Article i 'Tidsskrift for arbejdsliv' 1 2006, page 96-110.
Economic Paradigms and Health Care in Sweden
The starting-point for the article is the transformation of the Swedish public sector over the last decades and in particular the changes for employees in health care due to privatization, unbundling and decentralization of labour relations. The article argues that the public sector in Sweden is on the one hand highly influenced by a neo-classical economic paradigm and an international management discourse. Yet, on the other, due to its historical roots (i.e. path dependency), social partnership and collective bargaining has to a large extent survived the ideological challenges. Some major changes have however taken place within the frames of the collective bargaining system and one of the most important ones is the growing difficulty for groups of employees in the public sector to keep up with the wage development in private-owned firms. This is, the article argues, very much a result of the neo-classical dominance in the view of services in general and health care in particular; this view states that services are best managed in the same way and according to the same principles as a company in manufacturing is run. The challenges to the health care sector was met by two large strikes, one in 1995 by skilled nurses and another by employees in health care with less formal skills and education in 2003. The latter was a part of a campaign by the Municipal Workers' Union and thus complemented by strikes by several other groups of blue-collar workers in Swedish municipalities. The outcome however differed a lot. The high-skilled nurses of the first strike stressed formal competence and individual qualifications as a reason for higher salaries, which has led to a strong increase. Yet, the participant of the second strike did not have the same possibility to stress any formal competence and were thus never able to break down the employers’