Sc h o o l o f P u b lic A d m in is tr at io n W o rk in g P ap er s Se ri es 2014:27 Stig Montin Between hierarchy, market and networks The case of public utility and care for the elderly in Sweden Contributions published in SPA Working Paper Series are scientific reports produced by researchers at the School of Public Administration, University of Gothenburg. Working papers as well as finished reports are included in the series. Paper could be published in Swedish or in English. A member of the Editorial board must approve the publication of each paper. Editorial board: Gregg Bucken-Knapp Henry Bäck Vicki Johansson David Karlsson Gustaf Kastberg Lena Lindgren Stig Montin Östen Ohlsson Björn Rombach Osvaldo Salas Iwona Sobis Rolf Solli Patrik Zapata Editor: David Karlsson E-mail: david.karlsson@spa.gu.se School of Public Administration, University of Gothenburg P.O. Box 712 SE 405 30 Gothenburg Sweden Papers from the SPA Working Paper Series can be downloaded from the Internet: www.spa.gu.se (publications) School of Public Administration Working Paper Series 2014:27 Between hierarchy, market and networks. The case of public utility and care for the elderly in Sweden © Stig Montin (2014) ISSN 1651-5242 School of Public Administration Working Paper Series: Published Papers 2014:27 Stig Montin: Between hierarchy, market and networks. The case of public utility and care for the elderly in 2014:26 Patrik Zapata & María José Zapata Campos: Unexpected translations in urban policy mobility. The case of the Acahualinca Development Programme in Managua, Nicaragua 2014:25 Eva Álvarez de Andrés, Patrik Zapata & María José Zapata Campos: Stop the evictions! The diffusion of networked social movements and the emergence of a new hybrid space: The case of the Spanish Mortgage Victims Group 2014:24 Patrik Zapata & María José Zapata Campos: The travel of global ideas of waste management. The case of Managua and its informal settlements 2013:23 María José Zapata Campos & Patrik Zapata: Switching Managua on! Connecting informal settlements to the formal city through household solid waste collection 2013:22 Hervé Corvellec, María José Zapata Campos & Patrik Zapata: Infrastructures, Lock- in, and Sustainable Urban Development – The Case of Waste Incineration in the Göteborg Metropolitan Areas 2012:21 David Karlsson & Ylva Norén Bretzer: Swedish Regional Reform and the Political Map: Party Interests at Stake 2012:20 Osvaldo Salas: Har kvasimarknaden fungerat som den skall i särskilt boende? 2011:19 David Karlsson: Gåtan Fagersta. Om partier som har större framgång i kommunalvalet än i riksdagvalet 2011:18 Evio Accinelli, Edgar J. S. Carrera & Osvaldo Salas: Labor force decision to migrate 2007:17 Johan Berlin & Erik Carlström: From Artefact to Effect - The Organising Effect of Artefacts On Teams 2007:16 Tobias Johansson & Sven Siverbo: Rational, Political and Cultural Explanations to the Utilization of Relative Performance Evaluation in Swedish Local Government 2006:15 Lena Andersson-Felé: Time to Revive Luther Gulick. On Span of Control and Organisation Quality 2006:14 Björn Brorström & Viveka Nilsson: Does Organization Matter? A Study of Physicians’ ideal organization 2006:13 Patrik Zapata Johansson: Legitimacy Lost and Back to Normality. Scandals in the Public Sector - The Swedish Case 2005:12 Staffan Johansson, Mikael Löfström & Östen Ohlsson: Separation or Integration. A Dilemma when Organizing Development Projects 2005:11 Tobias Johansson: Contractual Choice and Performance in Municipal Service Delivery. The Case of Swedish Elderly Care 2005:10 Sven Siverbo & Gustaf Kastberg: Activity based financing of health care. Experiences from Sweden 2005:9 Christian Jensen, Staffan Johansson & Mikael Löfström: The interactive project. A model for analyzing environmental uncertainty 2004:8 Henry Bäck: The complementarity of urban leadership and community involvement 2004:7 Henry Bäck: Communication, cohesion and coordination. Metropolitan regions in Sweden 2003:6 Henry Bäck: Partified City. Elite political culture in Sweden’s biggest cities. 2003:5 Sven Siverbo: Purchaser provider split in principle and practice 2002:4 Björn Brorström & Sven Siverbo: Successful Change? Explaining the Development in Five Municipalities 2002:3 Björn Brorström, Bo Hallin & Gustaf Kastberg: Significance of Control Models. Intentional and Unintentional Effects 2002:2 Henry Bäck: Fragmentation and consolidation in the big city: Neighbourhood decentralisation in six Scandinavian cities 2002:1 Björn Rombach & Rolf Solli: Learning Leadership. The Cinema as University Foreword This report is writt en withi n a n Acti on network ca ll ed Loc al Publi c Service Reforms: An Inte rnati onal Compariso n (Lo cR ef), which is part of COST ( European Coo perati on in Science and Technolo g y ), which in turn is a long term inte rnati onal network fund ed by EU FP7. The LocR ef netwo rk started i n 2013 and consi sts of more than 100 resea rche rs from close to 30 countries. The netwo rk is coordinated b y a Mana gement Comm it tee, which is headed b y Prof. Dr Sabine Kuhlm a nn (C hair), Universit y of Potsd am and Ge ert Bou cka ert (Vice - C hai r), Universit y of Leuven (http: // www.uni - potsd am.de/ls - kuhlm ann/cost/ cost.ht ml ) . The rese ar ch or ganised i n four Working Groups with specific res ear ch pu rpose, but the resea rch is guided b y t hr ee over all questi ons: (A) W hat insti tuti onal changes can be inv esti gated an d what is the ex planati on of (var yin g) reform d e gre es form a compa rati ve pe rs pecti ve? (B) W hat are the drive rs/caus es of reform acti vit ies, who are the promoters/s tak eholders and what imp lementation strate gies do the y foll ow ? (C) How can the (intended and un - int ended ) reform effects be evaluat ed? More specifi call y, thi s report is a countr y repo rt wit hin Work Group I, whic h deals with issues related to “External (Post - ) NPM”. The WG focuses on NPM - driven ex ternali z ati ons of local servic es to private or non - profit provide rs (co ntracti ng - out, functi onal/ asset privatiz ati on, corporati z ati on, competit ive tendering). It also assesses the more re cent Post - NPM reforms that are tar get ed towards re - muni cip ali z ati on and re - int e grati on of previous l y ex ternali z ed local functi ons . 1 Between hierarchy͕ ŵarket and networks The case of public utility and care for the elderly in Sweden Stig Montin1 1. Introduction: The local government system in Sweden The aim of thi s countr y report is to provide an overall view of chan ges i n the regulation and mana gement of the “hard” and “soft” service sectors in Swedish municipalities in recent decad es. Hard servic es are tr adit ional publi c uti li ti es and soft services are const it uted b y elderc are. A des criptio n of the local governm ent s ystem and a short hist orical back ground ar e provided by wa y of int roducti on, together with a definiti on of concepts used. A sep arat e descriptio n of the develo pment of publi c uti li ti es and elde rc are is subsequ entl y provided, and finall y a numb er of concl usion s are drawn. The term “local government” (kommun ) include s muni cipalit ies and cou nt y council s, whic h overlap but which hav e diff erent ar eas of responsi bil it y. Muni cip ali ti es are thus not subordinated to count y council s. Whil e muni cipali ti es are responsi ble for a wide ran ge of acti vit ies, the prin cipal responsi bil it y of count y council s is prim ar y healt h ca re and hospi ta l care (about 90% of the bud get). In fou r cas es (Vä stra Götaland, Skån e, Hall and and Gotland), the count y coun cil s are call ed regional council s. The diffe renc e betw een th e regional council s and the oth er count y co uncil s is that the forme r have mor e wid e - r an ging responsi bil it ies. In 