Vocational rehabilitation of the socially disadvantaged long-term sick: inter-organizational co-operation between welfare state agencies

Abstract

Vocational rehabilitation targeted to the socially disadvantaged long-term sick requires that the client keep in touch with a number of welfare state agencies, all of which have different regulations, conflicting goals and various types of benefits. This is an arduous and time-consuming task for clients with medical, social and labour market problems. Many of these clients run the risk of ending up in a no-man's land or being endlessly circulated between agencies because their problems do not correspond to the profile of the typical client. Both government and welfare workers see institutional co-operation between welfare state agencies as the remedy to such problems. This article, which is based on interviews with participants in fourteen cooperating projects, focuses on difficulties and opportunities experienced in such co-operation. It is concluded that such co-operation, when initiated in local settings and supported by local players, is a way of rejuvenating the existing Swedish model.

Keywords

inter-organizational co-operation long-term sick multi-problem clients vocational rehabilitation welfare policy.

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References

Esping-Andersen G. , Korpi W. From poor relief to institutional welfare states: The development of Scandinavian social policy. In: Eriksson R , Hansen EJ , Ringen S , Uusitalo H , editors. The Scandinavian Model . Armonk, New York: ME Sharpe, 1987: 39-74.

Sinfield A. Poverty, privilege and welfare. In: Bean P , Whynes D , editors. Barbara Wootton: social science and public policy: essays in her honour. London: Tavistock, 1986: 108-23.

Aronsson G. , Sjögren A. Samhällsomvandling och arbetsliv (Societal transformation and work life). Solna: Arbetsmiljöinstitutet, 1994 : 36-7.

Lindqvist R. , Marklund S. Forced to work and liberated from work. A historical perspective on work and welfare in Sweden. Scand J Soc Welfare 1995; 4: 224-37.

Prop 1990/91: 140. Arbetsmiljö och rehabilitering (Government proposition: work environment and rehabilitation).

Prop 1990/91: 141. Rehabilitering och rehabiliteringsersättning (Government proposition: rehabilitation and income protection).

Riksförsäkringsverket.

Långvarigt sjukskrivna-arbetslöshet och sammansatta riskfaktorer (National Social Security Board. Long-term sick clients-unemployment and complex risk factors.)

RFV Redovisar 1996: 14.

Lipsky M. Street-level bureaucracy. New York: Russell Sage Foundation, 1980.

Johansson R. Vid byråkratins gränser (At the boundaries of bureaucracy). Lund: Arkiv, 1992.

10.

Hasenfeld Y. The nature of human service organizations. In: Hasenfeld Y , editor. Human services as complex organizations . London: Sage, 1992: 16.

11.

En allmän och aktiv försäkring vid sjukdom och rehabilitering, Del 1 (Swedish public investigations: a universal and active insurance of sickness and rehabilitation). Stockholm: SOU 1996; 113: 177-90.

12.

Egon Jönsson-en kartläggning av lokala samverkansprojekt inom rehabiliteringsområdet (Swedish public investigations: Egon Jönsson-a survey on local cooperation projects in the field of vocational rehabilitation). Stockholm : SOU, 1996; 86: 123-65.

13.

Hvinden B. Divided against itself. A study of integration in welfare bureaucracy. Oslo: Scandinavian University Press, 1994: 10-1.

14.

Lindqvist R. Arbetsrehabilitering av utsatta gruppersamverkan mellan olika ak-lörer. Social medicinsk tidskrift 1997; 10: 34 - 39 (Vocational rehabilitation of socially vulnerable clients - co-operation between different players).