA.org:uu-319246DiVA: diva2:1086376
Available from: 2017-04-02 Created: 2017-04-02 Last updated: 2017-04-05
In thesis
1. Marketization in Swedish Eldercare: Implications for Users, Professionals, and the State
Open this publication in new window or tab >>Marketization in Swedish Eldercare: Implications for Users, Professionals, and the State
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

During the last decades, Swedish policy makers have implemented various marketization reforms into the public welfare sector in order to make it more cost-efficient and to improve its quality. The aim of this dissertation is to investigate what implications this marketization trend has had for the organization of Swedish eldercare. In particular, the research question addressed is how marketization reforms such as privatized provision, increased competition, and user choice have transformed the relationship between the service users, the professionals, and the state. To answer the research question, four articles are presented in the dissertation, each corresponding to a separate empirical investigation. Together, the articles demonstrate that the increased reliance on marketization in Swedish eldercare has made it more difficult for the local authorities to directly control the quality of the services, since it reduces their ability to allocate public resources and expects them to govern the provision of eldercare through the entering of contracts. This development has also implied that service users themselves become increasingly responsible for ensuring that the quality of their care is high. Moreover, the articles show that the increased reliance on audit by the national government and its agencies has tended to undermine the professionalization of eldercare staff, thereby limiting their autonomy and ability to ensure service quality. As a whole, the dissertation contributes with a more comprehensive understanding of how marketization has altered the organization of Swedish eldercare and under what conditions it might undermine the goals of social equality and ensuring that all citizens have equal access to good quality care.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. 48 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 142
Keyword
Marketization, Eldercare, Universalism, Social care, Privatized provision, User choice, Competition, Swedish welfare state
National Category
Political Science Public Administration Studies
Research subject
Political Science
Identifiers
urn:nbn:se:uu:diva-319504 (URN)978-91-554-9886-3 (ISBN)
Public defence
2017-06-02, Brusewitzsalen, Statsvetenskapliga institutionen, Gamla Torget 6, Uppsala, 10:15 (Swedish)
Opponent
Supervisors
Available from: 2017-05-10 Created: 2017-04-05 Last updated: 2017-05-29

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