1 Stig Mo n tin i s P ro fesso r in Pub lic Ad mi ni str atio n at Sc ho o l of Pub lic Ad mi nistr atio n, Un iver sit y of Go thenb ur g. (sti g. mo nti n @g u . se) 2 a ddit ion to primar y he alt h care and hospi tal care, the y are responsi ble for regiona l developm ent and infr astr ucture plannin g. Loc al self - government in Sweden is mainl y defin ed throu gh a “general powers” clause in the Loc al Governm ent Act (LG A, 1991:900): m unicipali ti es and count y council s must themselves attend to matters of general concern which are related to the municipality’s or county council’s area, or with their members and which are not to be the sole responsibility of the state, another muni c ipalit y, another count y council or some other bo d y. (LG A, Ch. 2, Secti on 1). There has alwa ys be en a strong principle of local self - government in Swe den and it is given further emphasis in the const it uti on. However, whil st local self - governme nt is a principle, i t has never been cle arl y defined. It is basicall y dele gat ed state - powe r . What local self - gove rnment actuall y m e ans at a specific hist orical mom ent is a negoti ated order, mainl y between th e poli ti cal pa r ti es and betw een centr al gove rnment and the Swe dish As sociati on of Loc al Authorit ies and Regions (SA LAR). Vi ewe d over time, the major tendenc y is towards decentr ali sati on, howev e r, occ asionall y and withi n specific poli c y areas, central gove rnment control has sim ult aneous l y incr eas ed. Ove r a per iod of seve ral ye ars a certain pr acti ce has developed, which has recentl y been const it uti onali sed. Accordin gl y, in the revised const it uti on of 2010, a chapter has been add ed wit h six articles concernin g loc al authorit ies, including both s elf - gove r nment and restrictions o n it (Instrument of Gov e rnment, Ch. 14). In addit ion to the principles stated in the const it uti on, the Planning and Buil ding Act states that “planning the use of land and water areas is a matter for the municipality” (The Planning and Buil ding Act, Law 198 7:10), which is generally referred to as “planning monopoly”. On the other hand, it stat es that detail ed rules con cernin g responsi bil it ies are laid down in law, that “local authorities may be obliged to contribute to costs incurred by other local authoriti es if necessary to achieve an equal financial base” (a system of financial equalisation), and more generally that “regulations regarding grounds for change in the division of the realm into local authorities are laid down in law” (Instrument of Government, Ch. 14). 3 2. A broad historical background Ex pressed differentl y, the Swedish s ystem is charact erised b y a stron g central state and a system of stron g local go vernment. First, it has ro ots related to the principle of the Rechtstaat and the int roducti on of civ il and poli ti cal rights. The principle of the Rechtstaat holds that three dema nds have to be fulfil led. First, cit iz ens must enjo y a numbe r of fundam ental freedoms and ri ghts. Second, even the highest authorit y is bound by t he rule of law. In Sweden thi s i s articulated in the Instrument of Government by the statement “public authority is exercised under the rule of law”. Third, publi c power has to be or ganise d accordin g to th e principle of divi sion of power (M att son & Peterss on, 2004). Second, man y hist ori ans claim that Swedish democrac y has its roots in how ever yda y m att ers were dealt with in the co untr yside. Ho weve r, loca l governm ent had no impact on the inst it uti onali sation of the Swedish form of govern ment (Strandber g 2004: 188). The role of local gov er nment be cam e far mor e important duri ng the developm ent of th e welfa re state, especiall y post - W W II. Developm ent of th e welf are stat e mainl y started i n the 1930s, and has bee n described in term s of “rationalistic planning”, “the era of the great programmes”, ”the strong state”, ”the corporative state” and ”to put life in order”. The political ambition was to construct a good societ y on the basis of enli ghtenment, sci e nce, and democ rac y (Hermansson 2003). Throughout the 20 t h cen tur y inst it uti onal capa cit y was incre ased in ord e r to solve societal problems. In gener al, reforms have bee n frame d and implemented withi n what has bee n regard ed as a repr esentat ive chain of comm and charact erised b y a repr ese ntative democra c y based on poli ti cal parties, and a publi c adm ini strati on based on the rule of law and effe cti veness. In reali t y, the frami ng and implementation of welf ar e reforms has be en influenced by interest organisations, mainly regarded as “representatives of society”. Hence, thi s form of corpor ati sm has gener a ll y not b een re ga rded as a democ rati c problem. The ex pansion of welf ar e state se rvices in Swed e n can be reconceptu ali se d as the ex pansion of muni cipal welfar e (Li dström 2011). Since the 1950s, local autho rities (muni cipalit ies and count y council s) have be en more or less regarded as the most important i nsti tut ions when it comes to implementi ng social and educ ati onal poli cies. This does not mean that the autonom y of local government th roughout thi s period has been as stron g as it is now. Several decentr ali sati on reforms have made th e muni cipalit ies more a utonom ous. 4 Two boundar y reforms have been implemented since the 1950s (1952 and 1974). The numb e r of muni cipalit ies was re duced from about 2,500 in 1951 to 278 in 1974. Since the 1980s a number of muni cipalit ies have been partiti oned int o two or more unit s with the result that in 2014 there are 290 muni c ipalit ies. The growth of local auth orit ies as welf ar e inst it uti ons can be measur ed in a number of wa ys. At its height durin g the 1960s and 1970s, the an nual growth in volum e was around seven t o nine per ce nt. Wit h an in dex of 100 in 197 0, state consum pti on rose to abo ut 120 in 1980 an d 130 in 1991 (and has decli ned since then) and muni cipal consum pti on rose to 145 in 1980 and 180 in 1991. 1992 was the first ye a r in modern times when the volum e decli ned. Tod a y, muni cipal and count y co uncil ex pendit ure ac cou nts for about 25 per cen t of GDP , a figu re which has rem ained rou ghl y the same sin ce 1980. Mainl y as a response to t he amal gamation reform s of the 1960s and 1970s and the growth in resourc es, a period of de centralisation measures was instituted, with the experiment of “free municipalities” during the 1980s and subsequently giving municipalities the freedom to organise poli ti cal and admi nist rati ve functi ons (which was laid down in the new local gove rnment act in 199 1), dec entrali sati on of responsi bil it y for prim a r y and s econd ar y educati on and the transf ormation of central gove rnment subsi dies (from earmark ed subsi dies to gen eral subs idi es) in 1993. 