Journal of European Social Policy

http://esp.sagepub.com

European Social Care Services: Is It Possible To Identify Models ?

Anneli Anttonen and Jorma Sipilä
Journal of European Social Policy 1996; 6; 87
DOI: 10.1177/095892879600600201

The online version of this article can be found at:

http://esp.sagepub.com/cgi/content/abstract/6/2/87

Published by:

http://www.sagepublications.com

Additional services and information for Journal of European Social Policy can be found at:

Email Alerts: http://esp.sagepub.com/cgi/alerts

Subscriptions: http://esp.sagepub.com/subscriptions

Reprints: http://www.sagepub.com/journalsReprints.nav

Permissions: http://www.sagepub.com/journalsPermissions.nav

Citations (this article cites 6 articles hosted on the

SAGE Journals Online and HighWire Press platforms):
http://esp.sagepub.com/cgi/content/refs/6/2/87

Downloaded from http://esp.sagepub.com by guest on July 13, 2008

© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
 ARTICLE

EUROPEAN SOCIAL CARE SERVICES: IS IT POSSIBLE TO IDENTIFY

MODELS ?
Anneli Anttonen and Jorma Sipilä, University of Tampere, Finland

Summary R6sum6

The purpose of this article is to bring social LES SERVICES EUROPEENS DE SOINSS
care services into the domain of comparative SOCIAUX: EST-IL POSSIBLE DE
social policy research. The reason why it is DISCERNER DES MODELES ~
important for social care services to be incor-
porated into the debate is that they represent
an expanding component of the welfare state;

that they are important for women; and that
there are major differences between different
countries in social care services. We have
defined social care services as a specific way of
increasing the autonomy of both care pro-
viders and care receivers
. sons : tis constituent une composante qui prend
Comparative research into social care ser-
vices has not, as yet, made very impressive pro-
gress. There still remains much conceptual
ambiguity and even the identification of the
services is difficult: that requires clear distinc-
tions to be made in relation to health care and
education services. There are hardly any inter-
national comparative data sets available.
However, we have carried out some small em-
pirical analyses, using international materials
to compare the volumes of institutional care
and home help services provided for elderly
people as well as children’s day care and pre-
school services in Scandinavia and in the E U
countries in the late 1980s. In addition, we
have looked at the connections between
women’s gainful employment and social care
services, finding that at the country level the
two are indeed very closely related.
Two distinct models of social care services
emerge from the analysis of service volumes
and state policies; two, possibly three other
models remain more tentative. These models
seem to offer very different options and oppor-
tunities as regards women’s gainful employ-
ment and care solutions outside the family
. outre, nous avons examini les rapports entre
Cet article a pour but de faire entrer les ser-
vices de soins sociaux dans le domame de la
recherche comparative en polttlque sociale. Il
importe que les services de soins sociaux soient
mcorporés dans le dibat pour plusieurs rai-
de plus en plus de place dans 1’Etat-provi-
dence, tis sont importants pour les femmes, et
tl existe de très grandes dlfférences entre les
services de soins sociaux des divers pays. Nous
avons défint les services sociaux comme un
moyen spéclfique d’accroitre l’autonomte tant
des dispensateurs que des receveurs de soins.
La recherche comparative sur les services de
soins sociaux n’a pas, à ce Jour, avanci de
faqon spectaculatre. Il subsiste une grande
amblguïté conceptuelle, et les dlfficultés risi-
dent jusque dans l’ldentificatl0n mime des ser-
vices: des distinctions préclses en matlère de
services de som de santi et de services éducatlfs
s’lmposent. Il n’existe guère de données com-
paratives internationales. Cependant, nous
avons effectué plusieurs analyses empiriques
de taille ltmltée, dans lesquelles nous avons
employé des matiriaux internationaux afin de
comparer le volume des soins en établtssement
spéclalisé avec celui des services d’aide a domi-
ale fournis aux personnes dgies, amsi que le
volume de garde d’enfants de Jour et de ser-
vices priscolaires en Scandmavie et dans les
pays de 1’ UE à la fin des annies 1980. En
l’emplor rimuniri des femmes et les services de
soins sociaux, et nos risultats au niveau

