Mai-Brith Schartau
Södertörn University
Stockholm
The Road to Welfare Pluralism
Old Age Care in Sweden, Germany and Britain
Paper presented at IPSA XXI World Congress of Political Science in Santiago, Chile, July 12
– 16, 2009
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Introduction
Many countries have been experiencing a welfare crisis for some years. Especially three kinds
of crises have been highlighted in the literature. First, welfare systems have become too
expensive for the state. The demand for welfare cannot be satisfied through state-financed
policies. Demand is exceeding supply. Second, welfare programs do no longer give proper
solutions to the problems in the society, drug abusers are not cured, elderly people are still
isolated, poverty still exists and many people are unemployed. There is a growing discrepancy
between existing programs and social needs and demands of today. The much greater
occupational and life cycle differentiation that characterises post-industrial society implies
more heterogeneous needs and expectations. In the post modern society of today with
fragmentation in norms and values and pluralism of identities and ideologies, the welfare state
with universalism and centralised planning is no longer up to date. The social and cultural
pluralism in the society must be recognized also in welfare and it’s providing. Thirdly, as a
consequence of the first two, the public sector now experiences a lack of support and
legitimacy (see e. g. Baldock 1989, Kangas & Palme 2005).
One solution to the welfare state problems is to see the personal social services as a mixed
economy of welfare. Public services are being forced to become more efficient and to manage
with fewer resources. Alternative sources of provision have become attractive in systems once
dominated by the state. The family, the company and voluntary organisations can provide
services where the state left a gap. This is seen as an effective response to the rising costs of
social services. The challenge is however to work out a satisfactory integration of different
service providers. As follow below, there are grounds for scepticism about what can be
achieved.
A fascinating fact is that different countries can develop exactly the same policies but for
totally different reasons. The idea of welfare pluralism is one of these policies that seem to be
globally spread and cherished and also useful for different purposes.
During the last decade one of the major challenges facing Europe is how to prepare for the
demographic imbalance predicted for the twenty-first century and associated issues such as
intergenerational equity and the social integration of older people. Policy makers are faced
with the problems of ensuring funding for pensions and the provisions of adequate and
effective social services.
These problems are the main reasons for choosing old age care as an empirical field for this
paper. The situation is urgent, something has to be done, new solutions have to be found. If
welfare pluralism is developed here and it turns out well, it may be an inspiration also for
other political areas even if those needs are less striking. The opposite trend, that pluralism is
found impracticable and not even to be discussed in other fields, is of course also plausible.
The aim of the study
There are several grounds for scepticism about the benefits of welfare pluralism. We don’t
know if efficiency really is increased when private organisations play a larger role as provider
of social services or when quasi-market system are established in order to make public
providers behave more like the private ones. Furthermore, if public provision is to be reduced
there is a need for an increase in expenditure in order to build up voluntary and commercial
provision and to support informal care (Webb/Wistow 1987). The total costs will not be
reduced, at least not in the beginning. Another problem is that there seems to be barriers
between the four different kinds of service providers. Studies have shown that many kinds of
problems arise when these organisations are supposed to collaborate (Gynnerstedt/Schartau
1996).
In this paper three countries are studied; Britain, Germany and Sweden. These countries
represent three different kinds of welfare states. They also to some extent have different age
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structure and they spent different amount of money on elderly care. Are these countries from
different starting points adopting a policy of welfare pluralism in respect of old age care?
How is the idea of welfare pluralism motivated? How is it supported? The focus of this study
is on policy makers. What do they really believe in?
Methods and material
The choice of cases involved is related to the dichotomy between a most similar and a most
different design. In this project it is the latter case where it is assumed that the development of
welfare pluralism has similar features notwithstanding considerably varying systematic
differences. It is a comparison on the basis of dissimilarity in many respects according to the
hypothesis that after all the different circumstances the idea of welfare pluralism will still be
important.
Three different kinds of welfare states are chosen; Britain exemplifying the liberal model,
Germany that is classified as a corporatist or conservative country and Sweden, a good
example of a social democratic welfare state. Here is however a problem. Unlike the other
two, Germany is a federation where the Länder (Federal States, I will use the German term)
have a considerable degree of autonomy. Characteristic for the German system is that a
majority of administrative tasks are conducted at the Länder or local authority level. Apart
from a few expectations the Länder are solely responsible for applying federal law. This
together with the legislative authority accorded to them in a few spheres, provides the
autonomous function of the Länder. In the German case it is therefore necessary not only to
look on federal level but to choose a few Länder where the study can be conducted.
Following the design of the study comparing different cases I have chosen three Länder for
closer examination: Baden-Württemberg, Hessen and Sachsen-Anhalt. Political majority and
stability has been the main dimension for the choice of Länder. But also sizes of the Land,
east-west dimension and Catholic or Protestant influence have been of importance.
In this top-down study the empirical material is collected from official documents and public
statements made by centrally placed politicians and administrators as well as in Germany also
on Land level. Furthermore I have followed the debate in media and also interviewed some
experts on elderly care, public policy and welfare pluralism.
The main part of the empirical material is from after 1997 when some important changes in
the political leadership took place. Tony Blair became prime minister 1997 in Britain,
Gerhard Schröder became chancellor 1998 in Germany and Göran Persson became prime
minister in Sweden 1998. At this time there was also a shift in Government at central level in
both Britain and Germany. The collection of empirical date ended 2002 while five years in
this case should be enough to trace any changing. During these years all three countries had
Social Democratic governments.
Welfare states and welfare pluralism
Today many countries are classified as welfare states although look totally different when it
comes to political structure, government and public administration. In the literature we find a
number of different classifications of welfare states. Richard Titmuss began this process of
developing models of welfare. Here I will start out from another of the more well known
models, created by Esping-Anderson who has received a lot of acknowledgment for the
theoretical usefulness for comparative analysis (Rodger 2000). He ranked a number of
countries according to their decommodification scores. By decommodification he means
the degree to which citizens can freely, and without potential loss of job, income or general welfare, opt out
of work when they themselves consider it necessary. (Esping-Andersen: 1990:23)
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The definition is then concretized by examples like health insurance, parental leave and leave
of absence for study purposes. Esping-Andersen divided the nations into three different kinds
of welfare regimes: the liberal, the conservative and the social democratic welfare states. In
the liberal welfare state, exemplified by the Anglo-American countries, selective welfare is
targeted to the poor after an increasing use of means testing. A dual system of private and
occupational services provision is available for the middle classes and an attempt is made to
minimize direct intervention by the state in order to give free rein to the market forces. The
role of the government is prescribed to be as limited as possible in the welfare area. The state
should give support only when the market or family and neighborhood relations do not work.
Titmuss labelled this ideal type the residual model.
In the corporatist or conservative countries, exemplified by Germany and France, the central
government has, with influence of the Church, developed systems of occupational social
insurance welfare. Social insurance needs and rights are based upon employment, salary and
productivity, which are one’s contribution to economic life. As entitlements are based on
employment and not on citizenship, they are different for different groups, not solidaristic and
universalistic. Government plays a crucial role in supporting this system but the role of the
state in the organization of welfare is limited. In these countries there are normally also an
extensive corporate structure and favorable solutions for those publicly employed. This could
be compared with what Titmuss calls the industrial achievement-performance model.
In the social democratic welfare state, the Nordic countries, the state responds to the solidarity
of the working and middle class and provides universalistic services, premised on equal
opportunities between social groups and full employment (Kuhne/Selle 1992). A strong
alliance between different labor unions and the social democratic party guarantees a generous
welfare state. In the classification of Titmuss this is called the institutional redistributive
model.
Some of the leading academic promoters of welfare pluralism summarized the concept as:
•
•
•
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Greater emphasis on the plural provision of services; extending and recognizing the
possibility for voluntary action
Statutory services should be decentralized with far greater community orientation
The central and local government role would continue but would be focused more on
monitoring and inspection rather than always actually providing services
Consumers and users would be given a far greater role both in statutory and voluntary
organization (Lund 1993:310.)
During the 1980s the concepts of welfare pluralism, mixed economy of welfare and welfare
society were developed as a response to the criticism of state welfare put forward by both the
New Right and the New Left in the 1970s. Welfare pluralism assumes that a variety of
providers, like the state, the market, voluntary and charitable organizations and the kinship
network, will be involved in planning and offering services. The role of the state is reduced
both as a financier of social care and as a direct provider of services. A redistribution of
functions among the various suppliers takes place; the state may withdraw from direct
provision, encouraging employers, voluntary organizations and families to increase their
effort. This may be either on economic or ideological grounds, or both (see e. g. Mishra
1990).
The aim from an economic point of view is to reduce and control the public costs of the social
services by supporting voluntary organizations, encourage informal carers and shift the
emphasis from state to market.
The ideological grounds involve a critical attitude to the role of the state and state control.
Centralization, hierarchy, unwillingness to innovate, inability to engage people and
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bureaucratic principles are associated with public provided services. The idea of effectiveness
and competition is not a new phenomenon. Already during the 18th century, Adam Smith
discussed the disadvantages with monopoly concerning the lack of competition on the free
market.
An interesting question is why a declining role for the state in the provision of welfare is
discussed. Is it because we now live in a post-modern society with a post-industrial economy,
which is very different from earlier periods, and this generates a need for structural changes?