2.1 Conceptualisation B y wa y of classif yin g the inst it uti onal cha nge t hat has taken plac e duri ng the last de cade s withi n the areas of public uti li t y and elderc are, a comm on disti ncti on between hier arch y, market and networks can be used (cf. Meuleman 2008). “Hierarchy” refers to when central gove rnment inst it uti ons appl y formal authorit y in relation to loc al gove rn ment inst it uti ons or acti vit ies that are under local gov ernment respo nsibi li t y. An ex ampl e of “hard” control is when an agenc y uses sancti ons in ord er to make improvements. Central gove rnment mana gement of loc a l government in Sweden is mainly “soft”, based on the principle of local self - government. “Market” refers to a situation where public services are contracted out using publi c p rocur ement , or when consum e rs of pub li c services can choose between diff erent pr oviders (vouche r s ys tem). This does not i mpl y an abs ence of central gov ernment mana gement and contro l. For inst anc e, numero us rules ar e appli ed in order to facil it ate 5 “competition neutrality”. “Network” mainly refers to horizontal collaboration between int erdependent actors rel ated to a certain poli c y field. Int er - muni cipal co ll aborati on is one ex ampl e and another exampl e is when publi c and private actors coll aborate in frami ng th e quali t y of se rvices. All t hree t yp es of coo rdinati ng m echanism s can be use d sim ult aneousl y and durin g some periods one can be emphasised more than others. The drivi n g forc es that l ie behind the int era cti on betwe en thes e modes of gov ern ance ar e of various kinds . One important factor oft en used to ex plain and just if y a transit ion to wards a more market - li ke publi c admi nist rati on is the increasin g lack of publi c resourc es. The ar gument is that new forms of incenti ves and management are ne cessa r y. However, lack of resourc es as such do es not ex plain a specifi c app r oach to refo rm; ideas o f gove rnanc e are also important. Such ideas ar e imported, adjust ed or produced withi n a gener al logic of chan ges in how to coordinate comp lex organisati ons (Bou c kaert et al 2010). Put s im pl y, when centra l coordinati ng unit s, whether central gov ernme nt or l ocal gove rnmen t, find themselves overloaded b y iss ues, it is natural to decentrali se or dele gate functi ons an d decisi on - makin g. This is what happened in the 1980s and in the earl y 1990s. The dist ributi on of functi ons and responsi bil it ies, and thus risk - tak ing, was driven further b y the int ro duc t i o n of NPM. Lo gic all y, when coordin ati ng actors perc eive a tendenc y for publi c admi nist rati on and the organisati on of publi c welfar e to fra gment, the y t r y to incre ase centr al co ntrol again. This is what has happened since the turn of the centur y by placin g greater emph asis on scrutini zing acti vit ies (evaluations , inspecti ons, etc.). Henc e, the developm ent of new combi nati ons of inst ruments based on hie rarch y, m arket and netwo rks. 6 3. Changes since the 1980s A new er a of reforms ca n be identified since the late 1980s. The over all directi on has bee n towards adaptation of market mechanism s as drivers for developm ent (purchase r - provide r spli t, competit ion, customer choice, privatis ati on and perform ance control) , but also increased demand for cit iz en invol vement in handli ng compl ex poli c y matte rs and int er - muni cipal cooperati on in orde r to cope with operati onal and strate gic matters. Loc al gov ernmen t responsi bil it y fo r welfar e, edu cati on, economi c developm ent and b ro ade r iss ues related to sust ainable developm ent has increas ed, but so has central gove rnment contr ol and moni toring, for ex ampl e, with regard to publi c procurement, educati on and healt h car e. Several chan ges that have tak en plac e in legisl ati on dire cted a t muni cipalit ies and county coun cil s can b e viewed as ad aptations to EU le gisl ati on on th e fr ee movem ent of mon e y, people, goods and services. In contr ast to some other EU countries, there is no wav e of “re - municipalisation” taking plac e in relation to ei ther “hard” or “soft” services. However, the issue has been put on the agenda, esp eciall y concernin g healt hc are, so cial services and edu cati on. Poli ti cians and thi nk - tank’s from the polit ical left in particular are ar guing in favour of a re - muni cipalis ati o n of elderc are (or at least more control of private providers), but also that the state shoul d take back the ope rati onal resp onsi bil it y for publi c t rain transport and tra ck main tenance. 3.1 Public utilities Various concepts are used to define “public services” or “municipal services”. For instance, a distinction is made within EU legislation between “services of general interest” (SGI) and “services of general economic interest” (SGEI). As there is no explicit definition of what to be re gard ed as SGE I in the EU legisl ati on, member s tates can make their own definiti ons of wh at kind of services are to be included. Typic al SGEI se rvices at the muni cipal level might be transport, wat er dist ribut ion, ener g y provisi on an d electri cit y dist ributi on. A publi c s e rvice can be withdrawn from EU competition rules if there are “market failures”, that is if it is re gard ed as not possi ble for ma rket actors to del iver the s ervices. The Swedish governm ent have been ver y restrictive in defining services in thi s way. TEU vo c abular y is not actuall y used. The ar gument ha s been that servi ces in gen er al (public uti li ti es as well as social services) shoul d not be provided by just one actor (monopol y), but b y com peti ng actors in the market. For ex ampl e, provisi on of publi c housi ng ( bostadsförsörjning ) is not defined as SGE I in Swedish law (Govt. W hit e P aper. 2009/10: 185, p. 28). 7 Publi c uti li ties including muni cipal housi n g, water an d sewa ge services, prop ert y mana gement and privat e compan y servic es hav e to a large ex tent been trans formed int o muni cipal companies act ing in the market. Muni cipall y - o wned compani e s (based on private law) have alw a ys rep rese nted an important way of handli ng a ran ge of loca l services, such as water suppl y, en er g y dis tribut ion, propert y companies, publi c t ransport (l im it ed companies). Muni cipal companies ar e or ganised nati onall y wit hin specific s ectors. For i nstance, water and sewa ge is a muni cipal responsi bil it y and is nati onall y or ganised withi n a speci fic se ctor organisati on call ed Th e Swedish Water & Wa ste water Asso ciation, SW WA ( Svenskt Vatten ). SWW A was set up by a number of municipali ti es in 1962. There are s ever al reason s to establi sh a muni cipall y - owne d compan y. For ex ampl e, the y can act more flex ibl y and less publi cl y than an authorit y based on pu b li c law. Howev er discussi ons are conti nuousl y takin g pl ace conc ern ing iss ues su ch as transp arenc y and poli ti cal accountabili t y relat ed to these companies. Chan ge s have be en made in th e Loc al Gove rnment Act with the aim of enabli ng great er fulfil ment of de mocrati c valu es. In the mid - 1990s the const it uti onal principle of publi c ac cess to official do cuments ( Offentlighetsprincipen ) became appli cable to muni cipall y - own ed comp an ies (more than 50 per cent ownership). Th e level of transpa ren c y in the companies is thus sim il ar to that of ordinar y pu bli c authorit ies. Viewed ov er time, the number of muni cipal com panies was redu ced duri ng the 1970s. In the subsequent period, corp orati sati on has increased in two waves. In an ini ti al wave from the late - 1980s to the mid - 1990s a couple of hundred companies were estab li shed. The second wave started in 2007 and there are now about 1, 600 muni cipal companies. Most companies are sit uated in lar ge r cit ies and ar e mainl y invol v ed in private corpor ate se rvices and prop ert y man a gement. In terms of empl o yment, the lar ges t companies are in the areas of ene r g y and water suppl y. The tot al t urnover fo r muni cipal companies incre ased b y 27 per cent betwe en 2004 and 2009. Municipal companies can be seen as “hybrid organisations”. This means that the y ar e supposed to act in a busi ness - li ke manner in a competit ive environment and sim ult aneousl y contribut e to the publi c int erest ( allmänintresse). Accordin g to the LG A, the y cannot be set up principally to make a profit , but the y ar e all owed to make a reason able su rplus (the principle of prim e cost). This twofold missi on often leads to conflicti ng go als, whi ch, for