87- 0 © Addison Wesley Longman Lmuted 1996 0958-9287/96/06201087/$03 50

Downloaded from http://esp.sagepub.com by guest on July 13, 2008

© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
88
national montrent en effet un lien très étrolt
entre les deux.
L’analyse du volume des services et des poh-
tiques de l’Etat fait ressortir deux modèles dis-
tincts de services de soins sociaux; deux, ou
peut-etre trois autres modeles restent moms
précls. Ces modèles semblent o f frtr des options
et des posslbilité tres dlfférentes à l’ égard de
l’emplot rimuniri des femmes et des solutions
de dispense de soins hors du milieu familial.
Introduction
The purpose of our article is to contribute to
the ongoing debate in the place of social ser-
vices in comparative social policy research (see
Alber 1995; Langan and Ostner 1991; Lewis
1992; O’Connor 1993; Orloff 1993). The
focus of our analysis is on describing the quan-
titative differences in services in western Eur-
ope. We shall also be looking into ways of
incorporating social service models into the
debate on welfare state regimes. The article
reads more as a research programme than as
an elaborate analysis: this is simply because
the comparison of social services still involves
so many fundamental, inherent problems.
The social services perspective opens up
interesting and, we feel, important new angles
for comparative research on the welfare state.
First of all it can help towards a deeper under-
standing of the welfare state and of how it
works. Secondly, the incorporation of social
services into the ongoing modelling debate
provides one way of responding to the feminist
critique of welfare state theory. And thirdly,
the comparative study of social services is a
challenging project: the tremendous variety of
these services seems to tell us a great deal
about religious, politico-ideological and ad-
ministrative differences (see Alber 1995).
In theoretical terms, the perspective we take
on social series may be described as Scandina-
vian or emancipatory. We understand the
social care services that are at the centre of our
Downloaded from http://esp.sagepub.com by guest on July 13, 2008
© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
attention to be a means of strengthening the
autonomy of both service providers and ser-
vice receives; we do not regard them as a
means of subordination and control.
However, it is no easy task to do a quantita-
tive comparison of social care services in Eur-
ope : reliable comparative data are quite simply
not available. With the exception of the Nor-
dic Council, mternational organizations have
given very little support for efforts to compile
statistics on social services, and national stat-
istics are also incomplete in many western
European countries. This is why our article is
primarily intended as a new opening in the
debate that we hope will be followed up.
We will be using existing statistical sources
and concentrating on quantitative variables.
The cases of our comparison are children’s day
care services and welfare services for the frail
elderly in the EU countries of the late 1980s
and in Scandinavia. Finally, we shall look into
the question of why quantitative differences in
the supply of these services are so wide. West-
ern Europe seems to have different kinds of
social care service regimes, and the public
authonties quite clearly have a central role in
creating this differentiation.
Social services in a comparison of
welfare states
Goesta Esping-Andersen’s
The Three Worlds
of Welfare Capitalism (1990) has inspired con- J
siderable debate on the modellmg of welfare
states. His (1990) theoretical approach is
essentially grounded in the decommodification
of labour power. Social rights, for him, are
’exit out of work’ rights with which it has been
possible to undo the commodity nature of
labour power, i.e. the dependence of wage
earners on the market.
Feminist scholars (see Anttonen 1995; Hob-
son 1990; Langan and Ostner 1991; Lewis
1992; O’Connor 1993; Orloff 1993) have
attacked Esping-Andersen and other main-

stream researchers for concentrating, in
classifications, on the income security of wage
earners in regular wage employment. Both the
theoretical conceptualization and the empirical
analyses of the welfare state have largely
leaned on social insurance, such as pension
systems.
Ann Shola Orloff (1993: 307) points out
that mainstream research on the welfare state
has neglected to analyse social policy benefits
and services that are important to women.
Julia O’Connor (1993: 501) for her part,
observes that comparative research has given
too much attention to the relationship between
the state and labour markets and ignored the
relationships between the state and the family.
Both authors consider it problematic that com-
parative research on the welfare state is based
on a narrow understanding of social rights and
citizenship.
Thus, Esping-Andersen’s theory does not
really provide the tools we need for the analy-
sis of other types of relations of subordination
and dependence. As far as women are con-
cerned, crucial social rights mclude those that
make them less dependent on the family and
marriage - rights that Barbara Hobson (1990)
neatly captures in her expression ’exit out of
family’. Social care services for children and
for the aged are particularly relevant to our
discussion of exit out of family.
Orloff (1993) and O’Connor (1993) suggest
that the concept of ’decommodification’ be re-
placed with that of ’personal autonomy’. This,
they argue, would open up a much broader
perspective on evaluating the development of
the welfare state and the differences between
welfare state models. In Scandinavian coun-
tries in particular women have sought to
strengthen their personal autonomy through
state social pohcy (e.g. Anttonnen, Henriksson
and Natkin 1994). The Norwegian scholar
Helga Maria Hernes (1987) launched the idea
of a woman-friendly state which explicitly
contains women’s political activity, strength-
dening women’s labour market position and
reconciling motherhood an wag labour by
upgrading the service system. Scandinavian
Downloaded from http://esp.sagepub.com by guest on July 13, 2008
© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
89
their public have implied an expansion of
services
social rights
that are important most particu-
larly to women. Housing, education, health
care, employment services and personal social
services are all integral parts of the welfare
state. Services constitute an important part of
contemporary social policy.
To the best of our knowledge there exists no
research that compares and categorizes the ser-
vice systems of different ocuntries from a
broad perspective. There are several compara-
tive studies on individual service sectors such
as children’s day care and community care for
the elderly, but no works that take in several
different social services at the same time.
This is why we ask: Does the inclusion of
social services decisively change the results of
comparative social policy research, or are the
welfare state regimes proposed by Esping-
Andersen (1990) and Stephan Leibfried (1993)
applicable to the field of services as well? This
latter alternative receives support from Jon
Eivind Kolberg and Hannu Uusitalo (1992),
who observe that Esping-Andersen’s classifi-
cation is also relevant in an analysis of staff
numbers in public services. Anne Jamieson
(1991), in turn, fund in a comparison of home_,
help in Britam, Denmark and Germany that
the service system features are to a large extent
a manifestation of the general principles of
welfare state regime. On the other hand, Vicky
Randall (1994: 170-71) arrives at exactly the
opposite conclusion in her comparison of chil-
dren’s day care.
Defining social services: conceptual
and data problems
The first difficulties in any comparison of
social care systems have to do with concepts:
there is still no agreement in the international
debate on what count as social (care) services.
Above we have referred to the way in which
Orloff and O’Connor approach social policy
and social rights from the vantage point of
90
personal autonomy and independence. This
same perspective can also be utilized in the
conceptualization of social services; and it is
particularly well-suited to social care services.
Indeed, the distinction we make between social
services and social care services is an important
one. Social services is used here synonymously
with the British concept of personal social ser-
vices, which according to Samsbury (1977: 3)
refers to ’services concerned with needs and
difficulties which inhibit the individual’s maxi-
mum social functioning ... tailored to individ-
ual or group differences rather than to the
similarities between people’. Social care ser-
vices, then, can be understood as a domain
within which organized services are aimed at
strengthening the autonomy most especially of
women. Putting the issue of personal auton-
omy at the centre of social services highlights
the perspective of women, but autonomy is
also important to the people who use services,
such as frail elderly people and disabled
people.
In line with Esping-Andersen’s notion of
market dependency, we may also refer to ’care
dependency’, which is at quite sharp variance
with modern notions of individual autonomy.
The efforts of women to strengthen their
personal autonomy through wage employment
as well as the expectations of the disabled or
elderly people of a normal life have made care
dependency a social-policy issue. Social care
services are one way of reducing dependency
on care.1
The emphasis on the concept of autonomy
in the attempt to understand the idea of social
care services also helps to narrow down the
scope of the concept: these do not mclude non-
voluntary interventions, purely commercial
services or informal caring. Indeed our sugges-
tion is that social care service shall be under-
stood in the genuine sense of the word as
services that people need and use on a volun-
tary basis. This means first, the term should
not be applied to non-voluntary actions
imposed by the social welfare organizations
and aimed ultimately at controlling the behav-
iour of mdividual citizens.
Downloaded from http://esp.sagepub.com by guest on July 13, 2008
© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
Secondly, purely commercial services should
not be mcluded in the definition of social care
services, even though it is hard to draw david-
ing lines. Ideally, social care services are
universal services available to all citizens.
However, commercial services cannot be en-
tirely excluded from social care services
because in many countries social services are
financed by public authorities but provided by
private companies. What we can accept as a
cnterion is that social care services must be
controlled and subsidized by state authorities.
Thirdly, we do not regard informal canng as
a social care service. Informal caring may of
course be supported by social care services,
payments for informal caring and tax credits.
We do not want to deny the important role of
informal caring in the provision of care, but
simply to maintain our conceptual rigidity.
We have defined social care services from a
Scandinavian point of view, well aware that
the concept is still to establish its own place in
the scientific debate. Although the definition is
tentative and may be contested, it nevertheless
provides a reasonably solid basis for a
comparative investigation.
In addition to the conceptual difficulties, re-
searchers face many data problems in this
field. It is always a difficult job to produce
reliable data sets for international com-
parisons, and it is particularly so in the case of
social care services. Catherme Jones (1985 :
172-73) describes the difficulties as follows:
’Personal social care happens to be one of
the least researched and least documented
areas for comparative study. This neglect of
what represents, after all, the oldest form of
social intervention may seem iromc yet is
understandable, none the less. It represents a
messy area for research. It tends not to
generate quantities of good hard data in
convenient national form and much of what
goes on in the name of social care must, by
its very nature, be opaque to outside
scrutiny and measurement.’2
Any researcher doing an international com-

