Marketization of welfare services in Scandinavia

A review of Swedish and Danish experiences

Abstract

Scandinavian welfare states are undergoing a gradual transformation towards a more market-based mode of public service delivery. The results of these marketization reforms are, however, insufficiently documented in terms of their consequences for the price and quality of welfare services. This article presents the findings of a systematic review of Danish and Swedish experiences with private provision of welfare services within three areas: home care for the elderly, provision of child care, and the operation of nursing homes. The research shows that there is no general evidence in support of improved cost effectiveness or enhanced service quality within these three welfare areas. A part of the reason for this is that many studies are characterized by lack of data and insufficient methodological designs. The article concludes that more and better studies are needed in order to broaden the evidence base and inform future policy-making on marketization in general and within the welfare areas in particular.