Is it because of new political interests in government and the economy meaning there ought to
be a decline in collective provision? Or is it a response to the debate about contempt for
politicians, an attempt to make citizens more active and responsible and in this way improve
democracy? Once again, there are both political and economic reasons to cherish welfare
pluralism.
Changes in the society have paved the way for welfare pluralism. The increased recognition
of the limited resources available for public services at the same time as the needs for social
care has been growing, have stimulated the concern to find new ways of balancing the
respective contributions to the mixed economy of welfare. Social care has always involved
some combination of care within the family and from providers belonging to the private,
public and the voluntary sectors. The important news is probably the acceptance that the
contribution from the public sector is now more limited which has given rise to a lively debate
about the roles of the other providers.
New policies within old age care have also contributed to the development towards welfare
pluralism. Community care, which is highly recommended in most countries, involves the
closure of residential establishments and their replacement with a wide range of community
based services. When residential care cannot be avoided then the aim is to provide a shorter
stay for as many individuals as possible and return them for any continuing care to their
families. The link with policies of welfare pluralism is obvious in that a move away from
residential to community care requires greater contribution to the totally of social care from
the informal, voluntary and in some countries, to the commercial sector.
Also the main actors on the political arena have changed. It is no longer a struggle between
organized labor and capital; the society has become much more fragmented consisting of
many different groups. These groups have numerous different claims on the welfare state.
Rodger (2000) gives us some explanations to these changes; The standard family based on the
male breadwinner is now just one of many family constellations, membership in trade unions
and political parties has declined because of a new occupational and industrial structure, the
position of women has changed and social groups that used to be marginalized now organize
their own claims on the welfare state. We find a great many different opinions about what
kind of services that should be produced and also how it should be produced. The
effectiveness of the state as a provider of universal welfare services is therefore questioned
and other service providers are encouraged to complement public welfare. Rodger clearly
means, but then mainly from a British perspective, that we are now moving towards a society
in which family and community groups are being required to take on a more explicit
responsibility for sustaining the well-being of their members. But the important questions
remain unanswered; how shall this be organized and implemented? How is it supposed to
work? How shall we move from rhetoric to action?
Welfare pluralism is supported from all points of the political spectrum although for various
reasons and with different interpretation and emphasis. Right-wing supporters will favor the
extension of the market while left-wing supporters appreciate values such as user control
through less bureaucratic, centralized and professionally dominated forms of services.
Welfare pluralism was developed from the center of the academic/political divide in response
to critiques of state welfare emerging from the right via neo-classical economics/public choice
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theories and from the left through a variety of Marxist thoughts. Both left and right regarded
the bureaucrats and professionals working in the public sector as the main cause of the
problems in ineffective and unresponsive social services. The New Right asserted that the
public welfare organizations were dominated by producer groups, were a threat to liberty and
individual choice and inefficient because of their monopoly position. There was a dominance
of public sector trade unions and the bureaucrats would act in their own interest rather than
those of their political leaders. The voluntary provision was supported through charitable acts
and the mutual aid of family, friends, neighbors and associates.
The New Left regarded the professionals as servants of the capitalist class who were allowed
to run the organizations only to legitimate the system. Social control rather than individual
and collective services were regarded as the real purpose of state services. The welfare state
had failed to secure public involvement and support. The Left also recommended the use of
mutual aid and voluntary associations.
Especially countries with well-developed and relatively expensive welfare states accept the
idea of welfare pluralism. Even the most established welfare states; such as Germany and
Sweden have started to give up some of their firmness and to follow the British-American
example (Ferge 1997).
Some people believe that competition among service providers must lead to their
improvement, because the different producers will intensify their work and reduce price in
order to remain in business. The purchaser-provider split is one example of marketization in
order to encourage the public service providers to keep the costs down and still improve the
quality. A quasi-market is established in order to increase the competition between the
providers. The services remain publicly funded but distinguishing the role of purchasers and
providers creates a market. The expectation is to get the same effects normally associated with
the market; efficiency, consumer choice and a diversity of providers. In a market situation
however, there are costs for administration and transactions. These costs counteract some of
the effects of the competition but this is seldom mentioned (Cutler/Waine 1994).
These quasi-markets differ from conventional markets in a number of ways. On the supply
side there normally is competition between enterprises or service suppliers. However in the
quasi-market these organizations are not necessarily out to maximize their profits, they are not
always privately owned. The objectives of the non-profit enterprises are often complicated as
is their ownership structure. On the demand side consumer purchasing power takes the form
of an earmarked budget or it is centralized in a single state-purchasing agency (Le Grand &
Barlett 1993). The purchasers are not clients but professionals or managers in government
agencies. The clients themselves seldom have any alternatives to choose between.
An idea often mentioned in connection with welfare pluralism is the one of seamless service,
which means that from the client’s point of view, no joints in the service should be visible
even if different providers are involved. The task of the social workers will then be to hold the
packages together. They will spend more time in making assessments of client’s needs, in
negotiating and in supervising contracts with organizations from the other sectors.
This however requires a good collaboration between the organizations involved. They cannot
be analyzed as if they were only alternatives, they interact with each other, they collaborate
with each other and they may be able to control each other (Hill 1996). Collaboration between
different organizations is supposed to lead to cost efficiencies. Each organization can reduce
its expenses in planning, training, research and activities of a similar kind. Another benefit is
that together it is easier to deliver services based on the total needs of clients
(Mattessich/Monsey 1992). Elderly people have not only medical but also mental and social
problems. Gray notes that the quality of care increases when organizations work together. It is
then possible to do a more comprehensive analysis of problems and opportunities. Different
resources complement each other (1989).
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Collaboration is however difficult. In a review of the existing research literature Mattessich
and Monsey identified 19 factors which influence the success of collaboration. These factors
are grouped into six categories: environment, membership, process/structure, communication,
purpose and resources (1992). The presentation is rather normative and simplified. There are
many reasons to why representatives from different organizations act in a specific way. More
variables need to be added like power and negotiation. Collaboration and other interaction
between different organizations have not been theorized in an adequate way, probably
because it does not fit into any of the favored discourses in disciplines like economics or
political science (Schartau 1996, Ahrne 1994).
A multi-agency mixed economy promotes multiple and complicated patterns of interorganizational relationship, we can find both competitive and collaborative models. The
difficulties in finding new providers, and to specify social care contracts together with local
authority doubts about the value of fully marketized relationships, have made the public
purchaser prefer well known and trusted providers instead of a fully competitive approach.
However the relationship between the different actors has changed over the years towards
more formalized contractual patterns (Charlesworth et. al. 1996).
In a study of a cooperation project in München, Greca identified a number of variables
important for the work (2000). Cooperation between different actors was possible when there
was shared interest, personal trust and balance of power between the providers, when
cooperation was part of legislative procedure which forced participants to accept the decision
of political institutions, and when on the basis of communication the employees adhered to
the same kind of professional rationality. Cooperation was difficult when there were different
types of agendas, different ideologies, different goals or a different conceptualization about
time and space. Cooperation rarely occurred when there was a competition for resources,
different value systems or different political leanings and chronological codes.
Institutionalization was seen as the most important foundation for cooperation. It should be
stressed that even if the interests were different, the legal guidelines and questions of resource
distribution in bargaining processes forced the participants to cooperate. This is in accordance
with what is said above by Mattessich and Monsey.
One way of discussing collaboration is to present it in the form of a continuum with the
variables: isolation, encounter, communication, collaboration and integration (Powell 2000).
Encounter exists where there is some informal inter-agency and inter-professional contact but
these are of an informal and ad-hoc nature and marginal to the goals of each organization. At
the communication stage the organizations are engaged in joint working of a formal nature,
but this work is still not important to the individual goals. Here we find more frequent
interactions, a willingness to share information, instill a prime loyalty in their own
organization and a high degree of reciprocation. In collaboration joint working is central and
the other organizations are regarded as reliable partners. There is a high degree of common
interest, goals and interdependency with joint planning and joint service delivery. At the final
step, integration, the level of collaboration is so high that the organizations see their separate
identity as insignificant. The degree of trust and respect is also very high.
However there are some problems connected to this rather deterministic view. For instance
why should formal arrangements be better than informal ones? What about connection to
network theory? Furthermore, nothing is said about the impact of the environment.
One form of cooperation between private and public sector is PPP, Private Public Partnership.
Here we find much experimentation with new forms of cooperation but we still have little
knowledge under what circumstances PPP really can work, even if it has been an important
catchword in the debate surrounding modernizing the public sector. In the literature
concerning this phenomenon it is stressed that legal agreements are not enough, other
incentives, like to gain something from the cooperation, are needed. This can be, for instance,
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knowledge transfer to the organization. The idea is that, with a common goal sharing risks and
responsibility, establishing rules for conflict solution and cost distribution.
In a research project on PPP concerning port development in Rotterdam, van Ham and
Kooppenjan found that procedural and institutional innovations were needed if the
cooperation should work. As the situation for each project is different there are no tailor-made
solutions. The critical phase is in the very beginning; the parties must reach an agreement that
creates surplus values and a satisfactory allocation of risks and responsibilities (2001). This
ought to be true for all kinds of organizational cooperation, even welfare pluralism.
