Får jag LOV att hjälpa? Biståndshandläggarens nya dilemma

Sammanfattning: Am I allowed to help? – The care manager’s new dilemma Authors: Thea Nilsson Svegard and Helena Rülf Title: Am I allowed to help? – The care manager’s new dilemma Supervisor: Staffan Blomberg Assessor: Alexandru Panican The aim of this essay was to examine how care managers working with elderly look upon their own role in relation to customer-choice. The customer-choice reform is spreading rapidly within the Swedish municipalities as a result of the introduction of the Act on System of Choice in the Public Sector (2008:962) and financial incentives from the government. The care manager’s role is under change since it is prescribed a new task which is to, in an impartial manner, inform the users concerning the different providers of care services which the user can choose from. The study was carried out using a qualitative method and was based on interviews with nine care managers in three different municipalities where customer-choice had been implemented. The theoretical premises that were used in the essay were Lipsky’s theories on the street-level bureaucrat and the concept of discretion. In addition to this theoretical frame of reference we applied Hirschman’s theories on the constructs voice, exit and loyalty to analyze how the discourse surrounding the benefits of customer choice regarding user influence can be understood. We found that the care managers have certain discretion but it was used in accordance with the guidelines that the organization endorsed. The way the care managers interpreted the required impartiality at times contradicted the user’s wishes. We found an inherent contradiction within the role of the care manager since the expectation is to be at once the impartial representative of the organization and the advocate, working to ensure that the user’s needs and rights are met in the best fashion possible. We also found that the customer-choice model in itself and the arguments that it is built on has problematic features when it comes to the goals generally expected to be its effect.