parison of social care services will encounter at
least the following problems (see Doty 1988:
145-47):
1 The same service comes under different
fields of administration in different
countries. The same services provided
for the care of elderly people and
disabled people may be categorized
under social care services or health care
services. As far as children’s day care is
concerned the dividing line runs between
education and social services.33
2 The dividing line between voluntary and
non-voluntary usage of services can
never be unambiguous. In some coun-
tries old people put away m poor houses,
in others there are long queues to get m.
3 The varying intensity of services also
causes problems of demarcation. For
example, solutions for children’s day
care may vary from playground activities
to regular, full-day care.
4 Statistical principles vary in the absence
of any far-reaching standardization for
social care services.4 The statistics do not
necessarily make a distinction between
private and public services.
The research material and
quantitative variation in social care
services
In ourinternational comparison we focus on
two categories of social care services, i.e. care
of older people and children’ day care. We will
be looking first at the volume of these services;
secondly, at the connections between women’s
wage employment and social care services; and
thirdly, at the role of public authorities in the
production and funding of services. We begin
by looking at the differences and similarities
between the volumes of social care services
provided in the EU countries and Scandinavia.
A quantitative analysis may provide a useful
Downloaded from http://esp.sagepub.com by guest on July 13, 2008
© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
91
frame from which to proceed to building
regimes. However, given the limitations of the
data at hand it is very difficult to carry out an
m-depth and comprehensive quantitative com-
parison.
The quantitative description of the services
is based primarily on surveys carried out
within the OECD and the EU. The data are
based on the situation in the late 1980s. The
comparison takes in 11 EU countnes (all
except Luxembourg) and three Scandinavian
countries (excepting Iceland), i.e. a total of 14
countries.
Our main source on services for frail elderly
people is the summary report by the OECD on
old age welfare (OECD Directorate ... 1993),
which seeks to provide an overall picture of
institutional and community care services.5
However, the OECD indicators include some
of the problems mentioned above. The first
problem is that the OECD makes no distinc-
tion in the category of institutional services
between social welfare and health care. The
distmction would be useful because users are
in different positions n the systems of health
care and social welfare. For instance, the main
criterion in any decision on a hospital ad-
mission in western Europe will have to be the
person’s health status, and treatment in hospi-
tal does not normally cost very much for the
user; whereas in most countries admission to a
nursing home will be dependent on the
person’s financial status, and the services pro-
vided are quite expensive for users.’ Another
problem arises from the fact that the OECD
definition of care services for elderly people
comprises commercial services that we would
have preferred to omit from the comparison.
Although the numbers are presumably quite
small, no estimate can be given of their true
proportion.
A key source on volumes of day care services
for children is a report on public day care ser-
vices in the EU countries (Phillips and Moss
1989); we also refer to the Yearbook of Nor-
dic Statistics 1992 for data on Norway,
Sweden and Finland. These indictors are better
suited to our purposes than those on the ser-
92

