Quality Reforms in Danish Home Care: Balancing between Standardisation and Individualisation

Despite relatively generous coverage of the over-65 population, Danish home help services receive regular criticism in the media and public opinion polls. Perhaps as a consequence, reforms of Danish home care policy for senior citizens have placed strong emphasis on quality since the 1990s. This reform strategy represents a shift from the welfare state modernisation program of the 1980s, which built mainly on economic strategies of cost-efficiency and New Public Management (NPM) princi-ples, including contract management and performance management. Recent reforms have instead attempted to increase the overall quality of care by increasing the transparency at the political, administrative and user levels. However, reforms have revolved around conflicting principles of standardisation and the individualisation of care provision and primarily succeeded in increasing the political and ad-ministrative control over home help at the expense of the control by users, care workers and case managers.