Welfare pluralism has not only been strongly criticized for the problems concerning
cooperation and competition but also for a number of other reasons. The capacity of the state
to regulate the welfare market when the commercial sector has set up in business is
overestimated once state control is reduced (Munday 1989). There is a risk that when the
state’s role as owner, financing agent and service deliverer is slowly withdrawn, free or
subsidized service seems to disappear and different groups in a market system are excluded
from access and maybe a two-tier system is created which reinforce inequalities (Ferge 1997).
Another problem is the hidden assumption that women, in particular, should play the caring
role in community and family life and that doing so should be a priority for them over selffulfillment in other ways. There also seems to be a myth about community. This comes from a
time when we lived much closer together and there were few alternative services to provide
help (Payne 1995).
Welfare pluralism is not only connected to a number of structural problems. A serious
problem in the debate is that there are various definitions of the values, which are said to
underpin and give normative coherence to the concept of welfare pluralism. Pluralism as a
political tradition means that in a free society, compromises have to be made between
conflicting political objectives that may all be equally desirable but cannot be resolved to the
general satisfaction on the basis of any single criterion. There cannot be a total acceptance of
any single end because governments must all the time consider the diversity of human
interests, preferences and values (Pinker 1992).
Different influential researchers have had different opinions about the value of welfare
pluralism. Beveridge ideas of insurance principle expressed the values of welfare pluralism as
it combined statutory intervention with direct personal responsibility. It was neither socialism
nor capitalism. He regarded state intervention and self-help to be complementary. To the
national minimum individuals can add themselves according to their capacities and desire.
Beveridge was also convinced of the moral and practical values of a flourishing voluntary
sector. Titmuss however, was critical of occupationally based social services which he
accused of dividing loyalty, nourishing privilege and narrowing social achievement. He was
against welfare pluralism as he thought that the private and voluntary sector would undermine
the principle of equity, increase inequality and weaken social solidarity.
Welfare policies seem to build on a special hierarchical order of the mixed economy of
private, public and voluntary organizations and the informal sector depending on the historical
political discourses. The liberal view concentrates on the free market with freedom of choice
and competition. The socialistic approach focus on large public sector with centrally planned
and standardized service system where everyone is entitled to the same benefits. In the
conservative discourse the family still plays an important role. The voluntary sector is
incorporated differently in these hierarchical concepts. It is however important to stress that
although the background is different, with differences in tradition of conflict and co-operation
and values, which gives different attitudes and relationships of voluntary organizations
towards state and market organizations, different countries can still inspire each other and
borrow ideas from each other.
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Different advocates of welfare pluralism look upon the public and the private sector with
different eyes. Some regard the state and the local authorities as the primary financiers of
welfare in order to secure an equal access to welfare services through territorial justice, in the
distribution of central grants to local authorities, and give only a limited role to the private
sector. Others mean that the state instead of being a primary provider of welfare should act as
a planner, regulator and where it is appropriate, a financier of service. The New Right
however rejects state intervention to limit inequality. Writers from the New Left assert that
there is a great risk that welfare pluralism would support privatization and increase reliance
on unpaid caring, particularly from women. Welfare pluralism will then be seen as a
smokescreen for privatization with no other clearly specified objectives than pluralism.
Another problem is the different ideas of how social capital should be protected and
integrated in welfare pluralism. Social capital means trust, a sense of being able to rely on
other people and a duty and obligation built up over time, resulting in a strong sense of
solidarity and communal obligations. In one perspective social capital is enhanced by the
welfare state through the cultivation of altruism and creation of a sense of solidarity within the
community. In another perspective social capital is destroyed by the welfare state because it
negatively affects the networks of family and community relations, which have been
developed naturally (Rodger 2000). This last perspective is a strong and often used argument
for welfare pluralism.
We can see that the position is confused because of various definitions of the values, which
are said to underpin and give normative coherence to welfare pluralism. There is a danger that
the market can become the only context for the implementation and evaluation of pluralist
ideas if the notation of pluralism is not specified and if social justice is not given a more
predominant role. There sure is a lack of a well-specified alternative context, like corporate
bodies, to the market (Lund 1993).
The pluralist argument does not apply to the decline of the full employment welfare state. The
role of the government has been that of the enabling kind in maintaining employment through
a variety of policies. It is also important to distinguish between the ends and the means of
social welfare. Social welfare as entitlement to an adequate income or service standard can
only be guaranteed by the government, this is something totally different than deciding who
the most effective service deliverer might be. Welfare pluralism involves conflict, concerning
both values and interests. For example to shift the burden of the care for the elderly from the
public sector to the family is likely to have major implications for gender inequality (Mishra
1990).
Welfare pluralism has become such a diffuse concept. Even if it sometimes is said to be the
new orthodoxy of social policymakers throughout Europe, it is still uncertain what this label
stands for (Evers 2001). There is one form of pluralism in which the range and variety of
service provision is increased while central and local public authorities continue as main
source of funding. In another form the plurality of service providers is developed as an
alternative to public funding, with the final goal of privatization.
There seems to be a number of ideas of the concept welfare pluralism, Evers wrights:
…it could be very tempting to discuss what exactly is meant when in the Anglo-Saxon discussion the terms “welfare
pluralism” and “mixed economy of welfare” are used. To what degree does this label only stand for a minimalist
concept of welfare pluralism which simply adds the empirical existence of voluntary bodies and caring families to the
state- and market-based components? To what degree does it stand for a more rewarding research concept, which is
sensitive to a specific policy process with forms of cooperation and intersection that are more efficient and less
sectorialized and hierarchical than the traditional arrangements of a mixed economy? (2001:231)
As the concept is still subject to conflicting definitions among policy-makers and analysts, we
may ask why welfare pluralism has become such a widely popular idea open to so many
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different interpretations? Maybe the answer is that everyone can make her/his own
interpretation.
Three countries – three systems
The three countries not surprisingly have had different starting points concerning welfare
pluralism as they represent three different kinds of welfare states. But they still have many
common problems; an aging population, economic difficulties leading to curtailments, a
growing disbelief in the welfare state and a need to reform the bureaucratic public sector. This
has led to similarities also in the development during the last decades like elements of
decentralization, which can be seen as a condition for welfare pluralism, and privatisation.
Below follows a short description of the situation in each country in the middle of the 90:s
when the empirical investigation begins. Sweden was still a universal welfare state with high
equally spread standard of living provided by a large public sector and hardly any welfare
pluralism. The development towards a more pluralistic society has been gradually and the
process so far has been slow. Many factors have worked counter to these changes, a tradition
of consensus and corporatism but also elements in the Swedish culture and institutional
structure as well as a strong political and public support for the tax-financed welfare state.
The gender situation is different from the other two countries. The fact that most women work
outside the home affects the possibility to put more burdens on the informal and the third
sectors. Despite this the curtailment in public provided services have put more burdens on the
next of kin but it has also resulted in more work for private cleaning companies and demands
on developing the third sector, which is an increase of welfare pluralism.
Another difference between Sweden and the other two countries is the large sparsely
populated areas. This affects the possibilities for both the private and the third sector. A third
difference is the different kind and scoop of third sector. They are not directed towards social
care but serve more as meeting points for different interest groups. Because of a long tradition
of a social democratic welfare state the third sector is less well developed, and so is the
private sector. Anyhow some small corporative organizations have established themselves on
the welfare arena. In some case we find elements of self-help; old people helping other old
people.
In Germany we also find a strong tradition of consensus and different kinds of negotiations to
reach this consensus. Bargaining, not competition is the leading political style. In such a
system cooperation is highly valued. In the German model with its long tradition of state –
non-profit cooperation, the subsidarity principle has been important. The “Verbände” (large
third sector peak organizations) have for a long time been important actors in the welfare mix
which means that if their role is changing the whole welfare society will be changed as well.
An institutional interdependence has been established. In the 80:s and 90:s the “Verbände”
lost some of their legitimacy, they became too large, too strong and even rather despotic.
Other actors have grown in importance on the third sector arena. Economic support has been
given to the self-help movement, which means that this is a politically prioritised area.
In this country we also find changes in attitudes among the citizens. It is no longer a matter of
course that children should look after their old parents. But there is still a strong support of the
male breadwinner system, which has been important to the development and protection of the
third and the informal sector.
A special German problem is that the differences between east and west, especially in cultural
matters, have been and still are enormous. The background is very different, a new public
administration was needed in the new Länder, and the gender situation was different which
made the circumstances for the third and the informal sectors similar to the Swedish one.
Furthermore there is a lack of organizational traditions and cooperation; we find a more
individualistic culture that in the last years can be seen even in west.
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In Britain, more clearly than in Germany, a mixed economy was built into the system. As in
Germany we find interdependence between the public and voluntary sector. Welfare pluralism
has then been even more encouraged during the conservative rule. The conservative
government in the 80:s and 90:s introduced a more market like model for welfare services,
stressing the importance of competition, strengthened the private sector and strongly
supported welfare pluralism. This system was implemented with help of changes in
legislation, and it was done in political consensus.
As in the other two countries we find a growing scepticism towards large organizations,
which are not sensitive towards the needs of the clients. In Britain this goes for both the
voluntary and the public sector. The awareness of the need of reformation of the public sector
is strong, this sector will have a new role in a pluralistic society, especially then the SSD:s.