vices for elderly people. The sources only Table 1 Volume of four social care services in
include data on those day care services where 14 countries
the public sector is involved both in funding
and in a control function. However, most
arrangements for child care probably fall
beyond public control and are accordingly not
covered by official statistics, particularly since
many children have to move during the day
from one place to another (e.g. from prepara-
tory school to day care; OECD 1990: 133-
34). Family day care in particular is for the
most part unregistered and uncontrolled, but
in the Scandinavian countries the service is
provided and co-ordinated by the local author-
ities. Differences in the prevalence of unregis-
tered care no doubt is a significant source of
country differences.
The descriptions below of social care ser-
vices are based on the frequency of use of four
different services in the countries concerned in Notes: Column (1): Children under three in public
the late 1980s. The variables included in the day care as a proportion of the age group in 1985-
86.
analysis describe: Column (2): Children aged 3-5 in public day care
and pre-school as a proportion of the age group in
1 children under three in day care as a pro- 1985-86. The data for Norway, Sweden and
portion of the age group; Finland for children aged three to six.
2 children aged 3-5 in preparatory school Column (3): Elderly people over 65 in institutional
as a proportion of the age group; care as a proportion of the age group. Data for
3 elderly people over 65 in institutional 1985-91, with the exception of Belgium 1981.
care as a proportion of the age group; Column (4): Elderly people over 65 receiving home
and help as a proportion of the age group. Data for
1985-92.
4 recipients of home help services aged 65 The ’low’ for Spain is replaced by Figure 1 to
or over as a proportion of the age group.
calculate the correlation; the ranges are replaced

Table 1 highlights some dramatic country by the mean.

differences most notably in the day care of
small children and in home help services for
elderly people. The highest figures exceed the
lowest several tens of times over. However, we
shall not continue by looking separately at
these four services, but construct two sum vari-
ables. The rationale of combining different
variables can be weighed against the corre-
lation coefficients shown in Table 2.
The coefficients between services for the
aged (0.59) and between services for children
The figures given by the EU source quoted by Alber
(1993) are a couple of percentage points higher for
Belgium (7 per cent) and France (5 per cent) than
those indicated in the OECD source that we have
used.
Sources: Columns (1) and (2) Phillips and Moss
(1989), Table 2 and Yearbook of Nordic Statistics
(1992) Vol 30, Tables 219-20. Columns (3) and
(4) OECD Directorate for Education, Employment,
Labour and Social Affairs (1993).
Figure 1, we have standardized all four vari-

(0.63) are comparatively high, and that is why ables and summed up the variables describing
we think it is reasonable to summarize the the services provided for elderly people into
information for a graphic description.For the sum variable ’social care services for the

Downloaded from http://esp.sagepub.com by guest on July 13, 2008

© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.

Table 2 Correlations between four social
services m 14 counties
Note: The variables are described in Figure
elderly’; and, accordingly, those provided for
children under ’social care services
dren’.
Looking at Figure 1, we find that various
classifications into country groups are poss-
ible. If both social care services for the older
people and social care services for children are
dichotomized on the basis of mean values into
groups with abundant and scarce services
(unbroken lines), we get four groups:
1 Countries with abundant social
vices : Denmark, Sweden and Finland.
2 Countries with scarce social care ser-
vices : Portugal, Greece, Spam, Ireland
’
and Germany.
3 Countries with abundant services
elderly people but scarce
children: the Netherlands, Norway
Great Britain.
4 Countries with abundant services for
children but scarce services
people: Belgium, France and
A cruder distinction can be made by drawing a
lme along the diagonal m Figure 1 (the broken
lines). One of these lines would put the Scandi-
navian group, Belgium and France in the cat-
egory of abundant services, while all other
countries would remain in the category of
scarce services. On this dimension Denmark
and Portugal represent the two extremes of
Downloaded from http://esp.sagepub.com by guest on July 13, 2008
© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
93
care social care services in Europe. The other diag-
onal, then, separates countries with services
for children from those concentrating on pro-
viding services for the aged. In relative terms
the emphasis on services for children is clearest
in France and Belgium, while the Netherlands
gives preferences to services for elderly people.
Social care services and women’s
1 wage employment
The question of whether social care services
for chil- can provide autonomy for women is typically
discussed in terms of whether they have the
opportumty to take on a paid job outside the
home. Social care services excuse women, at
least in part, for their caring obligations (’exit
out of the family’) and in this way reduce
their dependence on the male breadwinner.
Women’s wage employment is therefore an im-
portant indicator of personal autonomy, even
though in the light of the decommodification
concept it is paradoxical that women have to
care ser- commodify themselves in order to enjoy the
decommodifying effects of social policy, i.e. in
the form of income security (Orloff 1993).
Table 3 describes the variation in women’s
wage employment in western Europe. The
for difference between Scandinavia and the coun-
services for tries of southern Europe is quite significant at
and almost 30 per cent. This is hardly surprising in
view of the extent of social care services in the
respective countries. What does seem quite
for elderly surprising is the fact that the countries with
Italy. abundant services for children, i.e. France and
Belgium, hardly differ from their central Euro-
pean neighbours in terms of the total figures
for women’s wage employment, even though
the supply of services for children in the latter
group of countries is minimal. However, if we
restnct the analysis to mothers of small chil-
dren and their participation in wage labour,
the role of the services provided for children in
France and Belgium becomes clearly visible. In
Belgium 68 per cent and in France 64 per cent
94
Figure 1 Fourteen European countries by the level of social
of mothers are in the active labour force, while
the figures for Germany and the Netherlands is
40 per cent.
It is a commonplace in the debate on
women’s wage employment to highlight the
connections between mothers’ gainful employ-
ment outside the home and children’s day care.
The connection is again seen in Table 4: the
correlation between the proportion of mothers
in the active labour force and children’s day
care is 0.86. Similarly, the corrections between
women’s proportion in the active labour force
and children’s day care is a high 0.75. By
contrast, the link between pre-school and
women’s/mother’s wage employment remains
lower.
The question as to how far services for
elderly people give women the freedom to join
the active labour force has not been addressed
very often. It is therefore important to observe
that in Table 4 women’s wage employment
shows a very high correlation with home help
services for the elderly (0.80) and also with the
sum variable describing social care services for
elderly people (0.69). This might help to
explain why women’s participation in wage
labour is higher in the central European
not
countries which concentrate on children’s ser-
vices than it is in those countries where the
emphasis is on services for elderly people.
Downloaded from http://esp.sagepub.com by guest on July 13, 2008
© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
care services
However, a word of caution is in order in that
the dependency figures calculated from the
country-level material do involve risks of in-
terpretation.
To an extent high
correlation between
the
social care and women’s gainful
services
employment is self-explanatory in that most
workers in social care services are women.
However, the expansion of social care services
has not just given women the freedom to work
m these jobs - their numbers have multiplied
several times over in other sectors as well
(Kolehmamen 1995).
Our material shows that the Scandinavian
countnes offer women the opportunity to
enter the labour market. Day care services are
closely linked up with the women’s gainful
employment: the Scandinavian welfare state
has been built to support the wage employ-
ment of every adult. As regards those people
who are in need of care, the Scandinavian
countries are characterized by children’s day
care and home help services for elderly people.
These are day-time services funded by the
public sector, which means that relatives have
to provide the necessary care during evenings
and weekends. In southern Europe in particu-
lar, women’s chances of gainful employment
depend on their ability to come up with private
solutions. Those who need care have very little
 95