inst an ce, is obvious l y the case withi n muni cipal housi ng co mpanies. Acco rding to legisl ati on from 2010 the companies are ex pecte d to act in the nam e of publi c int erest, but als o act accordin g to 8 “business - like principles”. What this actually means is that they are not allowed to increase the rent of an apartment above what it is worth (the principle of the uti li t y value), but the y are also ex pected to max im ize their profit . This can be viewed as an adapti on of EU rules on stat e support and impli es that poli ti cians have a double role: on the one hand, representi n g the publi c, and on the other hand repr esenti n g the com pan y as a pro fit - seekin g actor. Muni cipal companies ar e actors in markets alon g with private compani e s, in the electricit y dist ributi on sector for ex ampl e. Since the liberali sati on of the Swedish electricit y market in 1996, profit - max im iz ing companies ca rr y the main resp onsi bil it y for dist ributi on and investm ent in new ele ctri cit y gene rati on. Ele ctricity consum ers have 122 di ffer ent dist ributors to choose from (see, for ex ampl e, www.elskl ing.s e). The lar gest companie s are E.ON (o wned by a lar ge German comp an y) , Vatt en fall (own ed by the Sw edish state) an d FORTUM, which togethe r dist ribute electr icit y to more than 50 per cent of all custom ers . The rest of the dist ributi on companies lar gel y consi st of muni c ipal companies. T o som e ex tent thi s high concentr ati on of ownership in the marke t has been rega rded as inadequate (Ener gim yndigh eten 20 06; Fridolfsson & Tange rås 2011 ). Dist ribu ti on of ele ctricit y consequentl y consi sts of a combi nati on of a ver y small numbe r of domi nant profit - max im iz ing companies with a lar ge numbe r of smal l municipal companies. Another, somewh at sim il ar, cas e is waste man agement, which also co mbi nes publi c and private actors. A privat el y owned s ystem of ex tended producer respo nsibi li ti es (EP R ) is responsi ble for coll ecti n g an d proc essi ng sp ecif ic waste str e ams such as pack a ging and electronic equipm ent an d batt eries. Hous ehold waste mana gement (which is not included in the EPR system) is a muni cipal responsi bil it y (Corvell ec et al 2013). Muni cipalit ies decide themselves how it is orga nised, as self - admi nist rat ion by muni cipal compan ies (independentl y or joi ntl y with other muni cipalit ies), joi nt boards or muni cipal associati ons. Two or more muni cipalit ies can joi ntl y own on e comp an y, wh ich means that muni cipal it ies coll aborate on improvements and coo rd inate t heir poli cies (Lind qvist 2013). Contracted private compani es perform th e bulk of the waste coll ecti on, but muni cipal companies do most of the waste treatm ent (rec ycli n g, biol ogical tre atm ent, en er g y recove r y, inciner a ti on and landfil l) (www.skl .se). Of the more than 220 waste companies in the Swedish market , ten predomi nate (five muni cipal compa nies and five private companies). Waste ma nagement is often connected to the muni cip al dist rict heati ng s ystem , which means that house hold waste is often used as fue l fo r district heati ng (Corvell ec et al 2013). 9 In 2012 a gov ernment comm iss ion (Government Comm ission Report 2012:56) proposed a new structur e of resp onsi bil it ies in waste mana gement. The mai n proposal is for muni cipalit ies to take over the responsi bil it y fo r coll ecti on of packa gin g, newspap er and waste pap er for rec ycli ng from the produc ers (produce rs of goods are responsi ble for rec ycli n g pa cka gin g and waste pape r etc.). Ho wever, the Sw edish Competit ion Authorit y ( Konkurrensverket ), am ong other bodi es, c onsi dered that the propos al would end up in a monopol y s i t uat ion ( ww w.konkurrensv erket.se ). This proposal can be int e rpreted as a kind of “re- municipalisation” of the waste collection operation, however, in Au gus t 2014 the Alli ance Government decid ed to maintain the s ystem of private coll ecti on of waste for rec ycli n g ar guing that thi s would sti mul ate further impr ovement of rec ycli n g based on economi c incenti ves rathe r than pu bli c authorit y. Another area of pol ic y that is undergoin g chan ge is publi c transport. In 2008 the sector organisati ons (the Swedi sh Transport Associatio n, the Swedish Bus and Coach Fed er ati on, the Swedish Tax i Association, the Association of Swedish Train Oper ati on Companies and SA LAR) joi n ed together as a “Partnership to double public transport” with the aim of doubli ng the volum e of travel b y publi c transpor t during the pe riod 2006 - 2020 in order to contribut e to a more sust ainable developm en t. The poli c y inst rume nts consi st of a combi nati o n of stren gth ening formal authorit y, market mech anism s and int er - muni cipal collaboration. Municipalities and municipal companies are engaged on “both sides” of the purchase r/provider spli t. In accord anc e with new legisl ati on from 2012 (the Publi c Transport Act), there is a region a l publi c transport authorit y t asked with making strategic poli ti cal decisi ons on the develop ment of publi c transport based on a la r ge - s cale overview and bett er coordinati on with other t yp es of so cial dev elopm ent (Swedish Tr ansport Association 2013). This new authorit y has i ts base withi n local and regional gov ernment and can be a region, a count y council , a region al associati on or an int er - muni cipal associati on. The regional publi c transport authorit ies do not, howeve r, pur chase act ual tr ansport. This fu ncti on sti ll lies with muni cipal transport co mpanies. A ma rket fo r comm erci al bus tra ffic withi n regions ha s sim ult aneousl y opened up, enabli ng for - p rofit bus companies to set up bus services an yw her e. 3.1.2 Re-municipalisation? A re se arch repo rt com mi ssi oned by the Eu ro pean Fede rati on of Pub li c Service Unions (EP S U) shows that there is a tendenc y to wards th e “re- municipalisation” of public utilities in a number of EU countries (PS IR U 2012). This is not (yet) the case in Sweden. Fo r m an y ye a rs the re has been a mix ture of hierarchi cal and market - ori ented inst it uti onal arr an gements. 10 Muni cipal companies ar e themselves hyb rids of formal authorit y and market oper ati ons. During rec ent dec ades t he combi nati on of form al authorit y and mark eti z a ti on has become even more prominent, ex empl ified by the electri cit y mark et and the publi c transport sector. In th is sense it can be ar gu ed that NPM it sti ll a major influenc e on reform . In line with the concepts used b y Poll it t and Bouck aert (2011 ) for ex a mpl e, the state of local publi c uti li ties in Sweden can be seen as a combination of NPM and the “Neo - Weberian state”. 