Providing help or restrictions? Frontline workers’ understandings of behavioural conditionality for health-related social insurance and social assistance benefit in a joined-up governance context

Abstract

ABSTRACT Norway has a strong welfare state that emphasises a combination of enabling activation policies and behavioural conditionality (BC) in a broad range of benefits, including the main health-related, long-term social insurance benefit and the last-resort social assistance (SA) benefit. The frontline workers in employment and welfare agencies thus need to form particular understandings of appropriate conduct of claimants with different needs when deciding what a measure should consist of (i.e. what is a suitable condition), and whether to impose a sanction in cases of non-compliance. The paper asks how frontline workers implement BC for recipients of different benefits in the era of increasingly unifying welfare policies. Reporting on qualitative interviews with 27 frontline workers, the findings suggest that frontline workers are less concerned with questioning conduct for claimants of the health-related insurance benefit, while frontline workers who provide with follow-up of recipients of SA more frequently question benefit eligibility. However, frontline workers of both benefits reason with a basis in ‘soft paternalistic’ and reciprocal justifications of conditionality, and both emphasise dialogue and relational work with claimants. BC can therefore also include reasonable help that protects against the risks of health and social problems for citizens.