Direct provision of services should be reduced. In the beginning the local authorities were
dissatisfied with their new role. One experience made is that the purchaser role is not at all as
well developed as the provider role; another one is that the advantages of competition are
much smaller than expected. Cooperation is in the later years more stressed than in the other
two countries. We also find awareness about the problems of coordination between different
agencies, even, as in Sweden, within the public sector or as in Germany within the voluntary
sector.
Development in Sweden
There have over the last years been some changes in the view of the Swedish model and the
Swedish welfare state and its possibilities to solve the problems of the society. Some experts
even mean that this model is braking down. However we can find proofs of deviations from
the universal welfare state, like the fact that some elderly people now can buy services from
private companies while those with less money have to rely on the informal sector.
In the general debate there has been a kind of opposition between on the one hand to restore
the curtailment in public providing and on the other hand the obvious difficulties in keeping
the high level of tax financed public expenses. Facts like the Swedish already highest tax level
in the world, the globalization and the reduced economic growth all speak against increased
taxes. The public expenses to care, medical care and education have never been so high as
during the end of the 90:s which is a good argument for not making any restoring (Fall et. al.
2001). In spite of these high costs there are still many problems within these three areas,
which indicate that higher general allowances is not sufficient as the only solution.
In a survey investigation almost all politicians said that the public work was stimulated by
competition from other providers, that entrepreneurs could lower the costs and bring new
ideas into the work. A majority also meant that it was good for the staff to have more than one
employer and that the quality of the care would rise (Fölster 2001). There are differences
between the local authorities in to what extent they have let in private providers. It is
interesting to note that these differences are not depending on the political majority. A very
important question is then why so many Swedish politicians mean that private providers and
competition is important but do not show this in political action. One theory about this is that
citizens and politicians do not agree in this issue. There is perhaps a discrepancy between the
opinion of the man in the street, who is often publicly employed, and the political standpoint.
The Swedish welfare model is difficult to change, and the large number of publicly employees
is one of the reasons.
We can see that there are some problems involved in the Swedish privatization debate. At first
a clarification of the concept of privatization is needed. Financing and providing services are
mixed together. Privatization in Sweden has mainly meant a reduction in state provision, very
little of reduction in state subsidy with the exception for the clients who buy themselves
additional services and hardly any reduction in state regulation.
10
The main arguments against privatization are the fear of unjustness and the fear of large
companies dividing the market among them, which would result in cartels or even private
monopolies.
Many social democrats find it difficult to leave the old kind of welfare state, which they once
created. However they do not have much support for their politics among the public sector
staff. Neither do they have strong support from “Kommunal”, a union close to the social
democratic party. A large group of the members has discovered the advantages in the private
sector; shorter distance to managers, less complicated decision making processes, higher
salaries and most important; influence over their own work. Furthermore only a minority of
the citizens seems to support the social democratic politics. To the man in the street, price and
quality is more important than the question about who the service provider may be.
The arguments for privatization are, beside an increased freedom of choice, that the services
will be cheaper and much more effective with an improved working environment. It is mainly
a different organizational structure that will bring these advantages. The public staffs are
dissatisfied with the working conditions; this has not so much to do with ideological factors.
We can also see that there is a very strong faith in competition and what can be achieved by
exposing public sector organization to competition.
In Sweden large areas are very sparsely populated. There are long distances between small
towns and the communications are not the best. A private company within the welfare sector
will probably not establish itself here. It is not surprising that the areas around the three major
cities are leading the privatization both in praxis and on the intellectual arena. It is truly a city
perspective that is dominating the debate more or less ignoring thinly populated areas.
The public sector bureaucracy causes other problems seldom touched upon. The purchaser –
provider split is a rather new phenomenon in Sweden. The public sector purchasers have not
yet found their role. A goodly number of public tenders end up in court because of some
administrative failure. The competition is not always on equal conditions. The purchasers
need further training in this area. Another problem is that the purchasing process is so
complicated. User- and staff cooperatives are highly supported in Sweden. But the routines
around bidding for a contract are so complex that it is nearly impossible for staff at lower
levels in an organization to succeed. Both legal and economic expertise are needed and
normally a group of staff do not have the resources to hire these professionals neither do they
have time to go through all the bureaucracy themselves. A related problem is that is it rather
large units that are exposed to competition. This pave the way for large private companies,
there is a risk of cartelization or a private monopoly instead of a public one.
Another problem is the uncertainty when a contract is to be renewed. Both staff and clients
feel insecure. This is a problem not only in privatization but as soon as any part of the public
sector is exposed to competition. This needs to be focused in a debate not only about
privatization but also about welfare pluralism. Are there other ways of creating freedom of
choice for the clients? Can other actors be involved in the system without purchasing?
Anyhow it has been proved that in local authorities where private providers are let into the
system, efficiency has increased. The failures of private providers are to a high degree
depending on lack of public sector competence in the purchasing process. Alternative
providers have also been a carrot for local authorities in improving the working conditions.
This has been clearly admitted by the union “Kommunal”, while some of the politicians still
refuse to see this.
The arguments are either for or against privatization, why are alternatives so seldom touched
upon? The third sector is very seldom mentioned in the privatization debate, neither are
different kinds of concrete improvement of the public sector performances. To stimulate
public employees for example through incentive wages and changing the bureaucratic
structure could be one way worth trying. Investigations have showed that the working
11
environment is better within the private sector, why not try to change the public sector and
introduce these good sides into public work?
During the very last years a new interest in the social economy has arisen. The importance of
the sector is stressed in different documents and money is provided for its development. The
government means that this sector can generate a plurality without profit motives. However
there still is a long way to go. Many problems remain and have been made visible during the
last years. Two ideological problems are often mentioned in the discussion about cooperation
between public and third sectors. The first is the risk of misuse of the voluntary work; the
members and their contributions are taken for granted. Related to this is the fear that paid
work will be transferred into charity. The second are the difficulties for a voluntary
organization to protect its members and criticize different problems in the society at the same
time as the organization should bid for and provide service after a contract with the local
authority. A connected problem is the fear among citizens, bureaucrats and politicians of
being dependent on voluntary work. There is a political unity on the fact that the voluntary
sector should remain a complement to the public service, not replace the public work.
The purchasing to voluntary organizations is uneven spread over the country but this is not
because of political ideology on local level, it is more likely to depend on how well
established the organizations are in the area.
Much of the development of the social economy is done in different project forms, a line of
action that is also common in other countries, as we will se below. This is a good way to test
different solutions adjusted to the situation. Public resources are given to these projects on
central, regional and local level.
Third sector organizations in Sweden are often founded with other goals than providing social
care; they are interest organizations and cannot easily fulfil the role that voluntary
organizations have in Germany and Britain. They also face financial problems and legal
hindrances. Many of their problems are connected to the public sector. The organizations
want to become more equal partners to the local authorities, participating in decision making
and planning, but they have problems with the attitude of the civil servants and politicians and
also with the lack of knowledge among these actors concerning third sector work. The social
economy organizations also need a kind of long-time plan from the local authorities, and so
do private providers, in order to plan their work. The timetable with its short-range view
seems to be a great problem in the purchaser provider relationship and in the long run also to
welfare pluralism.
Also members of the informal sector complain about problems connected to the local
authorities. They feel neglected and are ill informed about their rights and possibilities. There
is a great deal of difference in the public sector support between the local authorities. In the
party programs this sector has a huge political support. This can partly be because of
economical reasons. As long as the informal sector is able to put up with the work, there is no
need for public residential care, which is very expensive. Compared to these costs, some
offers of relief are a good investment.
Some of the problems concerning the public sector may emanate from the less satisfying
working conditions in this sector. Low salaries of course generate dissatisfaction but of more
importance is the distance to higher management and the limited possibilities to affect the
work and the environment. The lack of cooperation between county councils and
municipalities is another factor that has impaired the reputation of the public sector. After an
overview of the many problems connected to the public sector it is reasonable to ask if it will
improve when exposed to competition. As the sector has failed as an employer it is now
difficult to recruit people to some parts of the work, among them social care.
With many potential employers and a lack of workers, the salaries rise. Welfare pluralism is
in this way is good for the staff but in the long run it can affect clients and tax payers in a
12
negative way. The efficiency cannot go on increasing forever which makes it difficult to
compensate for higher costs in the future. This is an argument that could be used by the
opponents of pluralism but has so far not been very outspoken.
In the debate we find many arguments for welfare pluralism in old age care like freedom of
choice, competition and efficiency. There is a political support for plurality, the political
barriers depends on how this plurality should be constructed, what organizations that should
be let into the system and the different roles of the sectors. These are questions that need to be
carefully elaborated, the process needs time. But we already have, because of all the crises in
the welfare sector, a growing plurality where they who can afford it buy service from the
private sector and they who have less recourses are forced to rely on the informal sector. We
can say that in Sweden we have a growing unintended welfare pluralism that has no political
support.