3.2 Eldercare Historicall y, municipal eldercare has developed out of the responsibilit y for arranging homes for old and poor people in the 17 th centur y. Modern eldercare can be dated from the 1950s, when municipal care at home was introduced. Eldercare services in Sweden are deemed to be provided on a universal basis, which means comprehensive, publicl y financed and high qualit y service s should be available for all citizens according to their needs rather than their abilit y to pay. Approximatel y 85 per cent of eldercare funding comes from municipal/count y council taxes, while another 10 per cent comes from national taxes. What users pa y onl y covers 5 - 6 per cent of the costs (Erlandsson et al 2013). For several decades, official eldercare polic y has focused on home - based care (home help services). Special accommodation should onl y be considered when no other options are available, and it should be as home - like as possible. Providing care for the elderly is still ultimately a municipal responsibility. Local government’s overall political responsibility and accountability for private provision of public service s is regulated in the Local Gov ernment Act (LGA) and substantive legislation consisting of the Social Services Act ( Socialtjänslagen, S FS 2001:453) and the Medical Services Act ( Hälso- och sjukvårdslagen ), as well as regulations drawn up by national government agencies (such as the Swed ish National Board of Health and Welfare, NBHW). The very idea of havin g municipalities take responsibilit y for different kinds of welfare functions represents local democratic control and a proximity between the actual service provision and those who are politicall y responsible for making the provision in accordance with local needs. This means that municipalities are entitled to design health and social care services for the elderl y that are adapted to local conditions. From the 1970s to the 1990s, munici pal care for the elderl y was regarded as an exclusivel y public (municipal) matter, involving public financing and provision. During the 1980s, decentralised administrative management in terms of increased responsibilit y for managers at 11 different levels bec ame of prime importance in all polic y areas, including eldercare. Arms - length political control was introduced, including management by objectives (M B O), management by results (MBR), and purchaser/provider models. According to these models, politicians sho uld be able to focus on strategic issues rather than on time - consuming da y - to - da y politics. Toda y nearl y all municipalities have some kind of MBO/MBR, and most municipalities use some kind of internal contract s ystem (sometimes still called the purchaser/p rovider model). Along with this internal managerialism, initiatives were graduall y put in place to increase management autonom y by contracting out welfare services. Privatisation (contracting out) within care for the elderl y (and the disabled) has been co ntinuousl y expanded since the 1990s. Between 2000 and 2010, private provision of care for old and disabled people (home services and special accommodation) increased by approximately 12 per cent. The most extensive changes have taken place during the last couple of years. The proportion of all old people in private special accommodation was 21 per cent in 2012, compared to 14 per cent in 2007. In terms of hours for home help services for old people, private provision increased from 13 per cent in 2007 to 23 per cent in 2012 (Socialst yrelsen 2013). Private alternatives within care fo r the elderl y were initiall y a uniquel y metropolitan phenomenon (Stockholm), but the y have graduall y spread to adjacent suburbs and larger cities, and subsequently to smaller citi es. Nevertheless, in 2012 half of all municipalities (mostl y smaller ones) provided their own eldercare. On the other hand, some municipalities have put all eldercare into the hands of private providers (ESO 2014) This polic y diffusion cannot be explained simply by referring to a right - wing political majorit y, but is the result of an intertwined complexit y of ideological and economic factors and geographical proximity (Stolt & Winblad, 2009). Municipalities are not forced to contract out home help services or special accommodation (“in- house”), however, if that is what they decide to do, they have to follow the rules of public procurement (Public Procurement Act, 2007:1091), which states that there has to be competitive tendering (”ex - house”). Alternatively, another piece of legislation can be used ( Lagen om Valfrihet, LOV), which entitles service co n sumers to choose accredited and listed private help service providers. It should be noted in this respect that the rules in Sweden go beyond those rules require d by EU Directive 2004/18 in which welfare services can be regarded as “services of general interest” and hence do not have to be included in a competitive system (Erlandsson et al, 2013, p. 28). 12 The private providers consist mainl y of fairl y large for - pro fit companies. Privatization of eldercare in Sweden thus represents a shift in polic y from non - profit municipal organisations towards for - profit global venture companies (Stolt et al 2011). In this context it should be mentioned that when “freedom of choice” was launched nationally by the right - wing government as an important reform to enhance qualit y in health care for old people, it was assumed that there would be a large number of non - profit organisations providing elder care. However, due to the fact th at it is hard to provide an y precise qualit y criteria, the price of the services becomes the most important criteria and smaller companies and non - profit organisations are not able to compete with the big ones, which have thus far turned a rather good prof it in selling care to municipalities. In order to make it easier for municipalities and count y councils to introduce co ns umer choice instead of outsourcing, a new legislation called “system of choice” was introduced in 2009 ( LOV, Lagen om valfrihet, SFS 2008:962; Konkurrensverket 2012). It was also argued that this new legislation would encourage smaller and not for - profit providers to join the eldercare market. S ystem of choice entails a procedure where the individual is entitled to choose which of the suppliers with which a contracting authorit y (municipalit y and count y council) has approved and concluded a contract should perform the home - help service (Erlandsson et al, 2013). There are no restrictions on how man y providers can be approved. This m eans that the providers hav e no guaranteed c ustomers . Private service providers in accordance with LOV can suppl y supplementary services at a market price to “top up” subsidised municipal eldercare, which municipal providers not are allowed to do. LOV can basicall y be applied for all social services, home - based as well as residential. This legislation is compulsor y for count y councils but voluntar y for municipalities. In 2014 a Government Commission suggested that all municipalities should be obliged to cre ate conditions that enable users to choose between various providers of home - help services. Approximately 180 of the 290 municipalities had introduced this s ystem in 2014. Market - oriented reforms within eldercare have transformed the role of local governme nt from being the onl y provider towards a situation of being both purchasers and providers. This means that municipal politicians and professionals have had to develop new skills (Erlandsson et al 2013). The y have had to develop expertise in how to purchas e eldercare in a market dominated by care companies that are in some cases actuall y more powerful than the municipalit y. The y have also had to develop expertise in monitoring and qualit y control, which demands sufficient 13 resources. All in all, this has cre ated a rather complicated s ystem and an increase in demands for performance scrutin y and performance management. 