Contentious countrysides : social movements reworking and resisting public healthcare restructuring in rural Sweden

• Main Author: Enlund, Desirée
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: Umeå universitet, Institutionen för geografi 2020
• Subjects: welfare state retrenchment; public healthcare restructuring; contentious politics; social movements; cooperatives; self-organization; social reproduction; Sweden; rural areas; New Public Management; neoliberalism; välfärdsstaten; sjukvårdens omvandling; motstånd; sociala rörelser; kooperativ; självorganisering; social reproduktion; landsbygd; glesbygd; nyliberalism; Human Geography; Kulturgeografi; Gender Studies; Genusstudier; Northern Sweden
• Online Access: http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-169229

The broader aim of this thesis is to contribute to the understanding of the production and reproduction of spatial inequalities following from the restructuring of the public healthcare system. More specifically, by analyzing the contention around healthcare restructuring related to two cases spanning a longer period in northern Sweden, I aim to investigate the changing conditions for healthcare provision in rural and sparsely populated areas, and I explore the forms of collective action that local people engage in to sustain the access to healthcare, as well as how state authorities’ attitudes towards such collective action have shifted. In the context of larger public healthcare restructuring in contemporary Sweden, where the marketization and privatization of healthcare since the 1990s have impacted the provision of healthcare across the country, rural areas are experiencing deteriorating accessibility to both primary healthcare as well as emergency healthcare. This development is increasingly contentious, and is frequently met with resistance from rural populations as well as various strategies to rework these uneven conditions. The first case concerns the preceding protests as well as the occupation and opening of a citizen cooperative primary care center in Sollefteå, Västernorrland, in response to cutbacks at the local hospital. The second case follows the worker-cum-citizen cooperative primary and occupational healthcare centers in Offerdal, Jämtland. Through these two cases I explore people’s experiences of public healthcare restructuring, their motivations for engaging in contention around it, their experiences of self-organizing cooperative healthcare, as well as their visions and desires for a future healthcare. As shown throughout this thesis, healthcare restructuring is highly contentious and comes in many forms, ranging from protests, demonstrations, and occupations of healthcare facilities to the self-organization of healthcare services through worker and citizen cooperatives. Healthcare ...