Care Justice and the Old Ideal of the Caring State
What is a caring state? The concept of caring state has been discussed in an emerging feminist and political theory literature (Chatzidakis et al. Reference Chatzidakis, Hakim, Litter, Rottenberg and Segal2020; Daly, Reference Daly and Lewis1998; Engster Reference Engster2007; Kim Reference Kim2018; Vabø and Szebehely Reference Vabø, Szebehely, Anttonen, Häikiö and Stefánsson2012). Often viewed as a concrete materialization of the Nordic welfare state ideal, a caring state is conceived as providing care that is universal, generous, good quality, accessible, affordable, flexible, and used by (almost) all (Vabø and Szebehely Reference Vabø, Szebehely, Anttonen, Häikiö and Stefánsson2012). This definition contains two key elements: tax-financed, universal care accessible by all vulnerable groups, including pre-school children, the sick, the challenged, and the frail and older persons; and high-quality care carried out — and ensured — by professionally trained care workers (Dahl Reference Dahl2010; Dahl and Rasmussen Reference Dahl, Rasmussen, Kamp and Hviid2012). The Nordic countries have promoted a caring state by converting care into a social right predicated on a dual worker--‘dual’carer model. This model envisions a combination of full-time paid work with caring duties, both in motherhood and when one’s own frail, older parents need care. The ideal of the caring state thus understands care justice as twofold: a right to be cared for through public provision of services and a concern for the work conditions, education, and recognition of care workers.
The ideal of a caring state, however, has been called into question by Nordic researchers (Dahl Reference Dahl2010; Fagertun, Vike, and Haukelien Reference Fagertun, Vike and Haukelien2024; Hansen, Dahl, and Horn Reference Hansen, Dahl and Horn2022; Szebehely and Meagher Reference Szebehely and Meagher2018). Part of their critique is that this gold standard is modeled on a male breadwinner ideal (Holst Reference Holst and Holst2002), the white, heterosexual, middle-class woman (de los Reyes, Molina, and Mulinari Reference De los Reyes, Molina and Mulinari2002), and a simplistic universalism that is insufficiently sensitive to recognition and misrecognition of care (Dahl Reference Dahl2010). By “misrecognition,” I follow Fraser’s tridimensional theory of justice (Fraser Reference Fraser2003; Reference Fraser2008), based upon the three R’s: redistribution, recognition, and representation. Redistribution concerns the just allocations of money and time; recognition is about being seen, heard, and valorized on a par with other people or occupations; and representation is about voice and the discursive framing of care politically, including the governance of care. Beyond this institutional bias, the dynamics of neoliberalism have also altered the realities of this ideal. Neoliberalism was — and still is — a diverse and dynamic discourse with a seductive force that promised cheaper and better care (Dahl Reference Dahl2017), despite periodic claims about its demise or death (Venugopal Reference Venugopal2015).
How the Supposedly Caring State Turned Less Caring
Neoliberal rationalities have been taken up to varying degrees in the Nordic countries, a softer version in Norway and Denmark compared to more rampant neoliberalism in Finland and Sweden. Common to both versions are the well-known processes of outsourcing, marketization, and care offloaded back onto families themselves and voluntary work (Fagertun, Vike, and Haukelien Reference Fagertun, Vike and Haukelien2024). However, we know less about what happens with care practices financed and regulated by the state and municipalities. In the Nordic countries, neoliberalism has led to four significant changes: standardizing care, de-professionalizing care, instrumentalizing care, and silencing elements of care (Dahl Reference Dahl2017; Reference Dahl2026).
The logic of standardization focuses on measuring performance and quality. Informed by neoliberalism, the state endeavors to standardize the various elements of care practices by splitting them into ever smaller tasks that can then be measured and optimized. For care professionals, standardizing implies fragmenting care work (Dahl Reference Dahl2017; Trappenburg and Nordengraaf Reference Trappenburg and Noordengraaf2018) and compelling them to spend more time on documenting the tasks carried out so as to ensure that the care recipient’s rights to equality and quality have been respected. The result of the standardization project is that care professionals have less time available to do actual care work.
The second result of neoliberal discourse is de-professionalization. When care professionals are compelled to follow fixed guidelines and rules, they lose the kind of discretion needed to care properly for vulnerable people. Third, neoliberalism frames care as an expenditure and instrumentalizes it to achieve other ends beyond providing the actual care. Care becomes part of a larger strategy to “rehabilitate” frail, older people so that they can become “independent.” Alternatively, care becomes part of a social investment discourse applied to children. Care becomes a means to another end, and as a result, the important, relational element is lost.
