The fundament of European welfare societies is to give the whole population high quality services in health, care, and education. This can be obtained in a number of ways, and a core question is if the public, nonprofit organizations or for-profit firms provide the services. The different providers have different strengths, and the composition of providers, the welfare mix, is therefore crucial for the quality of the services provided to the population. The population is becoming more diverse and has higher expectations. A possible solution is to promote active citizenship where the users can choose providers, are empowered to influence the content and of the service, and participate in channels influencing policy-making.
It is within this context the project takes on the following questions: 1) How is the welfare mix in Europe changing? We investigate this by analyzing the experiences from Norway with a Scandinavian welfare model, Germany with a corporative model, and United Kingdom with a liberal model. 2) A new EU directive for public procurement implemented in the EU and EEC countries before July 2016. What room for maneuver do the states have to adopt the implementation to national policy goals? We investigate this by looking at how policy makers and stakeholders in the three countries differently approach the directive. 3) How do the users experience the differences between public, for-profit, and nonprofit providers?
1) Comparison on employment percentages in nonprofit, for-profit and public welfare providers in health and social services in Germany, UK and Norway, shows that service areas with a high degree of outsourcing to the private sector also have a faster growth in the commercial providers. The nonprofit percentage is kept on a more stable level and functions as a buffer between the public contracting authorities and the market. However, in certain service areas, the nonprofit services are shrinking or disappear completely, if they do not have a firm institutional footing. In Sweden, the nonprofit sector remains very small in European comparison with an employment share of little more than 3 percent from year 2000 to 2017, while in Norway there is an increase from 7.6 to 8.8 percent from year 2006 to 2017. This is a result of that Sweden lacks tools to regulate the composition of the welfare providers, while in Norway there is increased political support for nonprofit services in many municipalities and in Parliament, and this is followed up with more concrete goals and measures.
2) The debate about the implementation of the EU-directive was more intense in Norway than in UK and Germany. The new law for public procurement passed by the Storting in June 2016 presupposes utilization of all opportunities in EU-law for promoting services from nonprofit providers, which was quite different from the proposition of the government. In contrast to common views of EU as a driving force with an increasing relevance for market-based governance practices, the Norwegian case shows that, through an inclusive debate and an open political system, nonprofit actors in health and social care was able to turn the result to their advantage. This protects a plurality of actors in line with EUs ambitions of a social dimension.
3) When it comes to differences between welfare providers from different sectors and the users? satisfaction and possibilities to exercise active citizenship, the analyses show differences between the studied service areas kindergartens, compulsory education, and home-based care for elderly. The data are gathered by surveys of users in Norwegian municipalities, focusing on differences in experienced quality and active citizenship, i.e. the users possibilities for individual influence and participation in governance. In kindergartens, the analyses shows that even if parents in general are satisfied, they are least satisfied with public providers, and they are somewhat more satisfied with nonprofit than for-profit providers. The possibilities to adapt services to the users wishes, in particular when it comes to food served, has a large importance for satisfaction. Public regulation that gives more opportunities to adaption will probably increase satisfaction. Kindergartens operated by parents and nonprofit kindergartens have a higher level of satisfaction because parents are more involved in governance and because resources are used to purposes they care about. When it comes to parent surveys in schools, the analyses also show high satisfaction and small differences, but private schools, that all are nonprofits, have a somewhat higher level of satisfaction than the public schools. In homebased care for elderly, users with higher level of education are more likely to use opportunities to complain about services or change provider. This shows that equal opportunities for active citizenship not necessarily result in equal quality of services for the users.
Prosjektet bidrar til langsiktige samfunnsendringer ved at det brukes som kunnskapsgrunnlag for utformingen av velferdspolitikken når det gjelder i hvilket omfang og på hvilke måter ideelle og kommersielle aktører kan involveres og hvilke muligheter og utfordringer som reises. I tillegg har prosjektet gitt mulighetene for kvalifisering og nettverksbygging for yngre forskere, komparative analyser, internasjonal publisering, i tillegg til forskningssamarbeid nasjonalt og med forskere fra Tyskland og Storbritannia. Det gir også et grunnlag for å utforme ny forskning på andre tjenesteområder (som helsetjenester, arbeidsinkludering eller BPA) om endringer velferdsmiks, og økt bruk av koordineringsmekanismer som brukervalg og utkontraktering, og hvilke konsekvenser det har for brukernes muligheter for å utøve aktivt medborgerskap.
Public responsibility for funding and provision of welfare services and equal access to high quality services are central elements of a Scandinavian welfare model. However, its sustainability and legitimacy is challenged by new types of users, limited personnel resources, increased private prosperity, and social and cultural heterogeneity. Recipients increasingly require adaptation to individual needs. Recent policy documents therefore point out that the traditional, state-governed welfare is not sufficient. It is necessary to promote active citizenship by empowering the users to influence the content of services and also to assume more responsibility for the services. All sectors of society must be involved, including families, local communities, nonprofit organizations and social enterprises. The division of labour between public, nonprofit and for-profit providers is critical. This project is designed to improve our understanding of the conditions for making policies that influence the welfare mix and impacts on the room for active citizenship. The approach is a comparative analysis of the implementation of the new EU-directive on public procurement, public discourse and perceived service quality. We compare the Scandinavian model in Norway with the Liberal model in the UK, and the corporatist model in Germany. The project will be based, first, on employment data to trace the development of the welfare mix in all three countries over the last 20 years. Next, we seek to uncover the national room for maneuver within the EU and how different welfare models translate and implement the same external impetus into their legal and institutional contexts. We do this by gathering data from public media debate, hearings and interviews with key stakeholders in each country. Lastly, we design the first Norwegian user-survey that will be able to compare the room for active citizenship between public, nonprofit and for-profit providers, and the potential impact of user choice.