A number of leading welfare researchers contribute to the research anthology Konkurrensens konsekvenser – vad händer med svenskt välfärd? (The Consequences of Competition. What is happening to Swedish Welfare?) (SNS Förlag). At the request of SNS, they have made an inventory of available research and statistics about the effects of competition in the production of welfare services. The study covers all major welfare areas: preschool, school, individual and family care, health and medical care, labour market policy and care of the elderly and disabled.
A large knowledge gap
The most important conclusion of the study is that there is a remarkable lack of knowledge of the effects of competition in the Swedish welfare sector. On basis of existing research, it is not possible to find any proof that the reform of the public sector has entailed the large quality and efficiency gains that were desired.
Principles for reforming the market for welfare services
In the final chapter of the anthology, Laura Hartman points out a number of principles that should serve as a guideline for continued reforms of the market for welfare services:
FOLLOW-UP AND EVALUATION are totally decisive for providing politicians and citizens with those decision data that are required to obtain a well-working model. Politicians need to know what models that work best and the citizens need information about quality in order to make well-founded decisions. Better ways of collecting statistics and investments in open quality comparisons should be given high priority. When introducing new rules, an experimental design should be considered, for example through regional limitations, with the aim of making it possible to evaluate the reforms.
THE CORRECT BALANCE IN THE DEGREE OF REGULATION. There might be a need for regulation in order to make the market work better. For example, the segregating effects of the free school choice could be limited by forbidding so-called friskolor (free private schools) to use queuing time as a selection instrument. But the regulations must not be too extensive either – this would create a risk of limiting the innovative power.
BETTER SURVEILLANCE AND CONTROL. The government and the municipalities have a large responsibility for ensuring that non-serious agents are removed from the market as quickly as possible.
The next step
SNS will now proceed with in-depth studies within the framework of the research programme From welfare state to welfare society. The objective is to contribute with research-based suggestions for how the Swedish system for the production of welfare services can be improved. The in-depth studies will target two areas:
Control and quality control of welfare services
The application of market reforms in practice