Care as you like it: the construction of a consumer approach in home care in Denmark

Abstract

The free choice of a home-care provider was introduced in Danish home care in 2001. This article discusses the overall premises for the introduction of free choice in home care and how it constitutes an overarching response to the crisis of the welfare state. The government at that time intended free choice to lead to more user-led services, more cost-efficient services, and the development of a care market, all in line with its ideology. The article argues that to achieve these ambitions, the government introduced many new but implicit assumptions about the role and the responsibilities of the user of care. On the basis of qualitative interviews with elderly users, care workers, and care assessors, the article examines these assumptions and their implications for the user. The findings show that most users desire continuity in care more than the opportunity to ‘exit' a care relationship. Moreover, users do not rate quality any higher in the private for-profit sector than in the public. The article concludes that consumerism is in Denmark now part of the logic of governance, thereby changing the conditionality of the welfare state and its subjects, and creating new forms of risks, responsibilities, and dependencies.