Table 3 Proportion of women in the active Table 4 Correlations between women’s gainful
labour force by countries and groups of employment and social care services m 14
countries countries

Note: For data on the variables, see Tables 1, 2 and

3.

options in terms of professional or public ser-

vices.

None the less we feel it is legitimate to

Notes: Column (1): Women m the acnve labour force
as a proporuon of all working-age women m 1991.
Column (2): Women in part-time jobs as a proportion
of all women m the active labour force m 1991.
Column (3): women aged 30-34 with one child under
five and in the active labour force in 1988 as a
proportion of all economically active women. The
figures for Scandinavia mclude Finland and Denmark
only.
*Southern Europe: Greece, Italy, Portugal and Spain
~Central Europe: Belgium, France, Germany and
Netherlands
~Scandinavia: Denmark, Finland, Norway and Sweden
Sources: Columns (1) and (2) OECD, Tables D 188
and192. Column (3) Women m the European
Community (1992: 77-79) and data from Statistics
Finland.
follow Mary Langan and Ilona Ostner (1991)
and ask the question that is critical to our
research setting: Does the Scandinavian model
really create autonomy for women, does it
make possible a real choice between the home
and wage employment? The question itself
implies the notion that gainful employment is
not the only mdicator of personal autonomy.
However, within the confines of our material
we are obviously unable to answer Langan’s
and Ostner’s question.
Is it legitimate to talk about social
care service regimes?
Within the confines of our material it is not
possible to draw very far-reaching conclusions,
but we can none the less identify certain
,
features that different countries have in
common in terms of ways of organizing and

