Contracting out welfare services: how are private contractors held accountable?

Abstract

A challenge for governments contracting out public services is holding accountable contractors who fail to meet agreed-upon standards. In social services, contract monitoring is complicated by the fact that contracts tend to be incomplete and performance hard to assess. In this study, we examine how local governments in Sweden hold private contractors accountable in nursing home care. The main finding is that a mixture of accountability mechanisms was used, but that social accountability was seen as most effective. Marketaccountability measures like contract termination and financial sanctions could not be applied as local governments lacked the capacity to enforce them.