Development in Germany
Policy changes in the 1980:s and 90:s, the emergence of the self-help movement and a
decrease in public support of the “Wohlfahrtsverbände” has resulted in a major shift in the
corporatist arrangements between government and these large organizations. The different
situation in the former East Germany, where the West German third sector system was
imposed during a very short time, as well as the European integration, changing in regulation,
especially then the “Pflegeversicherung” and changes in attitudes and priorities within the
German population is also important. Instead of a very privileged position for the
“Wohlfahrtsverbände” we now see a much more pluralistic approach with different kinds of
organizations involved in the care. The institutionalized twinning between state and
“Verbände” in social politics that was a kind of trademark for German social policy has
because of political and economic reasons lost some of its legitimacy.
Welfare mix is discussed in different ways in the three countries. In Germany it is to a great
extent new roles for the third sector and to maintain, protect and support people’s will to
engage themselves in different kinds of unpaid social activities that has attracted the political
attention. This is a way to maintain the conservative welfare state where unpaid workers in a
number of organizations have carried out a large amount of the work.
Welfare pluralism is supported by all political parties except PDS, which is concerned about
the gender problems of the informal and third sectors. A better cooperation between the many
different actors and a more active role of better-informed citizens are wanted. To maintain
continuity, a structure secured by public professionals is needed. But as in Sweden no real
guidelines can be found on how the welfare mix should be organized.
In Germany there has always been a pluralistic system but the situation of today is different.
Many changes have taken place; demographic; changes within the informal sector, especially
the role of the woman; a new ethical orientation stressing solidarity and a new discourse
where justice is of great importance. Some of these changes have paved the way for welfare
pluralism but this development could be disturbed by the strong focus on economic matters in
the “Pflegeversicherung”. The introduction of this insurance is a more strict system with
fewer negotiations, which does not fit the German model. The German culture with a strong
solidarity within the family, a negative view of residential care and a suspicion towards
professional care are factors that definitely do not support the idea of welfare pluralism.
The different actors have new roles. The responsibility of the public sector has changed, now
the state tries to establish a framework for welfare pluralism, to create a suitable
infrastructure. According to political aims the role of the state should decrease while the
responsibility of the individual should increase. Anyhow the public sector now seems to
cooperate better with the other sectors than before. As in Sweden we see a movement towards
New Public Management where efficiency is of great importance.
13
The “Pflegeversicherung” has implied a paradigm shift where the market has got a new role
and where competition is a reality creating a much stronger welfare pluralism than hitherto.
The privatization has mainly taken place in the cities; third sector organizations are still strong
at the countryside. Like in Sweden many professionals want to establish a company of their
own which is one kind of privatization. They wish to make more money and it is also
supposed to be easier to deal with the labour unions in the private sector. The large
“Verbände” are seen as inflexible regarding wage policies and timetables. Then it is difficult
to develop tailor made packages and unconventional solutions together with the staff.
In the third sector the “Verbände” have lost their privileges and also some of their market
shares. A great problem to the large third sector organizations is the motivation and
recruitment of volunteers. Earlier it was a lifelong connection – cooperation but modern
people want to participate in projects over a short span of time. Individualistic tendencies are
much more common today. There are remarkable changes in the attitudes among the citizens.
Self-help groups have became important actors in the voluntary sector. As in Sweden we find
a political agreement on the importance of voluntary engagement but in Germany more is
expected from the citizens. Like in Britain, reciprocity is taken for granted.
We find a strong political support of Bürgerschaftliches Engagemang, a movement that
emphasizes involvement, democracy, cooperation and pluralism. Baden-Württemberg has
here been a kind of role model, policy makers in the two other studied Länder are well aware
of the results although they have for various reasons not been able to copy the system.
The informal sector must be better integrated. A large majority of elderly are still taken care
of by their families and not many of them take professional help. They are not used to
integrate home help in their work, maybe women are afraid of loosing their domain. Men take
much more help in the same situation. This could be a gender issue. At institutions, staffs do
not really want to be disturbed by relatives; contact with the next of kin is time consuming.
But now a changing family structure has changed the conditions for the informal sector. As in
Sweden other sectors are supposed to support and develop the informal network around the
client.
The “Pflegeversicherung” has, deliberately or not, supported the informal sector while a large
majority has chosen the cash alternative. This show the strong believe in the tradition of the
family. The regulation has supported the willingness of the informal sector to provide care in
accordance with the traditions in the conservative welfare state.
It is interesting to see the differences between the three chosen Länder. This truly confirms
the necessity of conducting studies like this one on Land level. We can see that if welfare
pluralism should be developed and flourishing it needs massive support both in material ways
but also in form of information, education and good role model like the projects in BadenWürttemberg. One thing that is said about welfare pluralism in the theoretical part has truly
been proved right; welfare pluralism must start at the local level, it is not something that could
be decided from the central level. This has been confirmed from the studies in BadenWürttemberg and Sachsen-Anhalt. Another important result is the importance of political
culture and historic traditions.
Development in Britain
Britain has gone a long way along the welfare pluralism road. The focus on pluralism has
been pronounced for a long time, but minor modifications have taken place during different
governments. It is however important to stress that even if the political unanimity is evident a
certain resistance among public employees, unions and even the public can also be noticed.
The governmental individualistic approach is not fully supported.
The former Conservative Government supported competition and so did the Labour
Government in the beginning, but has now turned to cooperation and partnership.
14
Competition sometimes led to a private monopoly instead of a public one. Large companies
divided the market between them just like some experts had warned us; the market forces are
difficult to control once they are free.
Important ingredients of the new approach are to put more responsibility on the individual and
encourage community work in order to promote engaged citizenship. Empowerment is one of
the key words; people must realize their full potential both as clients, citizens and workers.
This last word is important, as many people as possible should work, inclusion is an often
repeated catchword. There is a clear connection between rights and responsibilities, between
work and security, the same ideas can be found in Germany of today. In this system the role
of the state will be to provide opportunities. With active, well-informed citizens, democracy
can be improved too. It is very obvious that the government wants to change ideology,
restructure the state and decrease public expenditures.
The third sector in Britain is clearly established in the pluralism and has been so for a long
time. The different organizations are important partners and are supposed to have significant
influence on the policy making process. Especially, mutuality is supported which is not
surprising in the New Labour discourse, emphasizing empowerment and engaged citizens. As
in Germany we now find many small self-help groups. The voluntary sector is a broad
concept and an attempt has been made to categorize it into two groups: voluntary and
community sectors. Another similarity to the German situation is that the large organizations
no longer serve as advocates for the members’ interests.
In the British empirical materials a discussion concerning resources is lacking. If the third
sector is supposed to be more responsible for delivering services and especially if these
services should be developed and improved, they need to be adequately resourced.
Volunteering is of great importance but still some people fear that the responsibility will be
transferred from the public sector to unpaid voluntary work. We ask ourselves where we can
find all the necessary volunteers. The employment rate of women is increasing.
If the third sector should be a strong meaningful partner to the public sector, resources are
needed to change the culture within the public sector in order to create efficient cooperation.
It may also be important to think about the control system. Does this fit the many small
organizations that should be integrated in the large network? Other relevant and important
questions are: Do the public authorities really want this partnership? Does it help that the
Prime Minister says that they cannot do it alone?
The public sector itself is facing many problems not unlike those we find in Sweden.
Cooperation within this sector is, for different reasons, not easy and many examples of
failures can be found. An important question is then: would it not be better to solve these
internal problems before starting to cooperate to a higher degree with other sectors? Could
then, good cooperation between different sectors be a role model even for problems within
one of the sectors?
The informal sector is regarded to be very important in the care for the elderly. Surprisingly
we find old conservative elements in the rhetoric, such as the importance of the family as a
problem solver. Also here the old age care would not be possible to manage without the
informal sector, but even if this is well known, the practical support is not very extensive. The
support for the informal sector means so much. If the next of kin can get some relief and
receive some training and support, society is then able to save a lot of money. If not, when the
informal sector breaks into pieces, how can we afford elderly care tomorrow?
In the many White and Green Papers on the topic of the Third Way and its politics we find
many proud words, much rhetoric. It is an impressive work, carefully prepared and well
thought out. However, much of this is rather vague. Some considerations are made regarding
the problems connected to the Third Way politics. At least at the theoretical level we notice an
awareness regarding problems connected to cooperation over organizational boundaries. The
15
idea of local cooperation starting in different projects may be one way to solve the problems
in partnership that will most likely arise. However, many problems remain unsolved. No
concrete practical solutions are given.
A conflict without any solution is the one between on one hand trust and cooperation and on
the other centralization, demand and control. This contradiction makes us suspicious. The
New Labour approach is supposed to be a bottom-up one, but we find clearly evidence of topdown elements like many standards, new regulations and centralization. A new bureaucracy at
central level develops in order to balance the new freedom especially at local authority and
community level. How can this fit together with the aim to reduce public expenditure? All this
together gives us a reason to ask ourselves if some of the policies were really meant to be
implemented or if they should be regarded as pure symbolic politics.
Conclusions
Now I will return to the empirical questions presented and the theoretical discussion about
welfare pluralism. The all-embracing question was if the three countries have adopted a
policy of welfare pluralism in respect of old age care during the time for the empirical
investigation and if so, how is this motivated and supported. Britain most certainly has, and
this system began to be supported already in the 70s. As a matter of fact, some parts of the
welfare pluralism literature seem to be taken directly from different British public documents.