3.2.1 Performance scrutiny When NPM was introduced in Sweden in the 1980s, several critics remarked that too little emphasis was put on measuri ng performance. This was a period of “management by objectives”, however, it was generally regarded that there was a lack of relevant knowledge to enable politicians to make qualified and informed decisions. More information concerning the qualit y of publi c services was generall y required. Several motives can be identified behind this: cost - effectiveness, political accountabilit y, the rule of law and provision of information for users to make rational choices. The need for different kinds of performance mea surements increased concurrentl y with increased internal delegation within local government and privatisation (private providers). Large municipalities often have an advanced s ystem to scrutinise activities related to eldercare. However, several reviews s uggest that there is a lack of systematic control and follow - up of the activities of private providers in both large and small municipalities. For example, on man y occasions onl y a small number of measurable goals have been formulated as the basis for pub lic procurement of health and care, home care for elderl y has not been s ystematicall y followed - up and there is a general lack of resources and knowledge concerning the responsibilit y for control and follow - up within eldercare ( Swedish Government Official R eport 2013:53). During the 1990s a number of cases of “poor conditions” within eldercare were highlighted in the mass media, in Government Commissions and at the National Board of Health and Welfare (NBHW). These included qualit y deficiencies, lack of coo rdination between municipalities and count y councils and in adequate treatment. One particular event had a substantial impact . This was when in 1997 an emplo yee (Sarah Wägnert) drew public attention to significant l y unsatisfactor y conditions at a specific residential unit . This report from below became so significant that in 2001 new legislation concerning emplo yees the right and obligation of emplo yees to report bad conditions was name d after her (Lex Sarah). Beside s this example of “hard” control , new “soft” control was also introduced, including action plan s and development plan s . According to an anal ysis of new control measures based on performance scrutin y, these measures were mainl y soft and one explanation might be that central government tried to ba lance between on the one hand increased central control in order to cope with unsatisfactor y 14 conditions, and on the other hand the distribution of responsibilit y between central and local government (Feltenius 2010). At the same time , w ith eldercare issu es high on the national agenda in the 1990s , municipalities started to develop horizontal benchmarking activities with the support o f the Swedish Association of Local Authorities and Regions (SALAR), the national member ship organisation for municipalities and count y councils/regions. For instance, in the late 1990s some 20 municipalities formed a “comparing quality network”, which grew to involve around 50 municipalities b y 2001 , subsequentl y becoming a national project with almost 30 different local networ ks including nearly 200 municipalities. The national project was formall y concluded in 2010, however, several results and measures were collected into a national database. This was just one example of horizontal networking to develop eldercare and , accordi ng to comparative studies , this Swedish way of developing performance measurement and benchmarking was more voluntar y and horizontal than in other countries (Kuhlmann 2010; Kuhlmann & Jäkel 2013). This is one way to interpret the development of performance management, but more recent top - down processes should also be taken into account. There are a considerable number of public agencies and quasi - public organisations involved in performance scrutin y of eldercare. First of all there is the Swedish National B oard of Health and Welfare (NBHW) , a government agenc y with a wide range of activities (www.socialst yrelsen.se). T hese include monitoring, evaluation, developing standards and exercising supervision. In June 2013, the supervis or y and scrutinising activitie s w ere stream lin ed and put in to a new authorit y (The Inspectorate of Health and Social Care, IHSC ). There are also a number of “meta- scrutinisers” which assess the success and failure of scrutinizing activities, such as the Swedish Agenc y for Health and Ca rer Services Anal ysis ( Myndigheten för vårdanalys), t he Swedish National Audit Office ( Riksrevisionen), the Institute for Evaluation of Labour Market and Education Polic y, the Swedish Agenc y for Public Management ( Statskontoret) and the Expert Group for Public Economics and Government Committees (ESO). Supervision ( tillsyn), which is conducted by IH SC within health care and social care , has traditionall y been focused on monitor ing how public and private providers perform in relation to l egislation and regulation. In general, supervision consists of various forms of inspections in order to ensure compliance with the law and to safeguard the rights of the individual. I n the case of eldercare , compliance with the law mainly refers to the Soc ial Services Act 15 ( Socialtjänslagen, S FS 2001:453), but also to the Medical Services Act ( Hälso- och sjukvårdslagen). The Social Services Act states that the aim of elder car e is to ensure that old people live with “dignity and a sense of well - being”, which is referred to as a national “fundamental value” (värdegrund ). It also state s that the elderl y must be able to live and lead independent lives in safe conditions and have an active and meaningful existence in the compan y of others. According to NBHW , it i s important that the staff within eldercare (public and private providers) have equivalent training so that the care will be characterised by national equivalence (Socialst yrelsen 2011a). Over a period of three years (2010 - 2012) , NBHW conducted annual insp ections of eldercare ordered by the central government. Each year a speci fic focus was chosen and a summar y report was published in 2013. The se three years of inspection s ordered by the Government w ere operati onal, concentrat ing on activities which had pr eviousl y been highlighted as defective or characterised by poor conditions. A report from 2012 state s that 80 per cent of homes designed for the elderl y (special accommodations) that were inspected did not fulfil the requi site demands based on legislation, regulations and instructions (Socialst yrelsen 2012). The three years of inspections stipulated by the Government can be seen as an inspection process of its own, but it is also part of a process of scrutinising eldercare called “Regional and local comparisons” (RLC) or “open comparisons” (öppna jämförelser) (Lindgren 2012). RLC within eldercare consists of three documents produced annuall y : the Elder Guide (since 2008), old people’s perceptions of elder care (since 2009) and health - and social care for the elderl y (since 2010). The la tter is produced in collaboration with the Swedish Association of Local Authorities and Regions (SALAR ). It stat es that in 2014 a national s ystem of qualit y measures and criteri a will be developed. SALAR is putting a lo t of effort in to getting municipalities and count y councils to develop their own scrutinizing activities while also participating in developing national standards for qualit y. In order to produce a fuller picture of the expansion of scrutin y activities, so me other actors also have to be taken into account. There are two important organisations . F irst ly, the Association of Private Care Providers (founded in 1976) is an emplo yer organisation and a n industr y organisation for private providers of health and car e. One of the main objectives o f the organisation is to strive for freedom of choice and to demonstrate to the public the importance of variet y in care provision. The association makes frequent contributions to discussions concerning qualit y and qualit y me asures within health and care ( www.vardforetagarna.se ). The 16 second is the Swedish Standard s Institute (SIS), a member ship organisation for standard setting within different industries . SIS was commissioned in 2 012 to develop Swedish qualit y standards for social care and health care for the elderl y (homes for old people and home services). These organisations are not directl y involved in performance measurements but ar e important as