Social Care Services

The Key to the Scandinavian Welfare Model

Jorma Sipilä

• Publisher: Routledge
• Year: 2019
• ISBN:
  9780429794261
• Edition: 1
• Topic: Politics & International Relations
• Subtopic: Social Policy
• Index: Politics & International Relations

First published in 1997, this volume aimed to study social care services as a specific type of social policy that operates on a different set of principles as supportive services rather than as poor relief or social security work. The focus is on determining what is specifically Scandinavian about the world-famous Scandinavian welfare state, with studies on issues including the origins of four social care service models, the development of local authority social services in Iceland and social services as a gender issue.

1 Introduction

Jorma Sipilä

How was the Scandinavian welfare state created; how did it evolve? What is the history of this world-famous system that has been so widely praised and so heavily criticized? The story has been told many times over, but the picture has still remained more or less incomplete. Research on the welfare state has largely concentrated on income security, leaving the issue of services to the sidelines. For this reason we have had only a sketchy understanding of what is specifically Scandinavian about this model, i.e. the extensive coverage of social care services and their universal accessibility to everyone who needs them.

In our project we have wanted to study social care services as a specific type of social policy that operates on a different set of principles than, say, poor relief or social security or social work. We are concerned with supportive services, i.e. services that help people cope in their everyday life and that people need for themselves or for their dependants. Social care services are voluntary: no one will be forced to accept them, nor do they stigmatize the recipient. Produced in part with public monies, the services are not charged to the recipient at the going market rate. Social care services take shape in the interaction between the worker and client; we do not count income transfers as services. In quantitative terms the two main types of Scandinavian social care services are children’s day care and care for the elderly, and it is these services that represent the focal concern of our research project.

There are many reasons why we have felt it is important to explore the development of social care services. First of all a closer analysis is warranted by the exceptional dynamics of these services. Labour statistics indicate that during the 1970s and 1980s there was no other major industry that expanded as rapidly as social care services. Secondly, it is quite an interesting undertaking to study social care services as a Scandinavian peculiarity. After all there are two truly unique phenomena in the Scandinavian social policy system: the extensive coverage of social care services and their availability to the middle class/Thirdly, the subject also warrants attention as part of the broader research project of gender relations. It was indeed women’s studies that in the 1980s started to draw attention to the important role of social care services in women life, highlight- ing the fact that women needed these services not only as clients but also as relatives and workers.

And there is another, fourth motive: during the 1980s social care services became the prime target for welfare state critics, an extraordinary scapegoat. The public system of social care services attracts criticism like a magnet, from all directions: for some it represents a complete and unnecessary waste of tax money, some say it kills off the independent initiative of individuals, families and communities, some regard social care services as another tentacle of all- pervasive state control, others still consider the social service system as a prime example of a mass service that shows no imagination but is produced on terms determined by professionals. Public social care services are something that should be changed. When listening to all this criticism there are many good reasons to ask why during earlier decades they have been considered so necessary.

This book is the product of a two-year research project in which five Scandinavian teams (regretfully Iceland joined us very late) are writing the missing story about the secret Scandinavian social care model. The focal concern is with the post-war period, for it was only in the 1960s that the model started to take on its own distinctive features.

Our aim is to explain how and why the Scandinavian countries came to develop their distinctive model of social care services. Internationally, the feature that no doubt is most widely known about the system is that the provision of services is so heavily concentrated in the public sector. How and why has this solution come about? Another aspect, and a source of both satisfaction and even pride for Scandinavians themselves, is the universalism of social care services. This means that the services are intended not only for poor people or exclusively for the working class, but anyone can apply, regardless of income or social status. And further, an internationally excep- tional development has been the provision of universal social care services for children and the frail elderly. How did the Scandinavian countries come to adopt such an emphatically universal policy of social services? And the third question is: Why does Scandinavia offer such an abundance of social care services — taken together, probably more than any where else in the world?

We have, in our research, concentrated on the development of legislation, planning documents and on statistical comparisons between Denmark, Fin- land, Iceland, Norway and Sweden. Of course, we have also reviewed the earlier literature. All this has been geared at better understanding of the reasons underlying the changes that have happened.

When we started with our project we decided that we wanted to concentrate on developments since the 1950s, i.e. on the period which saw a phenomenal growth of social care services and increasing public debate on these services. However, during the course of the project we have found ourselves asking more and more often what happened before the 1950s. We have learned that even though the Scandinavian social care model may be the product of the welfare state and the 1960s, its roots go deeper still, in fact all the way back to the Reformation.

But the actual growth of social care services started in the 1960s. One of the prime movers was the long-standing ambition to ideologically reform social welfare. The idea was to transform objects into subjects, to move away from forcing people to adapt towards effecting change in society, to fight for civil rights and freedoms. The introduction of the service principles in the care of children, the frail elderly and the disabled had an important role to play in this struggle for modern society.

