Abstract
Market-based practices, including privatization and the increased emphasis on managerialism, have entered Nordic social- and health-care systems for elderly people. This article examines whether the adoption of these practices has affected the work satisfaction of care workers in Denmark, Finland, Norway, and Sweden. The data used comes from a postal survey conducted in spring 2005 among Nordic care workers, covering 2716 respondents who provided care for older people. The items analysed include background questions, Likert-scale questions on working conditions, and questions on the presence of different market-based practices in the workplace. The results indicate that there are many variations between the four Nordic countries concerning the adoption of market-inspired practices in the care for elderly people, with Denmark having been the most eager and Norway the least to introduce them. Employees of for-profit employers report a lower level of work satisfaction than public employees. On the other hand, the adoption of most market-based instruments correlates with higher and not lower levels of work satisfaction among care workers working with elderly people.The results do not show a simple connection between the adoption of market-based practices and lower levels of work satisfaction, which might have been expected on the basis of earlier research discussions. However, due to some weaknesses of the data and the many variations between individual market-based models as well as between different Nordic countries, there is cause for caution in the interpretation of the results. It is particularly necessary for policymakers to remain sensitive to the national context.
Highlights
Social- and health-care service systems of Nordic countries are well known as the most universal and publicly organized of their kind
The profile of Nordic care workers working with older people To put it briefly, in all four Nordic countries care workers who provide care for older people are, in general, middle-aged women who are born in their country of residence, who have training in and extensive experience of care work, who are employed by the public sector, and who work primarily in residential settings
The aim of this article has been to address the question of whether the recent adoption of market-based practices within Nordic care services for older people constitutes a risk for the work satisfaction of care workers
Summary
Social- and health-care service systems of Nordic countries are well known as the most universal and publicly organized of their kind. While in many other countries, for-profit and non-profit organizations play a central role in the provision of social- and health-care services, in the Nordic region their role has been limited. It has instead been the public authorities at the central, regional, and at the local levels that have assumed the overwhelming responsibility for providing the services and for employing care workers. Known as New Public Management (NPM), this trend has brought attributes of a new character, such as totalquality management, balanced scorecards, management by results, and costcontrol mechanisms These have appeared within Nordic public services and in the care services for older people (Doyle & Timonen, 2007, 21–38; Hasselbladh et al, 2008; Højlund, 2001; Julkunen, 2004; Vabø, 2003). It has been said that Nordic care systems have seen ‘a cultural change where the rationality of efficiency has become a salient logic in formerly socially defined care’ (Wrede et al, 2008, 28)
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