Tine Rostgaard

Preferences or institutions? Work-family life opportunities in seven European countries

In her Work—Lifestyle Choices, Hakim argued that attitudinal factors like work—lifestyle preferences are more important than institutions or structures in explaining female employment. Our aim is to study whether we can substantiate Hakims preference theory or whether we should lay more emphasis on institutional factors. We ask whether there are systematic differences in attitudes to work and family life as proposed by Hakim. To what extent do the attitudinal dimensions react to institutional variables such as day care and family leave possibilities? What are the relative roles of opinions on family life and working life and traditional sociological variables such as education, income and socio-economic status? How does a spouses opinion affect womens choices (intra-family attitudinal consistency)? We utilize the International Social Survey Programme data from 2002 and combine it with indicators of the quality of child-care and parental-leave policies in Denmark, England, Finland, Germany, the Netherlands, Norway and Sweden. Our findings suggest that opinions matter but they are constrained by opportunity structures which are not alike for all women across different countries; opportunities depend not only on structural factors but also on institutional factors, such as the availability of day care. In addition, the opinion of male partners seems to influence womens decisions about employment.

Care Between Work and Welfare in European Societies

Tensions Related to Care in European Welfare States B.Pfau-Effinger & T.Rostgaard Theorising Care and Care Work A.Anttonen & M.Zechner Tensions between Care Values and Care Policies in European Societies B.Pfau-Effinger Tensions in Family Policies in Post-Communist Central Europe S.Saxonberg Nordic Child Care - a Response to Old and New Tensions? G.Eydal & T.Rostgaard Tensions Related to the Transition of Elderly Care from an Unpaid to a Paid Activity P.H.Jensen & R.Juul Moberg Under Tension: Formal Care Work with Older People T.Kroger Tensions Related to Care Migration - The South-North Divide of Long Term Care T.Rostgaard, C.Chiatti & G.Lamura Migrant Carers in Eldercare Provision: Interaction of Policy Fields H.Theobald Tensions Related to Cash for Care Schemes B.Da Roit & B.Le Bihan

Changing policies, changing patterns of care: Danish and Swedish home care at the crossroads

Despite pursuing the policy of ageing in place, the two Nordic countries of Denmark and Sweden have taken diverse roads in regard to the provision of formal, public tax-financed home care for older people. Whilst Sweden has cut down home care and targeted services for the most needy, Denmark has continued the generous provision of home care. This article focuses on the implication of such diverse policies for the provision and combination of formal and informal care resources for older people. Using data from Level of Living surveys (based on interviews with a total of 1,158 individuals aged 67–87 in need of practical help), the article investigates the consequences of the two policy approaches for older people of different needs and socio-economic backgrounds and evaluates how the development corresponds with ideals of universalism in the Nordic welfare model. Our findings show that in both countries tax-funded home care is used across social groups but targeting of resources at the most needy in Sweden creates other inequalities: Older people with shorter education are left with no one to resort to but the family, whilst those with higher education purchase help from market providers. Not only does this leave some older people more at risk, it also questions the degree of de-familialisation which is otherwise often proclaimed to be a main characteristic of the Nordic welfare model.

Quality reforms in Danish home care - balancing between standardisation and individualisation

Despite relatively generous coverage of the over-65 population, Danish home help services receive regular criticism in the media and public opinion polls. Perhaps as a consequence, reforms of Danish home care policy for senior citizens have placed a strong emphasis on quality since the 1990s. This reform strategy represents a shift from the welfare state modernisation programme of the 1980s, which built mainly on economic strategies of cost-efficiency and New Public Management principles, including contract management and performance management. Recent reforms have instead attempted to increase the overall quality of care by increasing the transparency at the political, administrative and user levels. However, reforms have revolved around the conflicting principles of standardisation and the individualisation of care provision. This approach has succeeded in increasing the political and administrative control over home help at the expense of the control by users, care workers and case managers.

Trends in parental leave in the Nordic countries: has the forward march of gender equality halted?

The aim of this article is to provide an overview of the development of parental leave in the Nordic countries in the last decade or so and explain the different approaches taken by individual countries in this regard. Focusing on recent developments, though mainly on the provision of a fathers quota, we discuss whether we are actually witnessing a paradigm shift in some of these countries, i.e. a movement away from an emphasis on the dual earner/dual carer model and a reverting back to a more traditional family model approach where the mother is seen as the main parent. This change is commonly presented under the guise of it respecting the ‘free choice’ of individual families. Furthermore, the article asks why the changes in question have taken place and examines the positions of different political parties towards the issue. The article shows that the Nordic countries are developing somewhat different policies and the intra-Nordic gap in both policies and politics seems to be increasing rather than narrowing.