In Sweden the changes have been made step-by-step following the political opinion and the
crises of the welfare state while in Germany the introduction of the “Pflegeversicherung” and
a number of other regulations within the social field changed the picture rapidly. This is well
in line with other researchers declaring the utilization by the public sector of the voluntary and
private sectors for the delivery of public services as a growing phenomenon. Especially at the
local level governments in many countries have used different mixes of private and non-profit
organizations in order to carry out social services (see for instance Rosenbaum 2006).
The differences in the level and speed of movement towards welfare pluralism have been
great. In Sweden the transformation speed has been slow, cautious and not very far-reaching,
in Britain comprehensive changes have taken place over a long time and in Germany larger
changes, than in Sweden, were implemented although much of it happened during a short
period.
The three countries had different starting points concerning welfare pluralism as they
represent three different types of welfare states. In the middle of the 90s when the main part
of this investigation begins, they were much more equal, than when Esping-Andersen made
his famous classifications (1990). All three countries are developing towards a welfare society
just like Rodger predicted (2000). In both Britain and Germany the government wants to
change ideology, to restructure the state. This has not been the case in the social democratic
Sweden, even spokesman for the Moderate Party are highly defensive on this matter. We can
establish the fact that welfare pluralism is not an either- or- issue; it is a continuum.
We have seen that the three different welfare states have come closer to each other, but my
opinion is that the Swedish and German systems have become more similar to the British one
instead of all three countries travelling along the same road. The view of Pierson (1994)
stating that in times of retrenchment the welfare states will put on a more liberal form has
truly been confirmed. As the focus is on national policy makers, I shall not make a closer
examination of the role of the European integration. It seems plausible however that the role
of EU-policies emphasizing free competition, efficiency and contracting out has not been
insignificant in this matter. In a wider perspective it becomes difficult for a country to have
deviating solutions, something that even the Swedish social democrats have realised.
Even if welfare pluralism has been introduced we still find strong support for the welfare state
among citizens in all three countries. The public sector should take wider responsibility for
16
the welfare of the citizens (compare for instance with Hinnfors 2006). It is especially
interesting to see that the extensive British welfare cutbacks received very little support from
the citizens. According to a survey 2001 less than 3 % of the population wanted to reduce
taxes in order to spend less on social services (Bradshow/ Mayhew 2004).
Elderly care is one of the areas where pluralism is most pronounced and this development has
escalated after the time of the empirical investigation. In some other fields the changes might
be less obvious. There are many reasons for this; the very serious demographic problems and
the role of the informal sector are only two factors of this multi-faceted issue.
As was highlighted earlier, the concept of welfare pluralism is rather vague which makes the
empirical argumentation for and against even more interesting. What values have the policy
makers made mental notes of? In the theoretical literature two basic reasons are given for
introducing welfare pluralism. One is purely economic; the public costs should be reduced
and controlled. The local authorities lack adequate funding to support services needed and
then leave the responsibility to the market, the civil society and the family. The other is
ideological, involving a critical attitude to the role of the state, but also stress the value of
competition. Private and voluntary sector service delivery is supposed to be done not only
with greater efficiency and cheaper costs, but also with more flexibility and innovation; the
last three are also relevant for the informal sector. As we can see below, in an empirical
context these two reasons are however often mixed together and difficult to separate. We
should, at this point, remember that even if welfare pluralism is supported, both from left and
right side of the political spectrum, the reasons are different.
A third explanation has to do with the increasing political influence of the private and
voluntary sectors. A growing influence is an important incentive to encourage these
organizations to utilize their recourses to influence government to work more in conjunction
with them (See for instance Rosenbaum 2006).
If we turn to the empirical material how then is welfare pluralism motivated, what reasons are
given for its implementation? There are various definitions of the values, which support the
concept of welfare pluralism. Is it nevertheless possible to discern some common motivations,
or is the concept as fuzzy in reality as it is in the theoretical world? What values can be
detected behind different statements? Do policy makers really believe in welfare pluralism
and if so, why? Are these changes just emergency solutions in a time of many challenges for
the welfare state?
Starting with general statements, all political parties support welfare pluralism in Britain, the
political unity is great and the guidelines are also clearer on how the system should be created
and organized than in the other two countries. In Germany pluralism is supported by all
parties except PDS, which is concerned with all the unpaid work that especially women have
to undertake in such a system. In Sweden also we find a political unity concerning the value
of pluralism, especially on regional and local levels where this very pluralism is created. Even
the left-wing parties now accept a plurality of providers, but there must be no segregation.
The market must be regulated in order to diminish its detrimental effects. Nobody seems to
know how private and voluntary organizations should be involved. We find many questions
concerning how pluralism should be organized.
In Sweden the increasing welfare pluralism during the 90s sometimes seemed to be
unintended. Due to higher fees many clients cannot afford public home-help, they have to rely
on support from the informal sector. At the same time as the public services has decreased we,
for natural reasons, find an increase in help provided by both the private sector and the
informal one. The choice between these two options is mainly based on the private economy
of the client. This growing welfare pluralism is neither discussed nor mentioned in official
documents.
17
Although heavily criticized, the Swedish social democrats do not seem to be really interested
in any renewal. The focus on privatization is by some observers regarded as a way of moving
the interest from the real problems like lack of resources, demographic changes, globalization
and an increasing demand from the citizens on freedom of choice and high quality services. In
short, the famous Swedish model does not work so well any longer. An argument that
supports this is that non-public providers already were a reality and that there was no point
trying to stop an inevitable development.
Concerning the ideological motives, a critique of the welfare state has been pronounced in all
three countries, meaning that it suppresses the market and the will to work, save and invest
money. The social security system has not been able to meet new demands created by changes
in family structure, unemployment and a large number of immigrants either. In the highly
formalized welfare state there is a risk that spontaneity, creativity and solidarity decrease. A
connected argument for welfare pluralism is that monopoly of every kind is execrable. In such
a situation everything slows down. This is not surprisingly most clearly stated by the Swedish
non-socialistic politicians who want to decrease the public monopoly. On the other hand,
nobody wants a private sector monopoly either; welfare pluralism has to be introduced with
caution. In Britain we also find a fear of monopoly, this leads to inefficiency and gives too
much power to public employees.
An ideological argument presented by the Swedish Social Democratic Government is the
need to develop the voluntary sector because these organizations can guarantee a plurality
without profit motives. Another strong reason in Sweden for supporting the voluntary sector
is the expectation of a vitalized local democracy and the creation of a new local identity on
the countryside. This sector has a great capacity to engage the citizens.
Similar statements can be found in Germany; here “Bürgerschaftliches Engagemang” has a
broad political support. Important motives given are the improvement of democracy and
solidarity between the citizens through mutual actions. Self-fulfilment and the development of
social capital are also important. This could also be to the benefit of the enterprises, people
with social competence and wider perspectives are better co-workers.
In Britain the New Labour also wants to recognise the essential and invaluable contributions
of the voluntary sector to social, cultural, economic and political life. The main goal is to
promote engaged citizenship, but also democracy is stressed. In this country especially the
local level is in focus, voluntary engagement can foster community spirit and let more people
contribute their talents.
In Britain empowerment resulting in more independent citizens and an individualistic
approach is stressed, but this does not correspond with the UK collectivistic traditions. It lacks
support from public managers and professionals. The local authorities’ staffs have realized the
difficulties, their opinion deviates from that of the government. In the Swedish election
campaign 2002 the non-socialist parties also stressed empowerment of the citizens. In
Germany especially SPD and The Greens talk about the value of empowerment, which can be
achieved through activities in the third sector.
In all three countries new providers are expected to bring innovations, but as we can see,
mainly from the Swedish case, this is not a matter of course. As the local authority is the
purchasing unit, different providers try to imitate public sector performance in order to be
convenient to the existing system and win a contract. The rules of the purchasing process are
strict.
A strong motive in Sweden for supporting the informal sector is an increased quality in the
care. It is very important that the relationship to the public sector is good and that relatives are
allowed into the public work. All parties, except the Left Party, which is sceptical regarding
all the unpaid informal work often carried out by women, propagate for more support to the
informal sector. The awareness of all the problems that an informal care-giver faces and that
18
the system can easily break-down, without possibility of relief and some form of
compensation, seems to be great. In Germany the value of informal networks is stressed and
the help from outside should build on, cooperate with and develop these networks. In Britain
expressions like user involvement are common.
Freedom of choice is cherished in all three countries. In reality though it is not the client who
can make choices between different providers; it is different groups of public sector
administrators and professionals. This is however seldom touched upon in public documents,
but we can find some statements in the German context.
The top-down perspective of the Swedish system is disliked. In the national power
investigation, people complained about the limitation of freedom of choice. We find a fairly
strong demand for independence not having one’s whole life dictated by public experts. This
has resulted in a political support of greater influence for the clients, which also characterizes
welfare pluralism. According to the social democrats it is natural in a society of today that
citizens are able to choose between different providers. It is also important that this freedom
does not imply segregation. An increased freedom of choice would also imply a pressure on
the public sector to improve its performance. The possibility to vary the services more in
accordance with differentiated client demands is another motive connected to freedom of
choice. The non-socialistic parties go one step further meaning that freedom of choice leads to
competition, which is to the benefit of both citizens and the staff. In this way an efficient
service adjusted to the needs of the client can quickly be delivered. We find similar arguments
in the other two countries.