providers of norms and standar ds concerning qualit y measures. A s private providers have increase d within care for the elderl y, their interest organisations hav e also become highl y involved in tr ying to frame the qualit y of elderl y care. For instance, the Confederation of Swedish Enter prise ( Svenskt Näringsliv) appointed an “independent expert group”, which was tasked with provid ing “guidelines for increased quality” within health care, education and social care (including elderl y care). In addition, a close l y related private emplo yer o rganisation (the Association of Private Care Providers) has provided a “model for following up and account ing for quality within elderly care”. However, a close look at the documents presented by these two organisations reveals that the y do not live up to the expectation of delivering clear definitions or criteria for qualit y. As in the case of similar discussions within SALAR and the NBHW , “quality” is an elusive concept, which tend s to lead to measuring what is quantitative l y measurable. It is quite interesting that one of the documents (from Svenskt Näringsliv) contains an image illustrating “measuring quality” (within health care and social services) which shows someone using a calliper to measur e the exact circumference of a metal object. To sum up , a web of different public and private actors are increasingl y involved in scrutini s ing elder care. The m ost important of these are central government agencies, impl ying that the focus is mainl y on national values in relation to e quivalence, but the focus is also increasingl y being placed on how to facilitate market functions. There are also strong indications that th e scrutin y s ystem is strengthening itself ; when bodies find that eldercare is not fulfilling th e required qualit y , t he y promote further development of the scrutinizing process . 3.2.3 Re-municipalisation? Re - municipalisation of eldercare in Sweden is tak ing place sporadicall y , however, there does not (yet) seem to be a wave of re - municipalisation of previousl y privatised (contracted out) eldercare. As there is no systematic overview of re - municipalisation , it is onl y possible to highlight specific cases whe re for different reasons municipalities have withdrawn the management of special accommodation from private providers . A simple Google search gives the impression that there ha ve been a growing number of cases whe re individual special 17 accommodation has been taken back from Attendo, Carema and other private providers. Examples can be found in Arboga, Umeå, Järfälla, Stock holm, Malmö, Motala, Norrköping, Kalmar, Linköping, Gävle, Växjö and Örebro. Only in ver y few cases has the withdraw al taken place during the contract period. There are also a few cases were municipalities have withdrawn LOV - options , i.e. replac ed private providers with municipal providers of home help services. After the election in September 2014, the minority government consisting of the Social Democratic Party and the Green Party announced an “end to profit-making within welfare”, which means that private welfare and education companies should not be allowed to have profit-making as an aim. All surpluses should be put back into the business. Moreover, it is suggested that municipalities should have the power to veto the establishment of “free schools” and that county councils should have the power to veto the establishment of private home care and health clinics. All of this is supposed to bring “order” into the welfare system. However, the idea of an end to profit-making and a local government veto will first be investigated over a period of two years. A Government White Paper is planned for completion in 2016, and it will subsequently have to be passed in the Swedish Parliament, which might be problematic because the alliance parties have clearly stated that they will not support it. 18 4. Concluding remarks The poli ti cal s ystem in Sweden co mprises a strong state and stron g local gov ernment. Decentr ali sati on has be en a tr ademark o f dev elopm ent s since the 19 70s. Howeve r, th e increasin g us e of the ma rke t as a coordinati n g in strument since the late 1980s has tend ed to fra gment the s yst em int o and a mix ture of conti nuing ma rketi z ati on combi ned with hierar chical state coo rdinati on. Networks ar e also important in the two polic y fields of publi c uti li t y and e lde rca re, at the local as well as t he nati onal level. There is no obvious developm ent towards re - muni cipalis ati on in Sweden, but there are som e minor tendenci es that might transpi re to be of poli ti cal importance in the future, espe ciall y in the case of welfa re. With respect to publi c util it y , ther e ar e sever al hybrids between hier arch y (formal authorit y) and market. Muni cipal companies, which are the main providers of service s in several sectors, are to be seen as inst it uti onali sed hyb rid organisati ons in thi s sense. However, in order to adap t to EU - le gisl ati on, some adjust ments have to be made in nati onal legisl ati on to ensur e that muni cipalit ies are no t accused of illicit state support. Traditionally, eldercare can be seen as a “non - centralised” municipal responsibility, which has turned int o a market regim e since the 1990s. When it comes to the organisati on of performan ce man a geme nt, the developm ent has moved from network coordinati on towards hierar ch y. In the 1990s, indi vidual muni cipalit ies entered int o networks i n order to compar e and ex c hange knowled ge about what makes goo d elderca re. The result s of thi s networking have subsequentl y been converted int o nati onal standards with the aim of being appli cabl e fo r all muni cipalit ies. In addit ion, nati onal scrutini sing authorit ies hav e been given great er powers. The cas e of elde rca re sh ows an incre asing combi nati on of market orient ati on and a growin g performance scrutiny “industry”, which can be interpreted and explained in various ways, but a suggesti on is the following. An ideolo gical shift rega rdin g the classic al balance betw een equali t y and freedom has taken pla ce sinc e the 1980s, which means th at more wei ght is placed on the latter. It has been ar gued that fre ed om of choice is an important value and that competit ion is regarded as the most rel evant inst r ument for achi eving thi s objecti ve. Nati onal equivalenc e is sti ll an important value in thi s contex t as well , however, not in relation to the content of services but in relation to the formal rules of competit ion. Hence, two cont rol s ystems can be dist ingui shed. One s ystem focus e d on the content of services with the aim of 19 ensuring the re is a nati onal equivalence in ter ms of equal access and equal quali t y. This s ystem is based mainl y on social - democr ati c values gr aduall y establi she d since the 193 0s. The other s ystem is focused on the forms of service deli ver y, i.e. fre e dom of choice for indi viduals and fre edom of competit ion betw ee n service providers. Thi s leads to tensions between int e gr al and cen trifugal forc es. Accordin g to all poli ti cal parti es in the Swedis h Parliament and across differ ent int erest organisati ons, Sweden is sti ll regard ed as a univ ersal welf are stat e and t he equivalenc e of social servi ces is sti ll an important value. When the cent rifu gal forc es be come too obviou s there is a ca ll for integrating mechanisms. A common concept in this context is “quality”. As a value, qu ali t y is sim il ar to democra c y in that it is somethi ng to which no one can actuall y be opposed. Several publi c authorit ies, int erest organisati ons and or ganisati ons representi n g private servic e provide r s are int ensivel y invol v ed in finding