Quality Reforms in Danish Home Care

Despite relatively generous coverage of the over-65 population, Danish home help services receive regular criticism in the media and public opinion polls. Perhaps as a consequence, reforms of Danish home care policy for senior citizens have placed a strong emphasis on quality since the 1990s. This reform strategy represents a shift from the welfare state modernisation programme of the 1980s, which built mainly on economic strategies of cost-efficiency and New Public Management principles, including contract management and performance management. Recent reforms have instead attempted to increase the overall quality of care by increasing the transparency at the political, administrative and user levels. However, reforms have revolved around the conflicting principles of standardisation and the individualisation of care provision. This approach has succeeded in increasing the political and administrative control over home help at the expense of the control by users, care workers and case managers.

Guest editorial: Reforming Home Care in Ageing Societies

In the context of ageing societies, the importance of home-based care is growing in all OECD countries. Home care is widely considered to be a financially sustainable way of supporting the independence and accommodating the preferences of older and disabled people; demand for home based care and support is likely to increase in the future. The number and share of the population aged 80+ will continue to grow in all developed countries and, despite the fact that disability prevalence rates have declined in some countries, greater longevity is likely to lead to an increasing number of people at older ages with severe disabilities and need for long-term care (Lafortune & Balestat 2007). With falling rates of institutional living, growing numbers will rely on home care services; this also means that home care services will have to adapt to coping with higher levels of disability among their users (Jacobzone et al. 1999). The cost of long-term care for people aged 65 and over is expected to rise from the current level of 1% of GDP across OECD countries to between 2% and 4% of GDP by 2050 (Oliveira Martins & De La Maisonneuve 2006). When people under 65 are included, public spending on health and long-term care could rise from the current average level of 6–7% of GDP to around 10% by 2050 (Oliveira Martins & De La Maisonneuve 2006). Societal changes add further pressures for new care solutions. These include increasing female labour market participation, postponement of the retirement age for the workforce in general, changing family forms and in, some countries, changes in attitudes as to who bears responsibility for providing care for older and disabled people. Most countries also face difficulties in attracting and retaining care workers to what is often perceived to be physically and mentally demanding work. Strategies to reduce demand for long-term care workers include the increasing use of information and communication technologies; improved co-ordination between the long-term care and health care sectors; promotion of healthy ageing policies and self-care; and redefining job tasks so that less qualified assistants can carry out simpler care tasks (Fujisawa & Columbo 2009). Some countries have sought to address a shortage of long-term care workers by employing migrant workers in the formal care sector, or by facilitating the private employment of migrant care workers in the home (Simonazzi 2009). Concerns have been raised about both the quality of such care and the working conditions of these carers (e.g. Doyle & Timonen 2010). Strategies to overcome shortages of care workers have in many countries been underpinned by the introduction of cash-for-care allowances, although these are often also intended to facilitate choice by users between different sources of care (Timonen et al. 2006, Burau et al. 2007). These strategies have further contributed to the marketization of care, accompanied by a growing trend towards ‘New Public Management’ (NPM) market inspired reforms. How various countries have responded to growing needs for home care, the challenges encountered in the course of reform and the relative success of different reform strategies are the focus of this special issue of Health and Social Care in the Community. The special issue documents the responses of nine European countries (Finland, Sweden, Norway, Denmark, Germany, Austria, Italy, England and Ireland) to the challenges of providing greater volumes and intensity of home-based care for older and disabled people. All but two of the papers are based on LIVINDHOME, a collaborative research project on reforms in European home care for older and disabled people which was jointly commissioned in January 2010 by the French Mission Recherche (MiRe) of the Direction de la Recherche, des etudes, de l’evaluation et des statistiques, Ministere de la Sante (DREES) and the National Solidarity Fund for Autonomy (CNSA – Caisse Nationale de Solidarite pour l’Autonomie). (More information on the study can be found at: http:/www.sfi.dk/LIVINDHOME). In this special issue, collaborators to the study have been joined by colleagues from the Netherlands and France, who have addressed the same research questions. We want to thank the Nordic Centre of Excellence REASSESS for financing the language editing of all the articles. The aim of the LIVINDHOME project was to identify and compare how European countries have reformed their home help systems in the search for (1) high quality care which meets increasingly diversified and individualized needs; (2) efficient and effective provision mechanisms that facilitate cost containment; (3) a stronger user-orientation in the provision of care; (4) an optimal balance between formal and informal sources of care;

Parental leave, childcare and gender equality in the Nordic countries

De nordiske lande anses ofte for at vaere foregangslande inden for ligestillingsomradet. Det er sandt at kvinder generelt har en staerkere position i de nordiske samfund end i resten af verden. Der e ...

