Freedom of choice instead of equality – Changed objectives for Swedish policy for care for older people?

The development of care choice systems in Swedish eldercare represents a further step in the move towards a marketized welfare. This article discusses, through theories of social citizenship and universalism, whether the goal of the Social Services Act – that social services should promote equality in living conditions – may come in conflict with the care choice system in the care for older people. Care choice systems have existed in a few municipalities since the early 1990s, but have become more common over the past decade. Today, half of the home-help recipients in Sweden live in municipalities with a care choice system. The development has taken a leap through the law on care choice systems (Act 2008:962), which was introduced in 2009. There is an ambition to make care choice systems mandatory for the municipalities, which was expressed through the government investigation Framtidens valfrihetssystem

(Care choice systems in the future), presented in January 2014. The policy provision which gives the social services responsibility to promote social equality has not changed since the older version of the act was introduced in 1980. Yet, it is clear that the significance and importance of this objective has changed, at least in relation to eldercare. Instead, freedom of choice has become a central objective, which is made obvious through the governmental report which proposes making care choice systems in assisted living for older people mandatory for the municipalities. Freedom of choice and equality are values that in certain ways come in conflict, and are in turn connected to other dichotomies: selectivism instead of universalism; private rather than public responsibility for care and individual rather than structural explanatory models. The introduction of care choice systems in the care of older people points to a shift towards the latter stage in the division.