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From an international perspective, the Nordic model can easily be seen as an ideal welfare state. Additionally, more than any other welfare state model, the Nordic model is not just a label applied by welfare state analysts — it has also been used with pride by Nordic governments and citizens. Its striving for equality and high degree of universalism have been regarded as proof of the superiority of the Nordic model, while the concept of universalism is associated with the development of comprehensive social insurance schemes and general access to education and healthcare. Another central aspect of Nordic universalism is the development of comprehensive publicly funded, mainly publicly provided, high-quality care services available to, and used by, citizens of all social groups.
Elin Peterson holds a PhD in Political Science from the Complutense University of Madrid, and currently works as a researcher in the Department of Social Work at Stockholm University.
In Sweden, the idea of universal service provision was brought into public political discourse at the beginning of the twentieth century. The Social Democratic Party (SAP) was the main force behind social reforms. With the expansion of the welfare state, care services became a citizen right, closely connected to the promotion of both class solidarity and gender equality.
Care was effectively transformed from a private matter for families to a public matter for the state. Further, the process of de-familialization facilitated the reconciliation of employment and care and increased women’s economic independence. This development towards universalism explains why the Swedish — and Nordic — welfare state has come to be defined as “caring” and “women-friendly”.
Policy reforms and welfare state retrenchment in recent decades challenge these ideas. Overall, there has been a shift in care policies, away from egalitarian ideals and towards a focus on freedom of choice. The process of care “going public” has to a certain extent been reversed by welfare state cutbacks. For example, a process of re-familialization is evident in care for older people and privately funded help has increased among more affluent older adults.
The Swedish welfare state has indeed gone through far-reaching changes inspired by the global wave of New Public Management (NPM), which has strongly reshaped the organization and provision of care. In order to increase efficiency and productivity, market-inspired logics have been introduced and public organizations have become more business-like. In this vein, there has been an increasing reliance on the market and a focus on competition between public and private providers. Care work in the eldercare sector has become increasingly governed by detailed regulations, and control has been strengthened.
Coinciding with retrenchment, this has resulted in increased workloads, work intensity and stress among care workers. Such problems intensified with the outbreak of the COVID-19 pandemic. Women are particularly affected by the changing conditions of care work since care work is a female-dominated occupation, in Sweden as in other countries. Overall, these developments in the Swedish welfare state shape women’s lives, as users of care services, unpaid family carers and paid care workers.
The changes in care-related policies and practices have occurred in a context of increasing economic inequalities. Although starting from an initially low level, economic inequality has increased faster in Sweden than in most countries. Income distribution has gone back to the levels of the 1940s, and wealth distribution has worsened even more, resulting in the most uneven pattern in Western Europe. The pension system has produced a higher degree of relative poverty among Swedish pensioners than the EU average, and the differences in relative poverty between older women and older men are among the greatest in the OECD. In addition, the foreign-born and the oldest-old are particularly vulnerable to poverty.
While inequalities are increasing, important shifts have occurred in the perception of social rights and paid work. Like the other Nordic countries, Sweden has historically been highly work-oriented, but the workfare element of the Swedish welfare state has become stronger. This has resulted in “an increased requirement to take up wage labour at whatever pay is offered”. Neoliberal discourses have legitimized a shift in focus from citizen rights to citizens’ obligations. Additionally, a cost discourse has become prevalent in social policy (e.g. disability care policy), focusing on what can be afforded rather than on social rights. The growing inequalities, the focus on citizens’ obligations, and the cost discourse shape the lives of many women in vulnerable positions, such as those in precarious work or unemployment, living with disability, or affected by illness.
Without a doubt, the Swedish welfare state has many strengths, and women and men generally benefit from universal services and citizen rights. Nevertheless, the idea of Sweden as a women-friendly and caring welfare state can be, and has been, questioned. When we take intersecting inequalities and vulnerability as the starting point, the harmful effects of welfare reforms and retrenchment become especially visible. Following from this, A Caring State? adopts a critical approach in examining welfare state change and the effects on women and gender equality in Sweden.