Downloaded from http://esp.sagepub.com by guest on July 13, 2008

© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
96
volumes of social care services. Certain pat-
terns emerge in groups of countries which we
feel make it justified to talk about models.
These groups show an obvious correspondence
with the comparisons made by Leibfned
(1993) of income support systems. In the dis-
cussion that follows we wish to emphasize the
role that public authorities have taken upon
themselves in distinguishing different service
regimes.
First of all we may refer Scandinavian
to a
model of public services. Within this group of
countries, services for both children and for
frail elderly people are widely available, and
women’s participation in wage labour outside
the home is higher than anywhere else in the
world. That services are so extensively avail-
able is down to the principle of umversalism,
which means that there is a uniform standard
of services and that citizens obtain the services
they require through the same system. This
means that the service system responds most
specifically to the interests of women (Antto-
nen, Hennksson and Natkm 1994) and that
the middle class is also among the users of the
services, which again facilitates the public
funding of services. Another important basis
for the extensive public services is the relative
independence of local governments in terms of
their right to levy taxes. Citizens may call upon
their local councils to provide services and to
fund them collectively; the councils are politi-
cally responsible to the local citizens (Alber
1995; Kautto 1995).
In the Scandinavian countries local govern-
ment occupieskey role in funding and plan-
a Walker 1993).
ning the production of social care services, but
voluntary organizations and family child-
minders are also involved on the production
side. Commercial services are virtually non-
existent. Social care services constitute a broad
administrative entity, which is most clearly
seen in the fact that there is no separate prepar-
atory school for children aged 3-6. Citizens
have the subjective right to certain municipal
services. However, the right to services and the
universalism of the system are beginning to
lose their meaning now that user fees for
Downloaded from http://esp.sagepub.com by guest on July 13, 2008
© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
public services are going up. The Scandinavian
model is strong and in spite of mmor policy
differences (for example Leira 1993) it is
clearly distinguishable in all the Scandinavian
countries.
Secondly, we feel it is legitimate to refer to a
family care model which is distinctive of Portu-
gal, Spain, Greece and Italy. These countries
have a very limited supply of social care ser-
vices, with the exception of preparatory school
in Italy. Most services are produced on the
informal or grey market, while the more
affluent strata use private commercial services.
Companies also provide services for staff
members. All m all the public authorities play
a rather modest role, but in this regard there is
also significant variation across countries and
regions (Bianchi 1991). There is no supervised
day care(Dumon 1992: 85-88). The pro-
portion of women in the active labour force is
low, but the majority of those who are in gain-
ful employment have full-time jobs.
Other regional models are less distinct. One
might argue for the existence of a British
means-tested model, in which the state
assumes responsibility for the provision of
social care services but seeks at the same time
actively to downplay its responsibilities and
the quantity of public services. Owing to the
central role of the public sector, the British
model used to be very similar to the Scandina-
van model, but since the early 1980s Britain
has been moving towards residuality, while the
Scandinavian countries have shifted increas-
ingly towards universalism (Baldock 1994;
In Britam, public social services are means-
tested and intended exclusively for people with
limited means. Child care services are quite
limited and aimed chiefly at problem cases
(Cohen 1988: 25, 38, 39; Dumon 1992: 85-
92). Citizens who are economically self-suf-
ficient are expected independently to provide
for their own services, and commercial services
have an exceptionally visible role. The model is
also possible to identify in Anglo-Saxon coun-
tries outside Europe; perhaps one could go so
far as to argue for an Anglo-Saxon means-

tested model. Ireland comes rather close to the
British model but on the other hand also to the
southern European home care model.
In the case of old age welfare it is possible to
distinguish a central European subsidiarity
model, represented most typically by the Neth-
erlands and Germany and, somewhat more re-
motely, by Belgium and France. In this model
primary responsibility for the care of elderly
people lies, at least formally, with the family.
Religious and political organizations are major
producers of services, whereas the pubhc
sector carries the main responsibility for fund-
ing. The autonomy of voluntary organizations
vis-à-vis both the state and users is reinforced
by the fact that funding is provided from vari-
ous different sources and that health insurance
is a major source of fundmg for services (Dieck
1990; Dieck and Homolovd 1991; Jamieson
1991; Henrard, Ankn and Isnard 1991; Paco-
let 1992). Alber (1995) stresses how health in-
surance and the central role of organizations
undermine the motivation in Germany to
c. expand funding of services for elderly people.
-
In these countnes the volume of social care
services for elderly people is at an intermediate
level, the necessary exception to the rule being
the Netherlands whose exceptional service
history makes it one of the leading countries in
terms of both institutional and home help ser-
vices (Pijl 1993a; 1993b).
However, as far as services for children are
concerned, Belgium and France could hardly
be more different from Germany and the Neth-
erlands. The strong family-policy orientation
of Belgium and France is evidenced by the ex-
tensive day care and pre-school system, which
is the most comprehensive in the whole of
western Europe (Leprince 1991; Mostinckx
1993: 30; Pichault 1984: 57). Although the
main role of services m France is to support
families with children rather than women’s
autonomy (Hantrais 1993; Randall 1994),
large numbers of mothers of small children are
gainfully employed on a full-time basis. On the
other hand neither the Dutch nor the German
state do very much to support children’s day
care or pre-school, and the existence of both
Downloaded from http://esp.sagepub.com by guest on July 13, 2008
© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
97
these systems relies heavily on the voluntary
contributions of parents. Many women have
part-time jobs, and only a minority of the
mothers of small children are active in the
labour market. So in central Europe we can
identify one or two models, depending on
whether we take the angle of social care ser-
vices for children or for elderly people.
In conclusion
In this article we have looked into the possi-
bilities of integrating social care services into
the ongoing discussion on welfare state
regimes. Conceptual and methodological
problems as well as difficulties with research
data make this a formidable task indeed.
Before we can proceed to do a serious inter-
national comparison of social care services, we
need to reach agreement first of all on basic
concepts and then build up national and inter-
national systems for data collection. Inter-
national comparative projects are of course
already under way, but these will not be able
to provide a comprehensive overview of the
relevant services until the governments con-
cerned commit themselves to setting up a
mechamsm for data collection in this area.
Comparative research on social care services is
possible but not easy; that is clearly evidenced
by the joint Nordic efforts to compile statistics
and to do research on social care services.
We have carried out an empirical analysis of
the volumes of social care services in different
countnes on the basis of data collected in two
extensive international projects and have dis-
covered significant differences between those
countries. To some extent the patterns of vari-
ation in service provision for elderly people
and for children are consistent from country to
country, but certain countries are clearly
oriented more strongly either to frail elderly
people or to children. We have also found a
distinct pattern of symmetry in the variation of
women’s wage employment and social care
98
services. Further, it seems that in the European
context it is legitimate to speak
of European
social care regimes with their own distinctive
constructs. We have examined those con-
structs in relation to the role of the public
sector as a source of funding for social care
services.
Although we are unable to present any
decisive results here, the mclusion of social
care services in the research tradition con-
cerned with the modelling of welfare states is
nevertheless an important step to broaden our
understanding of the ways in which welfare
states operate. In future, it would also be use-
ful to extend the analysis to take in health and
education services. This would gradually make
it possible to start talking about welfare state
regimes m the true sense of ’welfare state’.
Acknowledgements
We wish thank Katn Hellsten, Olli Kangas,
to
Jon Kvist, Niels Ploug, Joe Larragy and our
anonymous referees for their valuable
comments. Thanks also to Juha Kddridinen for
his technical assistance.
Notes
1 This is not the place to go into the historical origins
of social care services, but their existence is an indi-
cation of the fact that ’care dependency’ has become
an issue of social significance. The women’s move-
ment in particular has called upon society to provide
social services, sometimes for single mothers, some-
times for women in wage employment, sometimes
for elderly women. It is perhaps no coincidence that
the first book to be published in Finland on social
care services was edited by Riitta Auvinen (1974),
the first ’feminist’ to complete a doctorate in social
policy.
2 Pamela Doty’s (1988: 47) study on the care of chro-
nicallyill patients in different countries highlights
some of the difficulties that any researcher will have
Downloaded from http://esp.sagepub.com by guest on July 13, 2008
© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
to encounter in a comparative investigation. First of
all there is an extremely wide range of services that
should have to be included in the comparison, but
the number cannot really be reduced without some
measure of randomness. That is why in her study the
data were collected from five types of medically
oriented institutions, four non-medically oriented
types of institutions, as well as from family care,
service homes for the disabled, professional and
auxiliary home nursing, home services, day care for
the elderly and meals on wheels services. Secondly,
there remains much conceptual inconsistency. The
same concept (such as ’nursing home’) may refer to
different types of institutions even in countries
which speak the same language. Some labels are
anachronisms: for instance, Belgian ’rest homes’
have at some point been precisely that, but they have
since been medicalized. Thirdly, the coverage of stat-
istics can be quite poor, especially for community
care.
3 In Scandinavia, for instance, the day care of children
who are not at school is a social care service,
whereas in most other European countries pre-
school for children over three is an educational ser-
vice.
4 Many of the problems occurring in studies of social
phenomena are in fact often resolved in advance by
the people who compile the statistics; or at least this
is the impression they convey. The continuity el-
ement in statistics creates such a strong aura of
credibility that it hardly even occurs to anyone to
question their validity and reliability. However,
there is good reason to ask whether international
statistics on participation in the active labour force,
for example, really describe the same set of phenom-
ena that the researchers using those statistics think
they do.
5 The figures for institutional care are more reliable
than those on home help services.
6 The problem is alleviated by Doty’s (1988: 153)
observation that the proportions of elderly people in
medical institutions vary from country to country to
a lesser extent than the proportions in non-medical
institutions. In other words the figures describe
differences more in social welfare than in health care
services.
7 Five of the six correlation coefficients between the
four variables are positive (Table 2). This sort of
discovery of co-variation lends support to the argu-
ment that services for children and the aged can be
discussed as integral parts of the social care system.
Another factor which lends support to the view of
consistency is the surprising discovery that the
highest correlations between individual variables
prevails between community care services for elderly
people and children’s day care services. The corre-
lations of pre-school with other variables are on
average the lowest, which raises the question as to
 99

