Vocational rehabilitation between work and welfare - the Swedish experience

Abstract

Vocational rehabilitation and activation of the long-term sick and unemployed have during the last decade become recognized as one of the most important objectives of welfare policy. Vocational rehabilitation incorporates several organisations, among them the medical system, the employers, social security and labour market authorities, who each have their special rules and routines. This article discusses the conditions for cooperation between organisations within this field. Are welfare agencies organised in ways that make adequate help for multi-problems clients possible? The point of departure is the so-called neo-institutionalism within organisational analysis. In the article the different parties will be presented, along with their institutional context. Then different forms of cooperation will be described and analysed, as will the dilemmas and possibilities they bring with them. It is argued that cooperation between organisations is difficult to achieve when each sector of welfare is tightened up and when boundaries between each one's duty are becoming more distinct. But there is also evidence of positive experiences of cooperation. Such cooperation was characterised by physical proximity and frequent face-to-face interaction between neighbouring agencies. The empirical basis of the article consists of policy documents, interviews with case-workers, medical doctors, human resource managers and staff participating in local cooperative projects dealing with vocational rehabilitation.