Abstract
Personal assistance (PA) has been characterized as a melting pot consisting of, on the one hand, a social rights discourse with its basis among disabled people, and, on the other hand, a consumer directed market discourse increasingly putting its stamp on welfare policy in the Western world. In the realm of welfare politics, these discourses are, in many ways, opposites, but have found common ground in the demand for a more individual and consumer friendly provision of services. Within a shared welfare state model, the application of PA has developed divergently in the Scandinavian countries and relates to the two discourses in different ways. In this article, PA in Denmark, Norway and Sweden is presented and similarities and differences are discussed and analysed. Questions raised include: How can the differences between the countries be understood? What dilemmas within welfare policy do they illustrate? How do the different discourses put their marks on the different PA-models in the Scandinavian countries? How do the PA programmes seem to develop further and what kind of PA will the Scandinavian countries end up with in the future?
Highlights
In brief personal assistance (PA) implies that disabled people employ their own assistants as an alternative to receiving assistance from the established services
The portion of persons with intellectual impairments had increased from 4% to 12%, and the percentage of persons with acquired brain injuries increased from 14% to 19%
Before the arrangement was authorized in the Social Services Act, organizations of the disabled in Norway [The national association of persons with physical impairments (Norges Handikapforbund), ULOBA] argued strongly that PA should be an individual right, as it was in Sweden, to secure equal treatment and freedom from dependency on the municipal judgements
Summary
In brief personal assistance (PA) implies that disabled people employ their own assistants as an alternative to receiving assistance from the established services. These trends are prevalent among different user groups but have probably been most noticeable among disabled persons and people with mental health problems (Beresford 2002, 2005; Barnes, Mercer, and Shakespeare 1999; Bonfils 2008, Oliver and Barnes 1998) Though they in many ways are political opposites, the social rights discourse and the market discourse have found common ground in their demands for a more individual and consumer friendly provision of services. Before the arrangement was authorized in the Social Services Act, organizations of the disabled in Norway [The national association of persons with physical impairments (Norges Handikapforbund), ULOBA] argued strongly that PA should be an individual right, as it was in Sweden, to secure equal treatment and freedom from dependency on the municipal judgements. In 2007 the Ministry of Health and Care issued a Green Paper proposing that PA should be authorized as an individual right for disabled persons in need of extensive services (Helse- og omsorgsdepartementet 2007).
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