whether pre-school should m fact be counted under Esping-Andersen, G. (1990) The Three Worlds of
social care services, or possibly educational services. Welfare Capitalism
, Cambridge, Polity Press.
Hantrais, L. (1993) Women, work and welfare in
France, in J. Lewis (ed.) Women and Social Policies in
Europe. Work, Family and the State, Aldershot,
Edward Elgar: 116-37.
Henrard, J.-C., Ankri, J. and Isnard, M.-C. (1991)
References Home-Care Services m France, in A. Jamieson (ed.)
Home-Care for Older People in Europe. A Com-
parison of Policies and Practices
, Oxford, Oxford
Alber, J. (1993) Health and social services, in A. University Press, pp. 99-117.
Walker, A.-M. Guillemard and J. Alber (eds) Older Hernes, H. (1987) Welfare State and Woman Power,
People m Europe. Social and Economic Policies
. The
Oslo, Norwegian University Press.
1993 Report of the European Community Observ-
Hobson, B. (1990) No exit, no voice. A comparative
atory, Commission of the European Communities, analysis of women’s economic dependency and the
pp. 52-72. welfare state, Acta Sociologica 33
(3): 235-50.
Alber, J. (1995) A framework for the comparative study Jamieson, A. (1991) Community care for older people.
of social services, Journal of European Social Policy Policies in Britain, West Germany and Denmark, in
5(2): 131-49. G. Room (ed.) Towardsa European Welfare State,
Anttonen, A. (1995) The welfare state, women and Bristol, SAUS, pp. 107-26.
social citizenship,T. Gordon and K. Kauppinen
in
Jones, C. (1985) Patterns of Social Policy, An Introduc-
(eds) Unresolved Dilemmas: Women, Work and tion to Comparative Analysis
, London, Tavistock.
Family in the United States, Europe and the Former Kautto, M. (1995) Eurooppalainen hyvinvointikunta?
, Aldershot, Avebury (forthcoming).
Soviet Union Osa II. Sosiaali - ja terveyspalvelut Tanskaasa ja
Anntonen, A, Henriksson, L. and Natkin, R. (eds) Espanjassa, Helsinki, Suomen Kuntalitto.
(1994) Naisten hyvinvointivaltio
, Tampere, Vasta- Kolberg, J.E. and Uusitalo, H. (1992) The interface be-
paino. tween the economy and the welfare state: a sociologi-
Auvinen, R. (1974) Sosiaalipalvelu, Espoo, Weilin and cal account, in Z. Ferge and J. Kolberg (eds) Social
Goos.
Policy in a Changing Europe, European Centre for
Baldock, J. (1994) The personal social services: the poli- Social Welfare Policy and Research, Frankfurt/New
tics of care, in V. George and S. Miller (eds) Social
York, Campus/Westview: 77-94.
Policy towards 2000: Squaring the Welfare Circle, Kolehmainen, S. (1995) Naisten ja miesten tyomarkki-
London, Routledge, pp. 161-89. nat. Segregaakio ja rakennemuutos Suomessa 1970-
Bianchi, M. (1991) Policy for the elderly in Italy: inno- 90, Tampere, Sosiaalipolitiikan laitos (unpublished).
vation or modernization, A. Evers and I. Svetlik
in
Langan, M. and Ostner, I. (1991) Gender and welfare.
(eds) New Welfare Mixes Care for the Elderly,
in
Towards a comparative framework, m G. Room (ed.)
Eurosocial Reports 40(3): 101-24. Towards a European Welfare State, Bristol, SAUS,
Cohen, B. (1988) Caring for Children. Services and Poli- pp. 127-50.
cies for Childcare and Equal Opportunities in the
Lebfried, S. (1993) Towards a European Welfare State?
United Kingdom
, Report for the European Com- On integrating poverty regimes into the European
mission’s Childcare Network, London, Commission
of the European Communities.
Community, in C. Jones (ed.) New Perspectives on
the Welfare State in Europe, London, Routledge, pp.
Dieck, M. (1990) Politics for Elderly People in the FRG. 133-56.
In A. Jamieson and R. Illsley (eds) Contrasting Euro-
Leira, A. (1993) Mothers, markets and the state: A
pean Policies for the Care of Older People, Aldershot, Scandinavian ’Model’? Journal of Social Policy 22
(3):
Avebury, pp. 95-119. 329-47.
Dieck, M. and Garms-Homolová, V. (1991) Home-care Leprince, F. (1991) Day care for young children in
services in the Federal Republic of Germany, in A.
France, in E. C. Melhuish and P. Moss (eds) Day Care
Jamieson (ed.) Home Care for Older People in Eur- for Young Children: International Perspectives:
ope. A Comparison of Policies and Practices
, Oxford, Policy and Research in Five Countries
, London,
Oxford University Press, pp. 118-56.
Routledge, pp. 10-26.
Doty, P. (1988) Long-term care in international perspec- Lewis, J. (1992) Gender and the development of welfare
, Annual Sup-
tive, Health Care Financing Review regimes, Journal of European Social Policy 2 (3):
plement, pp. 145-55. 159-73.
Dumon, W. (1992) National Family Policies m EC- Mostinckx, J. (1993) The Flemish community, in B.
Countries m 1991, European Observatory of
Munday (ed.) European Social Services
, European
National Family Policies
, Volume I, Brussels, Com- Institute of Social Services, Canterbury, University of
mission of the European Communities.
Kent at Canterbury, pp. 19-60.