However, an ideological revolution of social welfare would not necessarily have implied a deep-going reform of social services. Far more important to the future, as it turned out, was the new way in which the Scandinavian labour society was built up, with women taking up an increasingly important place. The new views on women and family policy made their political breakthrough in the 1960s: it was recognized that mothers of infants under school age had the right to work and on this basis to get a secure, subsidized day care place for their children. The same principles were regarded as applying to the adult children (and especially daughters) of elderly people: they should have the right to take on a paid job and move out from where their parents lived if that was what the job required. The Scandinavian notion of labour society showed its strength in the expanding social care services. Closely related to this was the development of proper occupations out of the everyday functions of human reproduction.

And since it had been decided that social care services were to be made available to all mothers and daughters who needed them, service production had to be started on an unprecedented scale. This was indeed what happened in all Scandinavian countries from the 1960s onwards, in a situation where the economy was posing no restrictions on the growth of the welfare state.

Five Scandinavian countries

We hope that this book will be read outside Scandinavia as well as within it, and therefore it is necessary to say a few words about this corner of the world that we have been studying. We refer to these countries jointly as the Scandinavian group, even though they themselves use the term Nordic. Scandinavia normally refers to the Scandinavian peninsula (Norway and Sweden) or to the area of Scandinavian languages (Denmark, Iceland, Norway and Sweden); but in this book we use Scandinavia to refer to the area that also includes Finland. Nordic is sometimes used as a synonyme with Scandinavia.

The five Scandinavian countries have a long history of both mutual cooperation and hostilities. In the fourteenth century the Scandinavian countries actually formed a Union. For most of the remaining modem history Denmark and Sweden have been sovereign states, with Finland, Iceland and Norway forming parts of them. The present-day political map is less than one hundred years old: Norway gained independence from Sweden in 1905, Finland from Russia in 1917 (to which it had been annexed in 1809), and Iceland from Denmark in 1944.

The mainstream religion in Scandinavia is Lutheran Protestantism. People in Denmark, Norway and Sweden understand each other’s written language, mostly spoken language as well. Finnish and Icelandic languages are not understood by the others. With the exception of a Sami minority living in the northern parts of Norway, Sweden and Finland, the Scandinavian countries have been highly homogenous in ethnic terms. Throughout recorded history Finland has had a highly influential Swedish-speaking minority, for whom Nordic contacts are very important. Over the past few decades new ethnic minorities have been arriving most especially in Sweden and Denmark with a growing wave of migration. Sweden also has a very considerable minority of Finnish-speaking immigrants.

The land in the North is rugged and the climate austere, and before industri- alization the countries of Scandinavia were poor. The Nobility did not thrive in the same way as it did in Central Europe and on the British Isles, but the population consisted chiefly of independent fanners. Democratic elements can be detected in Scandinavian power systems back in the early Middle Ages or even further: Iceland had an established parliament (Althing) already in 930. Although there was a strong royalty, the lower strata had for many centuries the opportunity to voice their interests at the Diet, where the peasants also had their own representatives. Power was handed down from the nobility to the bourgeoisie and eventually to the people without any major revolutions.

The early growth of strong peasant parties and the high degree of labour unionization have had a major influence on political life in the Scandinavian countries. After industrialization farmers and industrial workers joined forces especially in social policy matters, working together to build a society which in economic terms was exceptionally equal and in political terms exceptionally democratic. The Icelandic political history has been quite different because of a perpetually strong conservative party.

The Nordic Council was founded in 1953 with the aim of promoting cooperation among the Scandinavian countries. Denmark, Finland, Iceland, Sweden and Norway have coordinated their policies and among other things created a common labour market for its citizens. Steps have also been taken to harmonize social policy.

Scandinavian cooperation does not extend to all political domains, however. The most notable exception is defence policy. Denmark and Norway are NATO members, as is Iceland, which has a permanent base for US troops. Sweden has been most consistent in pursuing a policy of neutrality. Finland has also declared that it is neutral. However, following its defeat in the Second World War Finland was forced to sign an agreement of cooperation and mutual assistance with the Soviet Union (1948), which remained in force until the collapse of the Soviet Union in 1992. During the 1960s many politicians harboured plans of a joint Nordic economic union, but in the 1970s Denmark decided to join the European Economic Community (now the European Union), while the other Scandinavian countries opted to join the European Free Trade Association. The setting changed yet again in 1995 as Finland and Sweden joined the European Union. Norway and Iceland remain outside.

The Scandinavian countries have built up a strong Nordic identity. The peoples of these countries like to think that they are privileged to be born here. Foreigners are often amazed to see citizens in the Scandinavian countries taking a positive attitude not only towards their own country but often the state as well — they actually regard the state as their own. In everyday conversation people speak of society when they mean the state. Politically, the Scandinavian countries have been extraordinarily stable over the last decades.

Income security in the Scandinavian countries is in principle a combination of basic security based on place of residence, and earnings-related security based on employment. Basic security is fairly comprehensive and has helped to keep poverty very much in check.

The Scandinavian way of producing social care services is based on a close alliance between the state and local municipalities. State legislation obliges local councils to produce the services, but the government also provides subsidies to support them in doing so. During the period of expansive growth in social care services the state specified the level of services that it expected local municipalities to produce, but nowadays local councils enjoy consider- able autonomy in deciding on their own service policy. The state is mainly concerned with making sure that the minimum level is satisfied. As a general rule social care services are produced at the municipal level, but in certain cases at the regional level. Public administration may delegate the provision of services to voluntary organizations and other producers.

