sou · GOB383 · 2001-01-01 00:00:00 — Again, due to these problems of comparability national descriptions follow. In the drop in home help services was most pronounced between 1991 and 1994, but the trend continued thereafter, albeit at a much slower pace (Figure 19). In percentage terms, in 1990 21 percent of the population over 65 years of age received home help services, but by 1997 the share was down to 11 percent. Only for the oldest age group was there a slight increase in the number of home help recipients. Thus while the number of personnel stabilised, and then 68 Adaptation in social policy increased towards the latter part of the period, the number of persons receiving home help services decreased. This apparently odd situation is explained by a change in the content of home help services, which became more and more targeted at the households with the oldest and most frail elderly. While the number of households receiving home help decreased by 28 percent between 1989 and 1993, the number of visits increased by 22 percent (Lehto 1995). This targeting of the frailest elderly has also meant that time spent per client has increased (Vaarama and Noro 1997). In contrast, those deemed to have less severe needs have been left without home help services. Moreover, there has been an even more dramatic reduction in auxiliary services. In 1990 200 000 people over 65 years of age received auxiliary services, while in 1997 the number was down to almost half (103 000). Furthermore, for these services too, user fees have risen heavily. Home help services for elderly households in Source: Stakes statistics. Home help services as a support service have also been reduced in , and in a very similar (Figure 20). Between 1990 and 1997 the number of recipients of home help and home nursing decreased by 36 000 (from 182 000 to 146 000) (Szebehely 2000), and underlying this trend lies a targeting of services at the older elderly (see also SOU 2000:3: 170–172). In both countries the development in the 1990s in home help services has resulted in a situation where less receive more. The difference between and is that in the reductions started already in the 1980s, while in they have clearly been a phenomenon of the 1990s, and much more severe. Adaptation in social policy 69 Home help services for elderly persons in –97, percent of age group % of age group Source: SOU 2000:3, figure 2.2:21. Balance sheet of adaptation in elderly care services Summing up the development in elderly care services, it seems both countries have followed a relatively similar path. At times of economic problems elderly care services have been unable to respond to the growing numbers of elderly with an increase in service provision. The amount of institutional care has declined somewhat when we take into account the development in the number of older elderly. Deinstitu- tionalisation seems to have taken the form of leaving those already in institutions to continue living there, while being reluctant to take in more. Instead of institutional care we see growth in service housing, along with a reduction in services promoting living at home. There has been a major reduction in absolute numbers of clients of home help services. Targeting of home help services could perhaps be interpreted as a result of efforts to prevent institutionalisation. While home help services may have been able to promote independent living at home for the frail elderly, the consequence of this targeting at a time of no or minor growth in resources has been that a number of elderly deemed to have less need for care have been left without services. Although care needs are hard to measure, it is difficult to imagine that the care needs of the elderly have diminished along with the disappearance of home help services. It is more likely that the care needs of a growing number of elderly are more often answered by relatives, or by voluntary organi- sations and private market solutions. 70 Adaptation in social policy Contrasting this picture with the ideal type of Nordic public service state or caring state reveals that the reality does not match the idealised picture very well. First, during the early 1990s there was a shift from the public service state towards the transfer state, at least if we measure the balance between cash and care by expenditures. In both countries the share of services declined between 1990 and 1993 as expenditure on pensions and other income transfers continued to increase while the local authorities were considering savings in social care services for the elderly. Towards the latter part of the period under investigation here, expenditure on services increased faster than expenditure on cash benefits, and the balance moved toward the public service state again. This return was more marked in . Assessing the development from the perspective of caring, home help is the indicator which should receive most attention. Home help has traditionally been the form of service distinguishing the Nordic countries from the rest of Europe, but with the radical reductions in absolute number of services and consequent push for more family- or market-based care, and seem to have moved further away from an idealised caring state. Evidence that granting of services may depend on the proximity of relatives and the sex of the caregiver (see Szebehely 1998, 2000) suggests that the idealised picture of individual rights to services should probably be scrutinised more closely. Furthermore, heavy increases in user fees may lead to a change in the clientele and challenge the principle of rights (see e.g. Lehto 1998). For those with the lowest incomes even symbolic user fees may in practice mean a steep threshold for access to services. Those with high income may in turn be inclined to look for private care as an alternative, especially if there is a belief that the quality of services has also decreased. Altogether, the changes that took place during the decade suggest that the Nordic model of elderly care services has been eroded on several fronts, in both countries. 