The fourth result of neoliberal discourse is that some needs are silenced and not deemed relevant to the state (Dahl Reference Dahl2017). Silencing implies that certain groups of people with specific needs are no longer mentioned in policy documents (Bacchi Reference Bacchi2009) and are no longer the responsibility of the state or of care professionals. There is, for example, a silencing of social needs in old age care (Dahl Reference Dahl2000; Graff and Vabø Reference Graff and Vabø2026; Øye et al. Reference Øye, Kamp and Dybbroe2023).
In other words, the neoliberal approach to care has created an emerging care crisis in what was supposedly the archetypical caring state (Hansen, Dahl, and Horn Reference Hansen, Dahl and Horn2022). There is simply not enough care, nor good enough care, provided. There is less care because eligibility criteria are tightened (Szebehely and Meagher Reference Szebehely and Meagher2018). And the goodness of care is also less adequate because of the intensification of work, moral distress, and high workloads among professional carers, all of which lead to burnout and permanent recruitment problems (Hansen, Dahl, and Horn Reference Hansen, Dahl and Horn2022).
Care professionals find themselves unable to provide the care required in an adequate way, causing them moral distress (Jameton Reference Jameton2013; Vaaben et al. Reference Vaaben, Olesen and Gylling2023; Vike, Fagertun, and Haukelien Reference Vike, Fagertun, Haukelien, Fagertun, Vike and Haukelien2024). Little wonder that around half of care professionals within long-term care in the Nordic care sector want to leave their jobs (Aerschot et al. Reference Aerschot, Puthenparambil, Olakivi and Kröger2022). If many care professionals exit the care sector, the resulting recruitment problems will undermine the supposedly caring state and feed into the care crisis.
Contestations and Re-Imaginations of the Caring State
Neoliberalism and the neoliberal governance paradigm has been subjected to mounting criticism (Torfing et. al. Reference Torfing, Andersen, Greve and Klausen2020; Tronto, Reference Tronto2017). The care crisis has inspired political mobilization around the role of care in achieving the good life. Contestations about care in the Nordic countries center on issues of care needs, knowledge, gender equality, adequate time for care, governance, staffing, wages, and working conditions for care professionals (Dahl Reference Dahl2017; Grip Reference Grip2025; Hoppania Reference Hoppania2015; Pedersen Reference Pedersen2024; Peterson and Brodin Reference Peterson, Brodin, Fagertun, Vike and Haukelien2023). Actors have re-imagined the caring society and the role of the caring state, offering new conceptual images of what they could become (Cooper Reference Cooper, Copper, Dhawan and Newman2020). Here, I will focus on two such re-imaginations prominent in Denmark and Sweden, focusing on proper governance of care and the issue of time to care. These visions relate mainly to the third element of a caring society: the support and recognition of those doing the care (formalized and informal care).
Researchers have identified an emerging New Public Governance (NPG) paradigm (Torfing et al. Reference Torfing, Andersen, Greve and Klausen2020; Torfing and Triantafillou Reference Torfing and Triantafillou2013) that promises less fragmentation and innovation through an increased focus upon trust and co-creation. This move to a collaborative paradigm can be seen in old-age care (Vabø et al. Reference Vabø, Zechner, Stranz, Graff and Sigurdardóttir2022), where the Dutch Buurtzorg model, with its smaller, self-governing teams, has attracted the attention of local and national policymakers (Nandram Reference Nandram2015; Topholm et al. Reference Topholm, Møller and Buch2025). In Denmark, the 2025 old-age care policy reform combines elements of marketization with the NPG style team-based care. A 2024 law seeks to reduce standardization and fragmentation to improve care and retain care professionals by giving them more discretion in their daily work. Self-governing teams are currently being implemented in municipalities and, if truly self-governing, would improve the support and recognition of professionally trained care workers by recognizing their skills and increasing their discretion.
The relationship between time for care and paid work has also become a focus of the collective agreement system for professional care workers in Sweden and Denmark. In Sweden, care professionals have pushed their union to demand a reduction of the working week to 30 hours, whether by law or through collective agreements (Kommunal 2024; Kommunalarbetaren 2022). This politics of time (Ellingsæter Reference Ellingsæter2007; Grip Reference Grip2025) reflects a struggle between two different strategies for creating gender equality, either making full-time work the general norm or reducing the working week (Grip Reference Grip2025).