Another way to support freedom of choice in Sweden is the encouragement of small public
units to opt out of the local authority system and start a business of their own. This will
improve the medical care and provide a greater variety with more alternatives for the client.
This is also supposed to increase the working conditions for the employees. Social enterprises,
where clients are involved not only as consumers but also as co-workers, have attracted the
British government. It is supposed to bring a stronger sense of community, strengthen
mutuality and decrease social exclusion. The same can be said for the cooperative movement
which could be an opportunity for many people.
Are there any pure economic motives? We can see that many of the arguments fit the trend of
cost control. In all three countries financial difficulties have increased the attractiveness of
contracting-out public services to other providers. In Sweden the politicians have become
more and more concerned with the cost of public services since the 80s and especially after
the economic crisis during the 90s. New ideas and solutions were needed notwithstanding the
public and political resistance. Privatization means that the services will be cheaper and much
more effective.
In Germany also the cost of the social security system have reached its limit since the
beginning of the 90s. The increasing number of elderly people combined with less public
resources has been a burning question. Here it is realized that welfare pluralism needs support
and coordination, which could imply new jobs instead of redundancy.
Reducing the public expenditure is a very strong motive also in Britain. To involve private
and voluntary providers is supposed to increase efficiency. By working together with other
providers each organization could make more effective use of its resources. Competition
would result in better value for money. It is stressed by Blair though that economic efficiency
must be combined with social fairness. In this country we find a more pronounced support for
the private sector, a positive climate for enterprises must be created.
The cut backs of public social expenditure in Sweden are defended by the efficiency criteria,
but also with arguments that are based on a combination of ideological and economic motives.
Problems connected to the public sector like ineffective and unresponsive bureaucrats and
professionals are a common argument. Many voices are heard urging a better performance
19
from the public employees and a more appropriate organization of the public sector. Some of
the non-socialist parties in Sweden support welfare pluralism because of the better working
conditions in the private sector. This sector is better organized, the staff receive more training
and new working methods can be developed. This can then have a spill over effect on the
public sector. The possibility for the staff especially to affect their working situation and take
personal initiatives is stressed.
Similar arguments are presented in Germany, but here the criticism is also directed at the
large “Wohlfartsverbände”. A bureaucratic structure, limited possibility to participate in the
decision making process and a lack of flexibility towards new problems have led to a
disapproval of the old system. During the Conservative rule in Britain, the public employees
were not only accused of inefficiency, they were also supposed to have too much power and
in their own interest expanding public social services. Like in Germany the criticism of the
public sector also partly concerns the voluntary sector. We can see here that arguments
concerning a better public sector performance contain both economic and ideological motives.
The motivation of introducing the “Pflegeversicherung” in Germany builds on both
ideological and economic arguments. The main reasons were the high public costs, the burden
on informal carers and the risk of being poor in later life. According to the “neue Kultur der
Hilfe” it is a task for the whole society to safeguard the care. It cannot be handed over to one
single provider.
Concerning the third motive; the value of an increasing political influence of the private and
voluntary sectors, politicians from all Swedish parties believe that private providers will lead
to more entrepreneurship and as a result of this, an economic growth in the region. In Britain
counter-balancing the acceptance of markets with policy interventions to strengthen social
cohesion is stressed by the Blair administration. Community governance, emphasizing the
involvement of the local community in the policy process where citizens can participate in the
democratic process in a bottom-up perspective, is often included in the new political
discourse. In the German governmental declaration from 1998 self-help groups,
“Wohlfartsverbände”, churches and other groups were pointed out as important partners of
political life. Cooperation between the public and the voluntary sector is a way to learn from
experiences made in different groups in order to improve the welfare state and develop social
work.
The criticism of the welfare state has been manifested, but all political parties aiming at
dismantle the system will get into trouble (See Stephen/Hubert 1999). Welfare pluralism
could be one alternative and above we have grouped some of the motivations given. As we
can see there are many both ideological and economic reasons to support welfare pluralism
and empirically it sometimes is difficult to separate them. Many of them are ideological: with
welfare pluralism the service will be better implying higher quality of the care, more
innovations and service better adjusted to the needs when freedom of choice is implemented.
The working conditions for public staff will be improved as there will be competition from
other providers. It is also in general good for the citizens, democracy, social capital and
solidarity will grow, people will be more engaged, which is something that is particularly
beneficial for the local community spirit. Empowerment brings self-fulfilment and the public
sector services will be improved, something we all will benefit from. The economic
arguments are few, but the same motives are repeated in many texts and statements; welfare
pluralism will make the service more efficient, cheaper and lead to more effective use of
every provider’s resources. The third group of arguments, the value of an increased political
influence from the other sectors, is seldom directly touched upon. It is mainly mentioned in
connection to improved democracy.
The differences in motivation between the three different welfare states are rather small, and
there are many common arguments. We can however establish that the concept of welfare
20
pluralism seems to be as vague in the empirical world as it is in the theoretical one. When
promoting welfare pluralism, policy makers talk about different kinds of pluralism and this
makes us insecure about the real values underpinning the system. Many policy makers seem
to believe in welfare pluralism but for different reasons, depending on political colour and
also on national political colour.
As we can see a number of the motives given are not firmly established in practical work.
Expectations are not met. It is hard to believe that policymakers are unaware of this. The
question is then: why is welfare pluralism motivated in the way it is?
Some policy makers are afraid that privatisation and civil involvement will be supported
without the necessary framework because of the many crises at local level. Is pluralism a way
to escape the problems? From time to time other problems have overshadowed the debate
about welfare pluralism. Examples include the scandals in connection to old age care and the
poor economic health of elderly people. It has, in this study, not been possible to establish if
these problems have provided further grounds for motivating welfare pluralism or if they have
resulted in investments in other measures. Here we suggest further studies connected to
decision-making theories; can the introduction of welfare pluralism be regarded as
incrementalism, a strategy to move away from an undesirable situation? Or garbage can, a
possible solution that seems reasonable (Enderud 1986).
Theoretically, a supportive infrastructure for the other sectors is very important when moving
towards welfare pluralism. The social capital has been both overused and under funded (for
instance been discussed by Putnam 1995). A developmental approach that complements the
prospective contract culture is needed (see for instance Evers 1995). The other sectors must be
strengthened. This could be achieved in many different ways: by a facilitating legal
framework, by a tax system which allows people and organizations who financially support
voluntary organizations to get reduction in taxation, by giving voluntary and private sector
organizations possibilities to influence social policies, by constructing very clear criteria for
who is going to get a contract, by adequate funding and education both of public staff and
partner employees (Rosenbaum 2006).
How then is this idea of welfare pluralism supported in practical politics? What has been done
to facilitate the implementation? The support is presumably of a different nature in the three
countries as a result of different traditions and because they have so far reached different
levels of welfare pluralism. Nonetheless we can establish that different forms of combinations
of economic, legal and information steering have been used in all three countries.
In both Sweden and at central level in Germany welfare pluralism, in general, is supported in
different documents and statements, but no clear guidelines are given on how it should be
organized. One reason could be that the development should come from below, but other
reasonable answers are that the motives are, as we have seen above, very different in nature or
simply that nobody knows! We are dealing with a fuzzy concept and if the motives behind the
desirable changes are unclear so must the support be.
In Germany welfare pluralism has been strongly supported by the introduction of the
“Pflegeversicherung” and other social regulations which stress the importance of mixed
providers including competition, but also cooperation. Both legal and economic steering
measures have been used to support this regulation.
A good example of a supporting infrastructure is the German introduction of clearinghouses
and their umbrella organizations. They inform the citizens about self- help groups, they
support these groups in different ways and they support collaboration between the groups and
other actors. State, Land and local authorities provide economical support for these
clearinghouses. The state also finances a program for support of the self-help movement and
voluntary engagement on local level.
21
The assumption that the other sectors need to be strengthened is confirmed by the SachsenAnhalt case. Here the voluntary organizations have difficulties in recruiting members as the
GDR culture still in many ways is dominating. Due to this they are regarded to be weak and
of little interest as collaboration partners for the public sector. In order to change this, a
special program for supporting the development of the self-help movement has been
established. Another program supports the “Wohlfartsverbände” providing money for their
development. Those projects though have been heavily centralized, which made it far less
interesting for the citizens to participate. Once again, welfare pluralism must be developed
from below.
Baden-Württemberg is a society with great prerequisites for welfare pluralism; a historic
tradition of cooperation, a fairly good economic situation and a strong support from Landlevel. An infrastructure is created to implement pluralism. A number of documents are
distributed to the four sectors and to the public to inform about and promote welfare
pluralism. Courses and seminars have been provided both on university level, as further
training for public employees and directed towards engaged citizens. New public bodies, for
instance foundations, are established. Economic support to the development of different kinds
of project is important. Both economic and information measures are used in order to fulfil all
the three necessary conditions for a successful implementation, the actor should understand,
be able to and willing to follow the intentions from above (Sannerstedt 2001). It has also been
important that the experiences of all the projects conducted at the local level are introduced at
a general level. The value of feed-back cannot be underestimated when major reforms are to
be implemented. It is interesting to see that everything seems to be very well thought through.