obje cti ve and neutral qu ali t y indi cators and me asures that can be develop ed in to a nati onal standa rd fo r all providers. A gen erall y acc epted con c eptualis ati on and oper ati onali z ati on of quali t y in elderc are is thus assum ed to be used both as an inst rument for supporting values of equi valence and also to legit im ate privat e profit making. Th e sea rch fo r neutral indi cators of quali ty and the on - goin g inst it uti onali sation of di ffer ent s ys tems of ben c hmarking, ev aluation, in specti ons, rankin gs and other t ypes of scruti n y models shoul d be placed in thi s area of tensions between a social democrati c value s yst e m and a liberal m arket value s ystem. Sw eden is sim ult aneousl y described as in the fo ref r ont of int roducin g NPM in terms of der e gulating the welf are s ystem by, for inst anc e, makin g room for publi c financ ing of private pro fit making withi n social services and educati on, and rega rded as a univ ersal welf are state base d on equali t y. The ex pand ing “scrutinising society” can thus be seen as a logical outcome of trying to manage the tension s between soci al democrati c value s yste ms and market liberal v alue systems. 20 References Boucka ert, G., B. G. Pete rs & K. Verho est (2010) The Coordination of Public Sector Organizations. Shifting Patterns of Public Management . Houndmil ls: Palgr ave Macmi ll an. Corvellec, H., M. J. Z. Campos & P. Zapata (2013) “Infrastructures, lock - i n, and sust ainable urban developm ent – the case of waste incine rati o n in the G öteborg Metropolitan Area”, Journal of Cleaner Production , Vol. 50, p 32 - 39. Ener gim yndi gh eten (200 6) Ägarstrukturen på elmarknaden. Vem äger vad på den svenska elmarknaden? Stockhol m: Energim yndi gheten. Erlandsson, S., P. Storm, A. Strantz , M. Szebehely & G - B. Trydegård (2013) “Marketisation trends in Swedish eldercare: competition, choice and calls for stricter regulation”, in G. Mea gher & M. Szebehel y (eds.) Marketisation in Nordic eldercare: a research report on legislation, oversight, extent and consent . Stockholm: Stockholm Studi es in Social Work. Stockholm Universit y. ESO (2014) Goda år på ålderns höst? En ESO-rapport om konkurrens i äldreomsorgen . Rapport till Ex pertgrupp en för studi er i offentl ig ekonomi 2014:1. Fridolfsson, S - O. & T. P. Tanger ås (2 011) Investeringar på elmarknaden – fyra förslag för förbättrad function . Rapport till Ex pertgrupp en för milj östud ier 2011:5. Stockholm: Rege rin gskansliet. Government Comm iss ion Report 2012:56, Mot det hållbara samhället – resurseffektiv avfallshantering , SOU 2012:56. Hermansson, J . (2003) Politik på upplysningens grund – om den demokratiska reformismens möjligheter och problem . Malmö: Liber. Meagher & M. Szebehel y (eds.) Marketisation in Nordic eldercare. A research report on legislation, oversight, extent and consequences . Stockholm: Stockholm Universit y, Department of Soci al Work. Meuleman, L. (2008) Public Management and the Metagovernance of Hierarchies, Networks and Markets . Heid elber g: Ph ysi ca - V erla g. Feltenius, D. (2010) ”Decentraliserad äldreomsorg under förändring”, Scandinavian Journal of Public Administration , 14(3 - 4), 61 - 85. Hall , Patrik. 2012. Mana gem entb yr åkr ati – organi sati onspol it isk makt i svensk offentl ig förvalt ning M alm ö: Libe r Förla g. Konkurrensverket (2012) ”The Act on System of Choice in the Public Sector” ( www.konkur rrensv erket .se , 2014 - 02 - 25) Kuhlmann, S. (2010) ”Performance Measurement in European local governments: a comparati ve anal ysis of reform ex perienc es in Gre at Britain, Fran ce, Swed e n and Germany”, International Review of Administrative Science , 76: 331 - 245. 21 Kuhlmann, S. & T. Jäkel (2013) ”Competing, collaborating or controlling? Comparing benchmarking in European local government”, Public Money & Management , 33:4, 269 - 276. Lidst röm, Anders (2011) “Sweden: Party- domi nat ed subnati onal democr ac y unde r challenge?”, ch. 11 in Loughlin, John, Frank Hendriks & Anders Lidström (eds.), The Oxford Handbook of Local and Regional Democracy in Sweden . Ox ford: Ox ford Universit y Pr ess. Lind gr en , L. (2012) ”Vad är öppna jämförelser?”, i Lindgren, L i samarbete med M. Ottosson & O. Salas, Öppna jämförelser. Ett styrmedel i tiden eller ’Hur kunde det bli så här?’ . Götebor g: FoU i Väst, Rapport 2:2012. Lindqvist, K. (2013) ”Hybrid Governance: The Ca se of Household Soli d Waste Mana gement in Sweden”, Public Organization Review , 13:143 - 154. Mattson, Ingvar & Olof Petersson (2004) “Makten over politikens spelregler”, ch. 1 in Mattson, In gv ar & Olof Petersson (eds.), Svensk författningspolitik . Stockholm : SNS Förla g Poll it t, C., S. Harrison, G. Dowswell , S. Jerak - Zuiderent & R. Bal (2010) “Performance R egim es in He alt h Care: Insti tut ions, Critical J unctures and the Lo gic of Es calation in England and the Netherlands”, Evaluation , 16 (1) 13 - 29. Poll it t, C. & G. Bouck aer t, G. (2011) Public Management Reform. A comparative analysis: New Public Management, and the Neo-Weberian State . Third Edit ion. Ox ford: Ox ford Universit y Pr ess. Premfors, Rune, Peter Eh n, Eva Haldén & Gö ran Sundst röm (2003), Demokrati och byråkrati. Lund: Studentli tt eratur. Whit e Paper . 2009/10: 185, Government Le gisl ati ve Bil l . PS IR U (2012), Re - muni c ipalis ati on muni cipal services in Europe. A report comm iss ioned by EPS U to Publi c Services Inte rnati onal Rese arch Unit (PS IR U ). London: Un iversit y of Green wich, Busin ess School. Socialst yrelsen (2010) Öppna jämförelse r i socialt jänsten. Handli ngspl an för socialt jänst och hemsj ukvård 2010 - 2014. Stockholm: Socialst yr elsen. Socialstyrelsen (2011) “Description of Regional and local comparisons”. 27/05/11. Stockholm: Socialst yrelsen. Socialst yrelsen (2011a) Utbildning i värdegrundsarbete inom äldreomsorgen. Stockholm: Socialst yrelsen. Socialst yrelsen (2012) Nationell tills yn av vård och omsorg om äldre. Delrapport II. Stockholm: Socialst yrelsen. 22 Socialst yrelsen (2012a) Vad t ycker de äldre om äldreomsorgen? – en rikstäckande undersökning av äldres uppfattning om kvaliteten i hemtjänsten och äldreboenden 2012. Stockholm: Socialst y relsen. Socialst yrelsen & Sveriges kommuner och landsting (SKL) (2013) Öppna jämförelser – Vård och omsorg om äldre 2012. Stockholm: Socialst yrelsen. Socialst yrelsen (2013), Äldre och pe rsoner med fu nkti onsnedsättni ng – regi form år 2012. Stockholm: Socials t yr elsen. Socialst yrelsen (2014), Vad tycker de äldre om äldreomsorgen? En rikstäckande undersökning av äldres uppfattning om kvaliteteni hemtjänste och äldreboenden 2013 . Stockholm: Socialst yr elsen Stolt, R., P. Blomqvist & U. Winblad (2011) “Privatizatio n of soci a l services: Quali t y differences in Swedish elderly care”, Social Science and Medicine 72: 560 - 567. Stolt, R. and Winblad, U. (2009) “Mechanisms behind privatization: A case study of private growth in Swedish elderly care”, Social Science & Medicine 69: 903 - 911. Strandberg, Urban (2004) “Kommunal självstyrelse”, ch. 10 in Mattson, Ingvar & Olof P etersson (eds.), Svensk författningspolitik . Stockholm : SNS Förlag. Swedish Government Of ficial Report, Privata utförare – kontroll och insyn . SOU 2013:53. Svenskt Näringsliv (odaterad) ”Kvalitetsrekommendation för vård, skola och omsorg”, Ex pertgruppen för kvali t et i välfärd en ( ww w.sven sktnaringsli v.se , 2013 - 10 - 09). The Swedish Publi c Tran sport Association (20 13) The Road Map. The role of public transport in sustainable social development . ( ww w.svenskkol lektivt rafik.se , down loaded 2014 - 03 - 12.) Vårdföretagarna (2013), ”Vårdföretagarnas modell för uppföljning och red ovisn ing av kvalitet inom äldreomsorg” ( www.sv enskt narin gsl iv.se , down loaded 2014 - 01 - 30).