Marketisation in nordic eldercare

The Nordic countries share a tradition of universal, tax-financed eldercare services, centred on public provision. Yet Nordic eldercare has not escaped the influence of the global wave of marketisation in recent years. Market-inspired measures, such as competitive tendering and user choice models, have been introduced in all Nordic countries, and in some countries, there has been an increase of private, for-profit provision of care services.

This report, researched and written by Normacare members, is the first effort to comprehensively document the process of marketisation in Sweden, Finland, Denmark and Norway. Our hope is that the report will provide both a foundation and an inspiration for further research on change in Nordic eldercare.

Marta Szebehely
Marta Szebehely. Photo: Eva Dalin
The report seeks to answer the following questions: What kinds of market reforms have been carried out in Nordic eldercare systems? What is the extent of privately provided services? How is the quality of marketised eldercare monitored? What has the impact of marketisation been on users of eldercare, on care workers and on eldercare systems? Are marketisation trends similar in the four countries, or are there major differences between them? The report also includes analyses of aspects of marketisation in Canada and the United States, where there is a longer history of markets in care. These contributions offer some perhaps salutary warnings for the Nordic countries about the risks of increasing competition and private provision in eldercare.

Editors: Gabrielle Meagher and Marta Szebehely

Download a copy of the report from, or email email to purchase a printed copy (price 1OO SEK + moms; total 125 SEK; for delivery after 18 September 2013)

Chapter 1

Mapping marketisation: concepts and goals

Anneli Anttonen and Gabrielle Meagher

Chapter 2

Marketising trends in Swedish eldercare: competition, choice and calls for stricter regulation

Sara Erlandsson, Palle Storm, Anneli Stranz, Marta Szebehely and Gun-Britt Trydegård

Chapter 3

Marketisation of eldercare in Finland: legal frames, outsourcing practices and the rapid growth of for-profit services

Olli Karsio and Anneli Anttonen

Chapter 4

Marketisation in eldercare in Denmark: free choice and the quest for quality and efficiency

Tilde Marie Bertelsen and Tine Rostgaard

Chapter 5

Marketisation in Norwegian eldercare: preconditions, trends and resistance

Mia Vabø, Karen Christensen, Frode Fadnes Jacobsen and Håkon Dalby Trætteberg

Chapter 6

The regulatory trap: Reflections on the vicious cycle of

regulation in Canadian residential care

Albert Banerjee

Chapter 7

Regulating care: lessons from Canada

Pat Armstrong

Chapter 8

Understanding the relationship of nursing home ownership and quality in the United States

Charlene Harrington

Chapter 9

Four Nordic countries – four responses to the international trend of marketisation

Marta Szebehely and Gabrielle Meagher