Swedish care professionals, primarily women, have resisted the full-time working norm and argued instead that their union should support a shorter working week and workers’ influence over schedules to enable both better care for vulnerable citizens and more self-care for care workers (Grip Reference Grip2025). Self-care refers to the leisure time needed to recover from the strain of exhausting, intensified care work (Grip Reference Grip2025; Lorde Reference Lorde2017). Reducing the work week for one group in the labor market would be one pathway toward a caring state that takes “care for the carer” seriously (Dahl Reference Dahl2010). However, reduced working hours would also reproduce gendered inequalities in wages and pensions if not compensated by wage restructuring and pension reforms.
Although the Nordic states have been synonymous with extensive rights to receive care, there is, further, a new focus on the right to give care. In Denmark, collective agreements enacted in 2025 have allowed employees to take a couple of paid days off each year to care for a sick child or grandchild or to accompany an older relative to the hospital or doctor’s office (Danmarks Radio Reference Danmarks2025). These options are not rights, as they are neither paid nor part of legislation, but they have an affinity with formal social rights. Social rights to care for others — and oneself — are an example of how the key contradiction within capitalism between time to care and time to paid work might be renegotiated, as argued by Fraser (Reference Fraser2022). Allowing more time for the care of significant others would begin to change the Nordic care compromiseFootnote
1 and restrain neoliberal capitalism. However, this strategy assumes that the right to give care supplements existing rights to receive care, which raises ongoing questions about how access to these rights is structured along hierarchies of gender, class, and race.
Conclusion
The old notion of a caring state is no longer useful for understanding the Nordic ideal of a caring state. An overstretched social infrastructure, as well as overburdened, exhausted care professionals, have brought to the fore new — and old — issues regarding care injustices. A caring society has not been achieved through the Nordic caring state model and its emphasis on the right to receive care through public provision and good quality care provided by professionally trained care workers.
Inbuilt biases and neoliberalism have undermined this old ideal. Even when care workers are professionalized and care work is treated as work, we are still far away from an ideal caring society. In this essay, I have discussed some emerging issues, including proposals to shorten the working week and allowing time off from work to care for one’s own family. These ideas are about the redistribution of care and some recognition of the role of informal care in Nordic everyday life. They are also means of regulating capitalism.
Care justice depends upon redistribution and recognition. It also requires changes in how care is represented, framed, and governed politically. A truly caring society will not emerge unless we re-imagine the state and its governance to support both the professional carer and the person receiving care, as well as redistributing the goods and burdens of care more equally along the various intersectional vectors.
Care Justice and the Old Ideal of the Caring State
What is a caring state? The concept of caring state has been discussed in an emerging feminist and political theory literature (Chatzidakis et al. Reference Chatzidakis, Hakim, Litter, Rottenberg and Segal2020; Daly, Reference Daly and Lewis1998; Engster Reference Engster2007; Kim Reference Kim2018; Vabø and Szebehely Reference Vabø, Szebehely, Anttonen, Häikiö and Stefánsson2012). Often viewed as a concrete materialization of the Nordic welfare state ideal, a caring state is conceived as providing care that is universal, generous, good quality, accessible, affordable, flexible, and used by (almost) all (Vabø and Szebehely Reference Vabø, Szebehely, Anttonen, Häikiö and Stefánsson2012). This definition contains two key elements: tax-financed, universal care accessible by all vulnerable groups, including pre-school children, the sick, the challenged, and the frail and older persons; and high-quality care carried out — and ensured — by professionally trained care workers (Dahl Reference Dahl2010; Dahl and Rasmussen Reference Dahl, Rasmussen, Kamp and Hviid2012). The Nordic countries have promoted a caring state by converting care into a social right predicated on a dual worker--‘dual’carer model. This model envisions a combination of full-time paid work with caring duties, both in motherhood and when one’s own frail, older parents need care. The ideal of the caring state thus understands care justice as twofold: a right to be cared for through public provision of services and a concern for the work conditions, education, and recognition of care workers.
The ideal of a caring state, however, has been called into question by Nordic researchers (Dahl Reference Dahl2010; Fagertun, Vike, and Haukelien Reference Fagertun, Vike and Haukelien2024; Hansen, Dahl, and Horn Reference Hansen, Dahl and Horn2022; Szebehely and Meagher Reference Szebehely and Meagher2018). Part of their critique is that this gold standard is modeled on a male breadwinner ideal (Holst Reference Holst and Holst2002), the white, heterosexual, middle-class woman (de los Reyes, Molina, and Mulinari Reference De los Reyes, Molina and Mulinari2002), and a simplistic universalism that is insufficiently sensitive to recognition and misrecognition of care (Dahl Reference Dahl2010). By “misrecognition,” I follow Fraser’s tridimensional theory of justice (Fraser Reference Fraser2003; Reference Fraser2008), based upon the three R’s: redistribution, recognition, and representation. Redistribution concerns the just allocations of money and time; recognition is about being seen, heard, and valorized on a par with other people or occupations; and representation is about voice and the discursive framing of care politically, including the governance of care. Beyond this institutional bias, the dynamics of neoliberalism have also altered the realities of this ideal. Neoliberalism was — and still is — a diverse and dynamic discourse with a seductive force that promised cheaper and better care (Dahl Reference Dahl2017), despite periodic claims about its demise or death (Venugopal Reference Venugopal2015).
