Positioning the ageing subject: articulations of choice in Swedish and UK health and social care

Abstract

What happens when similar measures are being introduced in different national contexts? This article studies the ways in which patient choice has been articulated in public and official reports on health care in the two contexts of Sweden and the UK, whose welfare systems are typically comprehended as different. Specific interest is directed towards the construction of patient positions, and policy documents are analyzed using discourse theory. The results show many similarities between the national contexts; choice is primarily articulated with individuality, autonomy, consumption, and responsibility, as well as with support from state agencies, and patient choice is relentlessly normalized as the way forward. But there are also important differences that reveal that the presuppositions differ, for example, when pinpointing the stakeholders of patient choice reforms and how the different policies work to take the well-known edges off of patient choice ideology.