Towards a Framework for Assessing Family Policies in the EU

This report presents the results of a first attempt to create a framework for assessing the performance of national family policies. The report is part of a joint EU and OECD project, which aims to help the EU Government Expert Group on Demographic Issues in evaluating national family policies. The idea behind the framework is that it allows individual countries to compare their overall performance in the area of family policies with the performance of other countries. The main focus of the report is policies for families with smaller children. The framework provides a set of cross-nationally comparable indicators on contexts, policy measures, and outcomes, organised on a systematic basis. The policy measure indicators presented in the report cover leave schemes, early childhood education and care, family benefits and workplace policies. The indicators build upon, inter alia, previous work by the OECD in various studies on family-friendly policies that were carried out on a cross-national basis using different sets of indicators. Most of these indicators are today available in the OECD Family Database. Wherever the OECD Family Database contains indicators for the majority of EU member states and OECD countries, these data have been used in the present study. Otherwise, data from other cross-national databases have been included. Each indicator in the framework is presented as a single-standing indicator in the general absence of scientific consensus on different aggregation weights. In the report no explicit ranking of countries has been attempted, instead the relative position of countries has been illustrated with the help of standard deviation scores. In the last part of the report the linkages between policy aims and the various context, outcome and policy measures are indicated, which help construct “score cards”. This “score card-approach” is illustrated for three countries: Denmark, Germany and the United Kingdom. The report offers tools for assessment that may be developed further, and should offer an approach to using the OECD Family Database, acknowledging this unique data source for cross-country comparisons in the field of family policy. Ce rapport presente les resultats d’une premiere tentative d’elaborer un cadre d’evaluation de la performance des politiques nationales en faveur des familles. Ce rapport fait partie d’un projet elabore conjointement par l’Union europeenne et l’OCDE, qui vise a aider le groupe d’experts gouvernementaux sur les sujets demographiques de l’UE pour evaluer les politiques nationales d’aides aux familles. L’idee sous-jacente est de permettre a chaque pays de comparer ses performances avec celles des autres pays. Les familles avec de jeunes enfants sont le principal sujet d’analyse de ce rapport. Le cadre elabore propose un ensemble d’indicateurs comparables entre pays sur les contextes, les mesures politiques et les resultats, organises sur une base systematique. Les indicateurs de mesures politiques couvrent les dispositifs de conge, d’aides a l’education et aux soins accordees a la petite enfance, les prestations financieres et les politiques liees au lieu de travail. Ces indicateurs ont ete elabores, inter alia, a partir des travaux anterieurs de l’OCDE sur les politiques favorables aux familles qui ont ete conduites de maniere comparative sur la base de differents ensembles d’indicateurs. La plupart de ces indicateurs sont aujourd’hui disponibles au sein de la base de donnees OCDE sur les Familles. Ces indicateurs ont ete inclus pour la majorite des pays de l’UE et de l’OCDE pour lesquels ils sont disponibles. Lorsqu’ils n’etaient pas disponibles, des donnees provenant de bases internationales ont ete prises en compte. Chaque indicateur est presente ici de facon separee, car il n’y a pas de consensus scientifique sur la ponderation qui permettrait de les agreger. Aucun classement explicite des pays n’a ete tente ici ; la position relative des pays est, au contraire, illustree au moyen de scores d’ecarts-types. Dans la derniere partie du rapport, les liens entre les objectifs politiques et les variables de contexte de resultats et de mesures politiques sont pris en compte pour elaborer des « cartes de score ». Cette approche par « cartes de scores » est illustree pour trois pays : le Danemark, l’Allemagne et le Royaume-Uni. Ce rapport offre des outils d’evaluation qui pourront etre encore developpes, et devrait offrir une approche de la maniere d’utiliser la base de donnees de l’OCDE sur les Familles, qui constitue une source de donnees incontournable pour faire des comparaisons internationales dans le champ des politiques familiales.

Failing Ageing? Risk Management in the Active Ageing Society

According to the European Commission’s recent policy initiative on social investment, Danish long-term care for older people offers new and innovative perspectives on ageing and the management of the risks associated therewith. Other EU member states are thus encouraged to “get to Denmark” and to develop their long-term care in accordance with the Danish approach. With the introduction of reablement policies (rehabilitering), Denmark has, according to the European Commission, identified a viable way to address some of the problems associated with the presumed increase in need for long-term care in ageing societies. The change from a so-called passive to a more “active” approach emphasizes an overall strategy of “repairing,” by offering short-term intensive physical training interventions instead of only compensatory care and assistance, as this should ideally enable the individual to postpone and reduce the need for care.