Need, allocation and justice — on priorities in the social services

Cuts in public spending and financial constraints faced by Swedish municipalities have led to an increased interest in issues concerning priorities. This interest reflects a practical need to meet current rationing with accurate allocative decisions, where the interests of different areas and categories of users are dealt with in a well-considered way. In social work, these needs today are obvious. The article raises issues concerning priorities with relevance for social work in the Swedish social services. The purpose is to develop a conceptual and theoretical framework regarding how priorities on different levels of decision-making are made, where the main focus is on different principles as grounds for and forms of prioritizing. Central are the following questions: What actors can be identified in the process of shaping priorities in social work? What are the principles behind allocative decisions made on different levels of the municipal organization? Which categories of potential and actual users gain advantages or suffer disadvantages from different allocative principles? A theoretical division into first- and second-order decisions and of allocations from notions of efficiency, justice and self-interest offer the main structure for the article. First-order decisions are political decision-making concerning the total amount of resources distributed to various sectors or programs. Second-order decisions deal with the issue of how to allocate given resources among claimants or possible users. Efficiency is discussed from the aspects of productivity, marginal utility and longterm effects. Material principles of justice dealt with are the principles of need, increment, contribution and merit. Self-interest is discussed in terms of self-serving bias, group-oriented interests and professional gain.