In recent years it has become customary to describe Scandinavian countries as women-friendly welfare states. Women’s gainful employment is among the highest in the world, as is their level of education and their participation in politics. Scandinavian single mothers are not excluded; they are generally employed and their standard of living is, by international comparison, fairly high.

The Scandinavian countries may also be described as labour societies where a very large proportion of the population is in wage employment. This is made possible by the social care services; there are not many full-time housewives. On the other hand the Scandinavian welfare state needs a large number of jobs and tax-payers in order to operate properly. In Denmark, however, unemploy- ment has long been in excess of ten per cent. During the 1990s Sweden and especially Finland have been hit by a wave of mass unemployment, growing government debt and a crisis of the public economy, which have implied severe cuts in social welfare. Iceland has had a relatively low unemployment rate although it is increasing. The affluent Norway has not been troubled by unemployment or by a welfare state crisis.

In terms of population numbers the Scandinavian countries are small. The Swedish population is almost 9 million; Denmark and Finland have a population of over 5 million, Norway over 4 million. Iceland has a population of one quarter of a million people.

The life expectancy of people in Iceland, Norway and Sweden is among the highest in the world; the situation in Finland and Denmark is not quite as good. Old people often live alone, but even so, international comparisons suggest that they are very satisfied with their situation. On the other hand Scandinavia also has a fairly high fertility rate; Iceland, Norway and Sweden actually compete with Ireland for the highest fertility rate in Europe. Social services constitute an important part of family policy, which makes it possible for women to have a family and at the same time to go out to work and enjoy a high standard of living.

The organization of the book

Chapter 2 defines the field of our study. Lennart Nygren with others, look at how the “social service” concept, or more correctly its synonyms in the Scandinavian languages, have been used in Denmark, Finland, Iceland, Nor- way and Sweden after the Second World War. (A basic problem for translation is that in all these countries the concept of social service has a narrower meaning than it does in Britain, coming close to the British concept of social care service.) The discussion begins with a brief overview of the international literature, comparing the concept of social services with other related con- cepts. The bulk of this Chapter consists of a detailed account of the use of the concept of “social service” in the five countries concerned. The following questions are addressed: When and where did “social service” first appear in official documents? What were the arguments for using the concept? How does the use of the concept reflect shifts in political discourse? What specific activities are included in the concept? Finally, the Chapter summarizes the similarities between the five countries. It turns out that the concept of “social service” is not at all straightforward and unambiguous. This is why some of the national connotations of the service concept are examined from a more semantic point of view. However, some arguments can be presented for the existence of a common conceptual development in the five countries.

In Chapter 3, Jorma Sipilä and others describe how the five Nordic countries took an important step on the road to becoming the “Scandinavian Welfare States” when they started to modernize their social care services after the Second World War. The following key changes were made in legislation and public policies: the mixed clientele of the old municipal homes was divided into separate institutions for the elderly, for psychiatric patients and for persons with learning difficulties; the public sector began to support family and home care of the elderly, the disabled and the chronically ill; a new children’s day care system for working mothers was set up; it was stressed that these services were intended for all social classes in all regions: they were universal services rather than traditional welfare support; the volume of the service system, particularly children’s day care, increased dramatically.

The research material includes legislation and planning documents as well as statistical data. The most exciting questions concern the reasons and the motives for creating the famous Scandinavian social care service-system, which according to the critics looks after everyone from cradle to grave. The questions addressed in this Chapter may be formulated as follows: Why did the development of social services emerge as such a central issue of social policy? Why did the development effort concentrate so heavily in the public sector? Why did the new policy emphasize universal services?

Chapter 4 looks separately at the unique history of Iceland’s social services. Iceland differs from the other Nordic countries in terms of population size, fertility rate, political landscape and the development of modem social serv- ices which began later. Ingibjörg Broddadóttir et al. describe the development of social care services with emphasis on children’s day care and services for the elderly. The history and progress of these services are described and analysed and an attempt is made to answer the question whether Iceland belongs to the Scandinavian model.

Chapter 5 by Outi Ketola with others, address the following questions: Do clients of social care services have any distinctive characteristics which set them apart? Are children and elderly and disabled people treated as “second- rate” clients because they are too young, too old or (as is often the case) unable to represent themselves? What do we learn from a conceptual analysis of the terms employed in social care services, such as clients, customers, co...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Figures and tables
• 1 Introduction
• 2 New policies, new words — the service concept in Scandinavian social policy
• 3 A multitude of universal, public services — how and why did four Scandinavian countries get their social care service model?
• 4 The development of local authority social services in Iceland
• 5 From poor relief to social rights and social care services’ clienthood
• 6 Local government in Scandinavia: autonomous or integrated into the welfare state?
• 7 The Scandinavian model as seen from a local perspective
• 8 Why are social care services a gender issue?
• 9 The Scandinavian social service state in comparison
• Appendix A statistical summary of the development of social services for children, elderly and disabled in the Scandinavian countries