Explaining variations in enforcement strategy: A comparison of the Swedish health care, eldercare, and compulsory school sector

Abstract

This article analyzes whether, and if so, why, national inspectorates adopt different enforcement strategies when controlling the provision of welfare services, such as health care, eldercare, and the compulsory school. The findings show that the Swedish Schools Inspectorate uses a predominantly strict strategy, while the Health and Social Care Inspectorate relies on a more situational strategy. To explain this variation in enforcement strategy, the article tests four hypotheses derived from the literature on regulatory enforcement. The findings suggest that the variation between the agencies is not primarily the result of differences in resources or the authority to issue punitive decisions, as suggested by previous research. Instead, we find support for the hypothesis that the definition of quality can explain variation in adopted strategies, and partial support for the hypothesis that differences in regulatory mission can account for a variation in the agencies' formal enforcement strategies.

Regulation of long-term care for older persons: a scoping review of empirical research

“…Another qualitative study from Sweden focused on different types of enforcement strategies, used by different inspectorates in the welfare sector (Moberg et al ., 2022). They looked at stricter enforcement strategies based on the assumption that compliance is best enforced through a structured and punitive strategy, and more situational enforcement strategies based on the assumption that compliance increases if the aspects to inspect are decided on a case-by-case basis, using recommendations and dialog rather than a punitive strategy in case of noncompliance.…”

The governance of policy integration and policy coordination through joined‐up government: How subnational levels counteract siloism and fragmentation within Swedish migration policy

“…It is evident that the different intersections of migration policy across administrative tiers, functions, and sectors challenge policy coordination at the national level. Recent findings reveal variations in how similar welfare policies in Sweden are monitored (Moberg et al, 2023). Similarly, different spheres of migration policy are managed independently from each other, a model inspired from MLG-like settings (Hooghe & Marks, 2003).…”

Pacified citizens with a marketized school system: Causal evidence of boomeranging effects of user choice

“…Others contend that, on the contrary, the shift to markets has stimulated citizens' interest as they are now equipped with new means for affecting service providers. While accountability and responsiveness to citizens' interests have been explicit policy goals behind marketization (Friedman & Friedman, 1980; Greener, 2008; Le Grand, 2007), the realization of these goals is at risk if citizens turn out to be unwilling or unable under such conditions to influence public services (Moberg, 2017; Simmons et al., 2012) or political decision‐making generally (Dalton, 2017; Verba et al., 1995). Previous studies of citizens' prospects for realizing responsiveness and accountability in marketized settings have focused on whether informed user choice is likely in marketized public services (see, e.g., Moberg, 2017); on how marketization limits the influence that representative democratic institutions—and indirectly citizens in general—can exercise on public services (Fredriksson, 2013); and on how different groups of citizens choose to involve themselves in attempts to influence service provision (Dowding & John, 2011; Simmons et al., 2012).…”

“…While accountability and responsiveness to citizens' interests have been explicit policy goals behind marketization (Friedman & Friedman, 1980; Greener, 2008; Le Grand, 2007), the realization of these goals is at risk if citizens turn out to be unwilling or unable under such conditions to influence public services (Moberg, 2017; Simmons et al., 2012) or political decision‐making generally (Dalton, 2017; Verba et al., 1995). Previous studies of citizens' prospects for realizing responsiveness and accountability in marketized settings have focused on whether informed user choice is likely in marketized public services (see, e.g., Moberg, 2017); on how marketization limits the influence that representative democratic institutions—and indirectly citizens in general—can exercise on public services (Fredriksson, 2013); and on how different groups of citizens choose to involve themselves in attempts to influence service provision (Dowding & John, 2011; Simmons et al., 2012). A study by James and Jilke (2020) examines how the willingness of citizens' to co‐produce local public services is affected by private provision and customer‐oriented language; while James and John (2021) have studied the effects of user choice on attempts of citizens to influence providers of publicly funded health services through voice.…”