Ole Petter Askheim

Personal assistance—direct payments or alternative public service. Does it matter for the promotion of user control?

Personal assistance organised as direct payments is seen as an important means for securing user control and freeing disabled people from their reliance on welfare professionals and unpaid carers. The hypothesis put forward in the article is that just looking at whether personal assistance is organised as direct payments or as an alternative service represents an overly restricted approach to judge how the user’s preferences are taken care of. By comparing models of personal assistance in the US, the UK, Sweden and Norway it will show that several other factors influence user control. In the final part of the article the question is raised as to whether paternalism is always negative for welfare service users. Since the users constitute a broad group it might be questioned if the assumption of the service users as rational, well informed and competent to make the best choices is always valid.Personal assistance organised as direct payments is seen as an important means for securing user control and freeing disabled people from their reliance on welfare professionals and unpaid carers. The hypothesis put forward in the article is that just looking at whether personal assistance is organised as direct payments or as an alternative service represents an overly restricted approach to judge how the user’s preferences are taken care of. By comparing models of personal assistance in the US, the UK, Sweden and Norway it will show that several other factors influence user control. In the final part of the article the question is raised as to whether paternalism is always negative for welfare service users. Since the users constitute a broad group it might be questioned if the assumption of the service users as rational, well informed and competent to make the best choices is always valid.

'Meeting Face to Face Creates New Insights': Recruiting Persons with User Experiences as Students in an Educational Programme in Social Work

Even though empowerment and involvement of users have, for a long time, been important goals for educational programmes in social work, these programmes have only to a very little extent availed themselves of the resources that people with user experiences have to offer. This article will present a course that is part of the bachelor programmes in social work and social education at Lillehammer University College in Norway. Persons with user experiences were recruited and took part in a course on equal terms with the bachelor students. Four lecturers from the college, including the author as the project leader, carried out the planning and implementation of the course. The article gives an account of the experiences gained from the course as expressed by the students.

Personal assistance in a Scandinavian context: similarities, differences and developmental traits

Personal assistance (PA) has been characterized as a melting pot consisting of, on the one hand, a social rights discourse with its basis among disabled people, and, on the other hand, a consumer directed market discourse increasingly putting its stamp on welfare policy in the Western world. In the realm of welfare politics, these discourses are, in many ways, opposites, but have found common ground in the demand for a more individual and consumer friendly provision of services. Within a shared welfare state model, the application of PA has developed divergently in the Scandinavian countries and relates to the two discourses in different ways. In this article, PA in Denmark, Norway and Sweden is presented and similarities and differences are discussed and analysed. Questions raised include: How can the differences between the countries be understood? What dilemmas within welfare policy do they illustrate? How do the different discourses put their marks on the different PA-models in the Scandinavian countr...

Political citizenship and local political participation for disabled people

The theme of this article is political citizenship among people with disabilities. Political citizenship on the basis of gender and ethnicity has received attention internationally. However, there has been little attention on political citizenship of persons with disabilities. The article sheds light on political representation at the local level in Norway. The data used are from a survey sent to 767 political representatives in local politics and 50 administrative representatives. Our study shows that disabled people are under-represented in local political assemblies, and thus, their political citizenship is not fully acknowledged. We apply Fraser (N. Fraser, 1997. Justice Interruptus. Critical Reflections on the ‘Postsocialist’ Condition. New York and London: Routledge) concepts of redistribution and recognition to analyse the lack of representation of disabled people. According to the dimension of redistribution, the analysis shows that neither the physical conditions nor the organization of the different meetings is particularly well adapted for disabled people. The dimension of recognition shows that disabled representatives are expected to be more occupied with issues concerning disability than other representatives. The analysis also shows that over time it has become more important for elected disabled representatives to put issues concerning disability on the agenda.

Empowerment and personal assistance – resistance, consumer choice, partnership or discipline?

The concept of empowerment has been closely linked to the development of personal assistance (PA) and the independent living ideology. However, the use of the concept of empowerment has been disputed as it has begun to be used in both the marketization of the PA scheme and as a government strategy to promote active partnership. In this article, we take a closer look at the concept of empowerment and how different approaches capture different relationships between the state and the users of PA. We distinguish between empowerment as a form of resistance, as a form of consumer choice, as co-productions and as a liberal strategy of dominance in the modern society. The analysis indicates how the different notions of empowerment run alongside each other in the development of the PA arrangement in the Scandinavian countries and that the different perspectives will have different consequences when PA is to be analysed as a tool of liberation for disabled people.

Mend the gap – strategies for user involvement in social work education

Abstract A major strand in social work’s history has been its paternalistic character, partly due to a philanthropic tradition, but also to the tendency to import an individualist expert model into social work practice. As a result, gaps have arisen between expert and experiential knowledge. In this article, so called ‘gap mending strategies’ developed by the international network PowerUs are discussed. PowerUs consists of teachers and researchers from schools of social work and representatives from service user organizations in nine European countries. The gaps as the network identifies them are presented and we share some processes within our practices that mend or maintain gaps between service users and professionals. Two main strategies will be explored in more detail—a strategy that has been developed in the UK of mainstreaming service user participation in all stages of social work education, and a strategy that has been developed in Scandinavia of developing joint courses for social work students and students from service user organizations. A main conclusion is that alliances between educational institutions and service user organizations will be important to get a fuller understanding of what gaps we are facing and how they best could be mended.

Personal Assistance in Sweden and Norway: From Difference to Convergence?

Within the same welfare state model, Norway and Sweden have established very different models for personal assistance. Sweden has developed a model with a strong consumerist profile with extensive rights and choices for users. In Norway, state control of the arrangement has been stronger. Users’ rights have been weaker and decisions are left to the discretion of the professionals in the welfare services. Recent political signals in both countries indicate that the models might converge in the future. In Sweden, authorities are worried that users’ rights have become too extensive. Efforts have been made to restrict users’ rights and to make public control stronger. In Norway, the target group for the arrangement has been extended and stronger individual rights to obtain personal assistance are proposed. The article will clarify the tendencies in the two countries and discuss the consequences – for the arrangement and for the users’ control over their assistance.

User participation in the Norwegian Welfare Context: an Analysis of Policy Discourses

This article argues that the social construction of user participation policies includes both differences and similarities regarding three user groups: older people, disabled people and people with mental health problems. The article is based on a historical discourse analysis of national documents in Norway. It points at a democracy/social rights discourse, based on the idea of social citizenship, as a common and historically stable discourse for all three user groups and relates this to the specific characteristics of Norwegian welfare policies. A contrasting consumer discourse, stressing users’ consumer role and related to the impact of New Public Management reforms, is only evident in the case of older people and from the 1990s. A co-production/co-partnering discourse, stressing user/professional-partnership, is evident in the current policies directed at older people and those with mental health problems. Both the consumer and co-production discourse remain marginal in the case of disabled people.