Here we really find the clearness that is lacking on the German federal level. Is this a vital
careful preparation of citizens’ engagement or is it a massive propaganda campaign, well
thought out, covering the fact that public organizations lack adequate funding?
In Hessen new forms of voluntary work have been developed at local level based on the idea
of self-help. The development is economically supported and observed at land level. Offices
coordinating old age care and informing the clients are established. These are supposed to be
neutral, not favouring any special kinds of providers. This coordinating role could also be
given to one of the other sectors; it does not have to be a task for the public sector only.
The project form has also in Sweden been an important way of supporting and developing
pluralism, mainly cooperation between the public sector at regional and local level and
different voluntary organizations. Sometimes the other sectors are also involved; this can be
said especially for the local development groups where the goal is to build bridges between
different groups and different interests. In a social democratic welfare state, where the
different sectors are not used to cooperate, such projects are of great importance in creating a
common ground for understanding and inspiration.
Attempts to improve the relationship with the voluntary sector has also been made through
different investigations regarding what measures that would develop and strengthen this
sector, through the establishment of different groups at central level and through economic
contributions from state, regional and local authorities.
The value of the voluntary and informal sectors is pointed out in the revised Social Care Act.
By law the Swedish local authorities should support the informal sector. Central money has
been given to stimulate the development of this support. Here also a number of projects have
been carried out.
Also in Britain welfare pluralism has gained support in the form of both legal and information
steering. A number of Acts laid the foundation to welfare pluralism during the 80s by
encouraging greater cooperation between the four sectors and a closer partnership between
formal social services and informal work carried out by families and neighbourhoods.
22
The implementation of welfare pluralism has implied a new structure of regulation creating a
new kind of bureaucracy. Professional regulations, contractual regulations and new standards
in order to specify the rules and the rights have been established
To support the informal sector, a special Carers Act has been established and a National Carer
Strategy is established to the empowerment of carers, information about their rights, support
their involvement in planning and building up additional pension entitlements. At local level
though not much is done, the support is patchy and to a large degree dependant on local
initiatives.
Regarding the voluntary sector a compact was set up with principles for effective working
relationships between voluntary and public sectors. Voluntary organisations shall be consulted
in different matters and also participate in different planning groups. They shall not only be
involved in service providing, but also in planning, policy formulation and service
development. In this way their position has been strengthened. The Active Community Unit
was established to encourage people to take up volunteering and support those already active
in it. Economic support has been given directly to some voluntary organizations, but also to
local authorities in order to improve the cooperation. The knowledge of more experienced
volunteers is used to inspire young volunteers and to help volunteer bureaus to match people
to organizations.
Counterparts to the German “Bürgerschaftliches Engagemang” are the area based zones that
have been established. In these zones different themes have been focused on depending on the
local situation. The work is run by a combination of governmental bodies, private and
voluntary organizations.
As stated above, welfare pluralism is strongly supported in Britain, but some observers regard
the government collaborative discourse as rhetorical invocation of vague ideals. If the third
sector should take on new roles it needs to be adequately resourced. User involvement and
empowerment of the citizens is of great importance but there are very limited resources for
this. We can ask ourselves if welfare pluralism is really meant to be implemented, and if so,
why is it not prioritized in the budget?
To sum up a number of measurements have been taken in order to support the introduction of
welfare pluralism. The approach has been rather similar in all the three welfare states,
focusing on projects, creation of a supporting infrastructure, economic contributions,
information steering and adjustment of the legal system. In Sweden the methods have been of
a more cautious nature, many new investigations have been set-up, but less concrete measures
than in the other countries. This may be because of resistance towards welfare pluralism or
that the Swedish model normally includes long term investigations. The only case in which
welfare pluralism has been intensively supported is Baden-Württemberg. From this we can
learn that it must be decided which values underpin welfare pluralism giving clear motives to
different actors and then it is important to provide sufficient support if we want to reach a
stage of welfare pluralism.
The political majority is supposed to be important when it comes to supporting welfare
pluralism. This is one of the reasons for choosing three countries with Social Democratic
governments for the study. In Germany however the Christian Democratic Party had ruled the
country for a long time before the investigation. This could explain the hesitation to finance
social programs with high taxes or to promote increased women labour force participation.
We have seen that housewives are supposed to engage themselves in voluntary work and
provide care for the elderly within the informal sector. The British social democrats also took
over after a long time of conservative control. The foundations for welfare pluralism were
made before the time of the investigation; radical changes could be made due to a high power
concentration in the favour of the government. This can explain why German and British
politicians have found it easier to leave parts of the welfare state to other sectors while it has
23
been more difficult in Sweden with the existence of both long and strong social democratic
traditions. As Taylor-Gooby points out though, (2001) the German and British and, to some
extent, even the Swedish social democratic parties have changed, which opened the
possibility for reform. For a long time Swedish Social democrats seemed to reject worldwide
political trends in a conservative or neo-liberal direction (Pontusson 1992). This is slowly
changing although the basic character of the Swedish welfare state has not yet been changed.
Nonetheless we can see that not only political, but also cultural and institutional
circumstances have created obstacles for the introduction of welfare pluralism in the three
countries, although these obstacles are of a different nature. In Sweden the tradition of
consensus, a corporative system with powerful interest groups, a national culture that opposes
confrontation have created values and institutions that have made the transformation towards
welfare pluralism more difficult than in the other two countries. A federal system like the
German one is supposed to have a retarding effect on social policy transformation because of
the existence of several veto points. Also here different pressure groups play an important role
in the decision-making process and also here consensus is important. Cooperation is preferred
to competition and the system is characterized by inkrementalism and long-time solutions.
The differences to the former GDR is striking, the situation in Sachsen-Anhalt differs in many
ways from that in the other two Länder even if decades have past since the reunion. In Britain
the former Conservative government had already introduced welfare pluralism but New
Labour has provided a conflict between on one hand trust and cooperation and on the other
hand centralization, demand and control, we find too many evidences of top-down elements
like new standards and regulations in order to really believe in the outspoken bottom-up
approach.
It is important to remember that relationships between the four sectors have grown out of
different political, cultural and social contexts. To discuss welfare pluralism we must pay
attention to what different roles the four sectors have played from the Golden Age and
onwards. The nature of the other sectors, perhaps especially the voluntary one, is associated
with the structure of the welfare state. In Germany the state-non-profit cooperation enjoys
broad political support and legitimacy; voluntary organizations had a strong position also
before the time of the empirical investigation. The situation has been similar in Britain with
large voluntary organizations providing a great deal of social services while these
organizations in Sweden mainly have been interest organizations with an important mission as
schools of democracy.
Although the three countries have moved in a liberal direction the way welfare pluralism is
discussed clearly reflect the original type of welfare state. In Germany the role of the third
sector is in focus. How people’s will to engage themselves in different kinds of projects is
protected and supported is essential to maintain the conservative welfare state where
organizational members carry out a large amount of unpaid work. In Britain the emphasis is
on the community level where people are expected to take much more responsibility for their
welfare. In Sweden different kinds of improvements of the public sector is discussed in eager
attempts to preserve the social democratic welfare state.
It can be argued that the introduction of welfare pluralism is a natural consequence of the
transformation from modernism to post-modernism where pluralism and diversity is
supported and the responsibility of the family, individuals and communities are regarded to be
important. We can see that even if altruistic motives for engagements is important other
motives closer to the post modern values like having fun together, to be accepted and to
develop different skills are now more important. A new self-help orientation has emerged
combining voluntary work with democratic forms of service provision in the community. This
is a new form of individualism together with solidarity on the micro level. But, as we can see
from this study, there are different roads to welfare pluralism and there are different motives
24
to travel along these roads. Welfare pluralism cannot be regarded as an inevitable condition of
a postmodern society. But the post-modern spirit has truly facilitated the transformation.
Central elements in the discussion on the subject of welfare pluralism have been cooperation
and competition and the real problem consists of a combination of the two. A welfare mix
probably generates a higher quality of care and better value for money than a fight between
different providers for scarce resources, but still we do not know much about how this state
shall be realized.
Once again, it is important that the complexity of relationships and different social processes
are not simply reduced down to only economic terms. Political, social, organizational and
professional relationships must not be forgotten. Cultural and institutional differences must be
taken into account. The literature on welfare pluralism is oversimplified, but, as we have seen
from the empirical material, so is also the rhetoric among the policy makers. The latter is one
of the most important findings of this investigation.
25
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Interviews
Klaus Balke, NAKOS, Berlin, May 1999
Desi Gillespie, Disability North, July 2000
Desi Gillespie, Disability North, December 2002
Thomas Klie, Ev. Fachhochschule Freiburg, July 2001
Thomas Klie, Ev. Fachhochschule Freiburg, April 2002
Hans-Joachin von Kondratowitz, Zentrum für Altersfragen, Berlin, May 1999
Hans-Joachin von Kondratowitz, Zentrum für Altersfragen, Berlin, June 2001
Bernd Niederland, Volkssolidarität, Berlin, June 2001
Maria Oppen, Wissenschaftszentrum, Berlin, June 2001
Alexander Wegener, Wissenschaftszentrum, Berlin, June 2001
Hannes Ziller, Hessisches Ministerium für Frauen, Arbeit und Sozialordnung, July 2002
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