4.5Case 3: Adaptation in child day-care services In many broad comparisons services are often analysed in an aggregate way, which loses the different character of services for young children as compared to older people. While with elderly care services one should keep an eye on developments in the health sector, an analysis of child care services should be linked more to the education sector and to employment. The provision of child care services can be understood as Adaptation in social policy 71 a means of facilitating both parents to participate in the labour market. Childcare services have also been supported as a means for the sociali- sation and education of children. In recent years pedagogic aspects have received more emphasis. In an administrative shift of responsibility for day-care from the social sector to the education sector took place in 1996, and this has also been discussed in , although no reforms have been undertaken. Ideas about the role of family for children and about womens position have also influenced the way child care services are provided in the Nordic countries. Institutional and ideological differences have resulted in different choices when it comes to how childcare is arranged. In there are three main forms of support for children (and their parents) under school age.12 After the parental benefit period (44 weeks) ends there are then two options for arranging child care: public child day care or supported home care. Home care is supported by means of a home care allowance: a cash benefit is payable to parents after the parental benefit finishes and before the child reaches the age of three, on the condition the child is not using public day care. In the parental benefit period lasts a longer (64 weeks). Another important difference is that there is no home care allowance system (vårdnadsbidrag) in Sweden.13 While all countries have many different measures to support families with children, in accordance with their public service state image the Nordic countries have differed from other welfare states in the extent of public day care provision. But close inspection of levels and trends across the Nordic countries reveals marked disparities. and have had far more day-care places than and . The difference is most visible in places for children between 7–10 years. For instance, Nososco figures for 1997 reveal that while 47 percent (or 223 000) of children between 7 and 10 years attended childcare after school hours in , only 4 percent (or 10 000) had the opportunity in (Nososco 1999). As childcare for those above 6 years in is practically non-existent, we here concentrate on comparing childcare for those under school-age.14 As 12Child benefits apply to all children, not only those under school-age. 13Such a system was introduced in 1994 during government, and abolished when the Social Democrats returned to power in 1995. 14Basically this means the age group between 1 and 6 years, although there are some differences between the countries in the age day care arrangements start and end. 72 Adaptation in social policy with elderly care, the development in public child day-care is examined first in terms of resource development and then in terms of coverage.15 Figure 21 shows the development of resources in both countries (with the data limitations described earlier). Although the trends for are missing for the 1990–92 period, information from other sources confirms that in both countries expenditure on childcare first decreased and then increased. Szebehely (1998) reports for that childcare expenditure over the 1990–1997 period remained , with a slow decrease at the beginning of the decade followed by a gentle increase in the following years. As was the case with elderly care, relative growth since 1994 has been faster in . Yet the different starting levels should again be remembered. Development of expenditures on child day-care in and –97, 1993=100 Source: Calculations based on STM 1998:15 and 1999 Esspros figures. Looking at the period overall, expenditure on public childcare in has increased faster than other expenditures related to children under school-age. The trends for provide some insight into developments during and after the economic crisis years. Between 1991 and 1994 childcare expenditures decreased somewhat, partly as a 15 As with elderly care, issues related to quality of care, regional differences and user fees would undoubtedly be important for a thorough assessment over the period. However, as there are no comparable data, and not even much national data on these issues, the subjects are not covered here. Adaptation in social policy 73 result of the reduced demand for services. Since the economic upswing expenditures have risen, reflecting a rebound in demand. The recession years saw a rise in the number of parental benefit recipients, the increase being especially rapid for fathers (from 27 000 in 1990 to 43 000 in 1992). Expenditures also rose for home care allowances, as the number of recipients increased from 81 000 in 1990 to 95 000 in 1993. After 1993 there followed a decline in the number of transfer recipients. Some have regarded child-related transfers during the recession years as a reflection of problems in the labour market, in the sense that having children may have been some sort of alternative to unemployment. In however (Hoem 2000) states that declining numbers of women had children during the 1990s. She sees fertility development as having been very much related to resources and labour market development. The fact that – unlike – fertility rates did not fall in during and after the recession years could partly be an outcome of the different social policy systems and suggests that there is not necessarily a direct relationship between declining economic resources and fertility. Figure 22 shows the development in personnel in both countries. Again, the data are not comparable as the Swedish data for childcare employees comes from labour force surveys and no full-day, full-year etc. adjustments have been done. The Finnish data comes from Stakes statistics. If no changes in reporting practice have occurred, the trends can be compared. According to the figure, the trends in personnel development are very different. The trend in follows the expenditure trend: an increase between 1990–91, a decrease between 1991–94, and an increase since. The number of employees has not fallen below the 1990 figure, despite the reductions between 1991 and 1994. For the trends in employment are very stable until 1996, but according to figures employment decreased somewhat after 1996. 