How the Supposedly Caring State Turned Less Caring
Neoliberal rationalities have been taken up to varying degrees in the Nordic countries, a softer version in Norway and Denmark compared to more rampant neoliberalism in Finland and Sweden. Common to both versions are the well-known processes of outsourcing, marketization, and care offloaded back onto families themselves and voluntary work (Fagertun, Vike, and Haukelien Reference Fagertun, Vike and Haukelien2024). However, we know less about what happens with care practices financed and regulated by the state and municipalities. In the Nordic countries, neoliberalism has led to four significant changes: standardizing care, de-professionalizing care, instrumentalizing care, and silencing elements of care (Dahl Reference Dahl2017; Reference Dahl2026).
The logic of standardization focuses on measuring performance and quality. Informed by neoliberalism, the state endeavors to standardize the various elements of care practices by splitting them into ever smaller tasks that can then be measured and optimized. For care professionals, standardizing implies fragmenting care work (Dahl Reference Dahl2017; Trappenburg and Nordengraaf Reference Trappenburg and Noordengraaf2018) and compelling them to spend more time on documenting the tasks carried out so as to ensure that the care recipient’s rights to equality and quality have been respected. The result of the standardization project is that care professionals have less time available to do actual care work.
The second result of neoliberal discourse is de-professionalization. When care professionals are compelled to follow fixed guidelines and rules, they lose the kind of discretion needed to care properly for vulnerable people. Third, neoliberalism frames care as an expenditure and instrumentalizes it to achieve other ends beyond providing the actual care. Care becomes part of a larger strategy to “rehabilitate” frail, older people so that they can become “independent.” Alternatively, care becomes part of a social investment discourse applied to children. Care becomes a means to another end, and as a result, the important, relational element is lost.
The fourth result of neoliberal discourse is that some needs are silenced and not deemed relevant to the state (Dahl Reference Dahl2017). Silencing implies that certain groups of people with specific needs are no longer mentioned in policy documents (Bacchi Reference Bacchi2009) and are no longer the responsibility of the state or of care professionals. There is, for example, a silencing of social needs in old age care (Dahl Reference Dahl2000; Graff and Vabø Reference Graff and Vabø2026; Øye et al. Reference Øye, Kamp and Dybbroe2023).
In other words, the neoliberal approach to care has created an emerging care crisis in what was supposedly the archetypical caring state (Hansen, Dahl, and Horn Reference Hansen, Dahl and Horn2022). There is simply not enough care, nor good enough care, provided. There is less care because eligibility criteria are tightened (Szebehely and Meagher Reference Szebehely and Meagher2018). And the goodness of care is also less adequate because of the intensification of work, moral distress, and high workloads among professional carers, all of which lead to burnout and permanent recruitment problems (Hansen, Dahl, and Horn Reference Hansen, Dahl and Horn2022).
Care professionals find themselves unable to provide the care required in an adequate way, causing them moral distress (Jameton Reference Jameton2013; Vaaben et al. Reference Vaaben, Olesen and Gylling2023; Vike, Fagertun, and Haukelien Reference Vike, Fagertun, Haukelien, Fagertun, Vike and Haukelien2024). Little wonder that around half of care professionals within long-term care in the Nordic care sector want to leave their jobs (Aerschot et al. Reference Aerschot, Puthenparambil, Olakivi and Kröger2022). If many care professionals exit the care sector, the resulting recruitment problems will undermine the supposedly caring state and feed into the care crisis.
Contestations and Re-Imaginations of the Caring State
Neoliberalism and the neoliberal governance paradigm has been subjected to mounting criticism (Torfing et. al. Reference Torfing, Andersen, Greve and Klausen2020; Tronto, Reference Tronto2017). The care crisis has inspired political mobilization around the role of care in achieving the good life. Contestations about care in the Nordic countries center on issues of care needs, knowledge, gender equality, adequate time for care, governance, staffing, wages, and working conditions for care professionals (Dahl Reference Dahl2017; Grip Reference Grip2025; Hoppania Reference Hoppania2015; Pedersen Reference Pedersen2024; Peterson and Brodin Reference Peterson, Brodin, Fagertun, Vike and Haukelien2023). Actors have re-imagined the caring society and the role of the caring state, offering new conceptual images of what they could become (Cooper Reference Cooper, Copper, Dhawan and Newman2020). Here, I will focus on two such re-imaginations prominent in Denmark and Sweden, focusing on proper governance of care and the issue of time to care. These visions relate mainly to the third element of a caring society: the support and recognition of those doing the care (formalized and informal care).
