Protests against Welfare Retrenchment: Healthcare Restructuring in Sweden

The ‘new politics’ perspective in welfare state research holds that class‐based parties and unions have lost some of their influence and that they have been replaced by client organizations that are capable of resisting retrenchment pressures. However, scholars within the ‘power resource tradition’ contend that class is still fundamental and that client interests are weak in corporatist countries with a strong labour movement. It is argued in this article that scholars within the power resource approach have focused too much on social insurance programmes and traditional forms of political participation, and that this has made them blind to client protests. An empirical study of political efforts to close down nighttime emergency surgery in Swedish hospitals is presented. The Swedish counties planned to close down emergency surgery in 17 hospitals in the period 2003–04. The political proposals to close down emergency departments were met with strong protests from client groups, and politicians often withdrew their proposals of closures. In this case study, politicians claim that it was client protests that made them withdraw a decision to close the emergency surgery. This result suggests that client protests are politically important and diverges from the expectations deduced from the power‐resource approach but lends credibility to the theory of the new politics of the welfare state.     

Asking Routinely About Intimate Partner Violence in a Child and Adolescent Psychiatric Clinic: A Qualitative Study

Among children visiting child and adolescent psychiatric clinics (CAP), the prevalence of exposure to intimate partner violence (IPV) is reported to be approximately 25 %. The extent to which CAP clinicians are aware of this violence, however, is unclear. Some researchers recommend asking about IPV at intake, both to raise disclosure rates and to ensure adequate treatment. Many clinicians are reluctant to do so as a matter of routine when there is no indication of occurrence of IPV in the family. When we interviewed 14 clinicians about their experiences using a standard questionnaire about IPV, three themes emerged: (a) constraint (the questions hinder the development of good relationships with patients), (b) uncertainty (upon reflection, screening is acknowledged as important, but somewhat deficient), and (c) utility (the questionnaire provides a useful framework). Our findings indicate that clinicians’ negative feelings and ambivalence make the implementation of routinely asking about IPV a long process.