74 Adaptation in social policy Personnel in child day care in and – 98, 1990=100 Source: Stakes statistics, , own calculations. To make an assessment of public childcare coverage, information about public childcare places and family day care has been united here. Historically, the coverage of day care (measured as the percentage share of children attending childcare of all children) has always been lower in , and this is still true according to the latest national statistics (Figure 23). In 1997, 49 percent of children aged 0–6 years attended public child day care in (Stakes 1999). In the 0 – 3 years group the share of children in public day care was very small, 18 percent in 1995, compared to 55 percent for the 3–6 years group (and Muuri 1997). In 1997 the coverage of public day-care in for the age group 1–6 years was 73 percent (Statistics ). As in , the percentage shares were higher for the group aged 3–6 years (78 percent in 1997) than for the 1–2-years-olds (59 percent respectively). When it comes to trends, there are both differences and similarities. In 57 percent of children between 1 and 6 years were in public day-care in 1990 and the percentage share has since grown continuously to reach 73 percent. A breakdown of the age groups shows that for those aged 3–6 years an increase from 64 percent in 1990 to 78 percent in 1997 took place, while for the age group 1–2 years an expansion from 44 percent to 59 percent occurred. In there were no increases in the younger age group: 33 percent of the 1– 2-year-olds attended day-care in 1990 and 31 percent in 1996, while for the age group 3–6 years there was a small increase in coverage (from 55 percent in 1990 to 61 percent in 1996), but still not comparable to that in (SVT 1998:1, table 53). For the entire age group below Adaptation in social policy 75 7 years, the coverage grew from 35.7 percent in 1990 to 41.1 percent in 1998. Share of children under seven years of age in day care in and –98, percent of age group. Sources: SCB and Stakes Statistics. In there has thus been a stronger trend of fewer parents staying at home and the number of children in public day-care increasing. According to Szebehely (1998) the pattern to emerge is of increasing numbers of children in public day-care centres (kindergartens) and decreasing numbers in family day care (a childminder taking care of a small group of children in his/her own home). At the same time the use of private care solutions has increased in , from 16 000 children in private care in 1990 to 58 000 in 1998. Thus the share of private day-care places has increased from 4 percent in 1990 to 12 percent in 1998 (SOU 2000:3:119). In the decline in the numbers of children in public day-care in the early 1990s is almost totally accounted for by a reduction in family day-care (a loss of 28 300 places between 1990 and 1993 compared to an increase of 2 200 places in day-care centres) (SVT 1998:1, Table 53). A breakdown of coverage rates for the age groups 1–2 years and 3–6 years reveals that the decrease primarily occurred in the care arrangements for the youngest age group. Thanks to a change in legislation that since 1996 has guaranteed childcare for those below school age, and a downturn in unemployment that has revived the demand for childcare, the number of children in family day-care has again been rising, along with an expansion of places in day-care centres. Private day-care has remained marginal, although some 76 Adaptation in social policy increase can be detected, especially recently. In 1997 3.6 percent of children under school-age were in private day-care (1999).16 Balance sheet on adaptation in child day-care services Summing up the development in childcare services, in both countries we find a relatively similar pattern regarding expenditures: a decrease followed by an increase. Unlike , the expenditure decrease in was accompanied by a reduction in personnel, although with a time lag. The rising numbers of children attending day-care in resulted in less expenditure and fewer employees per child (SOU 2000:3: 116).17 The employees per child – and expenditure per child -ratios developed more favourably in because there was a reduction in the number of children needing care, and less reduction in employee numbers. In addition to reduced expenditure, there have been increases in user fees in both countries. User fees have played a role in improving municipal finances and decreasing demand. In user fees increased from 11 percent of total expenditure in 1990 to 15 percent in 1995; in the increase was from 10 percent in 1990 to 14 percent in 1995 (Lehto et al. Despite increases in user fees and modest expenditure development, both countries have experienced a trend of increasing childcare provision. This has occurred via an increase in both public day-care places and private places. Child day-care coverage rates continue to be much higher in . One explanation for the disparity in levels and the differing trends during the decade, at least for the youngest age group, is undoubtedly that the Finnish home care allowance system makes it possible not to be reliant on public child care.18 In 1997, of the age group under 3 years 24 percent were in day-care, while 29 percent were being cared for with the support of parental benefits and 41 percent by home care allowance (Stakes statistics; Affairs). 