Researchers have identified an emerging New Public Governance (NPG) paradigm (Torfing et al. Reference Torfing, Andersen, Greve and Klausen2020; Torfing and Triantafillou Reference Torfing and Triantafillou2013) that promises less fragmentation and innovation through an increased focus upon trust and co-creation. This move to a collaborative paradigm can be seen in old-age care (Vabø et al. Reference Vabø, Zechner, Stranz, Graff and Sigurdardóttir2022), where the Dutch Buurtzorg model, with its smaller, self-governing teams, has attracted the attention of local and national policymakers (Nandram Reference Nandram2015; Topholm et al. Reference Topholm, Møller and Buch2025). In Denmark, the 2025 old-age care policy reform combines elements of marketization with the NPG style team-based care. A 2024 law seeks to reduce standardization and fragmentation to improve care and retain care professionals by giving them more discretion in their daily work. Self-governing teams are currently being implemented in municipalities and, if truly self-governing, would improve the support and recognition of professionally trained care workers by recognizing their skills and increasing their discretion.
The relationship between time for care and paid work has also become a focus of the collective agreement system for professional care workers in Sweden and Denmark. In Sweden, care professionals have pushed their union to demand a reduction of the working week to 30 hours, whether by law or through collective agreements (Kommunal 2024; Kommunalarbetaren 2022). This politics of time (Ellingsæter Reference Ellingsæter2007; Grip Reference Grip2025) reflects a struggle between two different strategies for creating gender equality, either making full-time work the general norm or reducing the working week (Grip Reference Grip2025).
Swedish care professionals, primarily women, have resisted the full-time working norm and argued instead that their union should support a shorter working week and workers’ influence over schedules to enable both better care for vulnerable citizens and more self-care for care workers (Grip Reference Grip2025). Self-care refers to the leisure time needed to recover from the strain of exhausting, intensified care work (Grip Reference Grip2025; Lorde Reference Lorde2017). Reducing the work week for one group in the labor market would be one pathway toward a caring state that takes “care for the carer” seriously (Dahl Reference Dahl2010). However, reduced working hours would also reproduce gendered inequalities in wages and pensions if not compensated by wage restructuring and pension reforms.
Although the Nordic states have been synonymous with extensive rights to receive care, there is, further, a new focus on the right to give care. In Denmark, collective agreements enacted in 2025 have allowed employees to take a couple of paid days off each year to care for a sick child or grandchild or to accompany an older relative to the hospital or doctor’s office (Danmarks Radio Reference Danmarks2025). These options are not rights, as they are neither paid nor part of legislation, but they have an affinity with formal social rights. Social rights to care for others — and oneself — are an example of how the key contradiction within capitalism between time to care and time to paid work might be renegotiated, as argued by Fraser (Reference Fraser2022). Allowing more time for the care of significant others would begin to change the Nordic care compromiseFootnote 1 and restrain neoliberal capitalism. However, this strategy assumes that the right to give care supplements existing rights to receive care, which raises ongoing questions about how access to these rights is structured along hierarchies of gender, class, and race.
Conclusion
The old notion of a caring state is no longer useful for understanding the Nordic ideal of a caring state. An overstretched social infrastructure, as well as overburdened, exhausted care professionals, have brought to the fore new — and old — issues regarding care injustices. A caring society has not been achieved through the Nordic caring state model and its emphasis on the right to receive care through public provision and good quality care provided by professionally trained care workers.
Inbuilt biases and neoliberalism have undermined this old ideal. Even when care workers are professionalized and care work is treated as work, we are still far away from an ideal caring society. In this essay, I have discussed some emerging issues, including proposals to shorten the working week and allowing time off from work to care for one’s own family. These ideas are about the redistribution of care and some recognition of the role of informal care in Nordic everyday life. They are also means of regulating capitalism.
Care justice depends upon redistribution and recognition. It also requires changes in how care is represented, framed, and governed politically. A truly caring society will not emerge unless we re-imagine the state and its governance to support both the professional carer and the person receiving care, as well as redistributing the goods and burdens of care more equally along the various intersectional vectors.