Downloaded from http://esp.sagepub.com by guest on July 13, 2008

© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
I00
O’Connor, J. S. (1993) Gender, class and citizenship
the comparative analysis of welfare state regimes:
theoretical and methodological issues, The British
Journal of Sociology 44
(3): 501-18.
OECD (1990) Employment Outlook, July, Paris,
OECD.
OECD (1993) Employment Outlook, July, Paris,
OECD.
OECD Directorate for Education, Employment, Labour
and Social Affairs (1993) The Care of the Frail
Elderly. Draft Synthesis Chapter of the Final Report
(to be published).
Orloff, A. S. (1993) Gender and the social rights of
citizenship: the comparative analysis of gender re-
lations and welfare states, American Sociological
Review 58
(3): 303-28.
Pacelot, J. (1992) Recent Shifts in the Welfare Mix for
the Care ofthe Elderly in Belgium
, International
Expert Meeting at Hasseludden 3-5 April 1992,
Vienna, European Centre for Social Welfare Policy
and Research.
Phillips, A. and Moss, P. (1989) Who Cares for Eur-
ope’s Children, The Short Report of the European
Childcare Network, Luxembourg, Commission of the
European Communities.
Pichault, C. (1984) Day Care Facilities and Services for
Downloaded from http://esp.sagepub.com by guest on July 13, 2008
© 1996 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
in Children Under the Age of Three in the European
, Luxembourg, Office for Official Publi-
Community
cations of the European Communities.
Pijl, M. A. (1993a) The Dutch welfare state: a product
of religious and political pluralism, in R. Page and J.
Baldock (eds) Social Policy Review 5 , Canterbury,
Social Policy Association, pp. 288-304.
Pijl, M. A. (1993b) The Netherlands, in B. Munday (ed.)
European Social Services
, European Institute of
Social Services, Canterbury, University of Kent at
Canterbury, pp. 273-305.
Randall, V. (1994) The politics of child day care: some
European comparisons, Schweizerisches Jahrbuch fur
Politische Wissenschaft 34, Bern, Haupt.
Sainsbury, E. (1977) The Personal Social Services,
London, Pitman.
Walker, A. (1993) A Cultural Revolution? Shifting the
UK’s welfare mix in the care of older people, in A.
Evers and I. Svetlik (eds) Balancing Pluralism. New
Welfare Mixes in Care for the Elderly, European
Centre Vienna, Aldershot, Avebury, pp. 67-88.
Women in the European Community (1992) Luxem-
bourg, Office for Official Publications of the Euro-
pean Communities.
Yearbook of Nordic Statistics (1992) Edited by the Nor-
dic Statistical Secretariat, Nord, p. 1.