16 Unfortunately no reliable long time series exist on the development of private care. 17For many this is a sign of decreasing quality, although group sizes do not necessarily correspond with quality. 18In 1993 the recipient statistics show there were 96 000 families with 160 000 children receiving home care allowance. Adaptation in social policy 77 Conclusion on elderly care and child day-care service adjustments In the light of the expenditure developments, it seems that elderly care and child day care services did not experience cutbacks as severe as could have been imagined in the light of the problems in public finances. Surprisingly, expenditures for seem to have devel- oped more favourably than for . It is surely the case in both countries that at least the employees have been under more pressure (unemployment and worse working conditions, increased need for services), while service users have felt the savings measures in their purse as higher user fees. In terms of coverage of services the development patterns in elderly care and child day-care are divergent. While elderly care has seen a remarkable decline in the coverage of home help services, child day- care has enjoyed an increase in public service provision. In elderly care services the reductions in institutional care, and especially in home help, have probably contributed to more care being provided by relatives, markets and voluntary organisations. In child day-care the trend is towards increased public care in day care centres, although some expansion in the private sector has taken place, too, especially in . In terms of Nordic characteristics it could be concluded that elderly care services in both countries have retreated from the Nordic ideal, whereas in child day-care and have become even more Nordic in nature. In many respects the trends for appear more positive during the latter part of the period under investigation. This, however, may only be an illusion created by the remarkably lower absolute levels at the beginning of the period and faster growth at the end, both in expen- ditures and coverage. And even with relatively faster growth, considerable differences in service provision between the countries persist. Regarding coverage trends, for elderly care services it seems the differences have diminished, while for child day-care differences in coverage have increased. 4.6Case 4: Adaptation in labour market policies labour market policies have various goals that meet at the inter- face of stabilisation policies, policy reaction to growing unemploy- ment, and goals of social redistribution. In international comparisons the Nordic countries, especially , have been used as a point of reference when it comes to the scope and status of labour market 78 Adaptation in social policy Labour market policies in have played a central role in economic policy since the early 1900s, and labour market policies (almp) started to play an important role after the 1940s when the so-called Rehn-Meidner model was developed (e.g. 2000). In addition to the obvious goals related to the functioning of the labour market, labour market policies have always had both macro- economic and social aims. Almp can be used as a form of stabilisation policy: in times of economic up-swing they aim to better serve the demand for labour, and during downswings they aim to fight unemployment. Almp also serve a redistribution goal, as they aim to improve the position of the weakest part of the labour force. has historically followed the example of when it comes to overall policy formulation and goals, but its volume of labour market policy measures has never reached the high levels of . This could be taken to signal that in the hierarchy of policies in almp have yet to achieve their status in Sweden.19 It is very interesting to see whether and showed some continuity during this exceptional period; but there is an additional concern. As Drøpping et al. (1999) have pointed out, to invest in almp is, at least in the short run, quite costly for the govern- ment. The fate of almp in a context where a deliberate policy goal has been to balance public budgets is therefore interesting. The scope of almp can be measured in different ways. The makes international comparisons possible, and Employment Outlooks contain figures based on definitions (see Drøpping et al. 1999 for a discussion of the definition of and passive measures and different ways to measure the degree of activation). practice mostly involves expenditure comparisons. collects statistics on the volume of almp and defines an activation rate in relation to the number of registered unemployed people. A problem for comparisons is that countries have a somewhat differing practice of defining registered unemployed. Here we assess the development with the help of national statistics on almp. The interest is on the volume of almp, measured in terms of participation to different almp measures during a year. To be able to compare development in the two countries the number of persons in the labour force is used as denominator, instead of the number of unemployed. The obtained ratios of almp participants to the labour force provide a clue about the differences between the countries, although it is naturally not possible to capture differences in lengths of activation measures, possibilities to switch from one measure to another etc. 19 This is of course not to say almp have been unimportant in . Adaptation in social policy 79 Compared to the situation of full employment in 1990, not only the level of unemployment but also its structure have changed. Almp have needed to react to differing circumstances not only by an increase in volume but also by a differentiation in policy measures.