Conclusion and key messages

Closing remarks 

This publication takes a broad approach to resilience and gender in terms of healthcare in Nordic welfare systems. Resilience in healthcare refers to the ability to withstand, adapt to, learn from and recover from crises. The starting point is that experiences from the COVID-19 pandemic and other global threats show that the resilience of the welfare state is crucial for both society and individual health. At the same time, it faces significant challenges, including demographic changes, skills shortages, a gender-segregated labour market and inequalities in healthcare. A focus on future resilience requires us to problematise how we understand crises, time and risk. Intersectional gender perspectives are necessary to understand how vulnerability during crises is affected by factors such as gender, class, ethnicity and disability. Structural inequalities need to be addressed to ensure resilience.

The texts in this publication emphasise that applying a gender perspective to these challenges is key. By combining resilience and gender perspectives, the texts highlight in various ways how structural inequalities affect caregivers, care recipients and society as a whole. The need for intersectional analyses, to understand vulnerability and build a more sustainable welfare system, has been highlighted. Above all, the texts have in various ways clarified the importance of viewing resilience not only as a capacity but as a process that involves social justice, representation and liveable conditions. In conclusion, here are some key points that have been highlighted in the various texts in the publication.

Key messages from the essays

Lapidus:

The rapid growth of private health insurance needs to be understood and managed from a crisis and resilience perspective, so that the resilience and equality of the systems can be strengthened.
The division of the Nordic healthcare systems requires political reforms and practical measures to counteract unequal access and ensure that healthcare remains a shared welfare resource.
Ways back to a common and market-free (decommodified) healthcare system should be developed and tested as an alternative to restore legitimacy, solidarity and equality in healthcare.

Liljas and Burström: 

Resources for healthcare and social care systems for older adults must be strengthened. Since multiple illnesses often require both healthcare and social care, it is clear that closer collaboration is needed between regional medical and nursing services on the one hand, and municipal medical and nursing and social care services on the other.
Clear visions and plans are needed at multiple levels for the implementation of proposed reforms. The implementation of proposed reforms should be monitored and evaluated scientifically.
Social care for older adults must become a more attractive field of work, and staff need to be the focus of initiatives aimed at improving training, employment conditions, working environments and salaries.
Greater exchange of experience and learning between the Nordic countries could enable new solutions, as the problems and challenges faced are in many respects common in these countries. Experiences from the pandemic should be utilised to avoid extra work and prepare and strengthen systems for future crises.

Mulinari:

Improving conditions for temporal justice is one of the major gender equality issues of our time.
If we seriously want a resilient welfare sector, we must also take the issue of gender equality more seriously. Temporal inequalities in the welfare sector are clearly gendered, and racialised and it is primarily women who are currently forced to juggle the care crisis with their own time, health and bodies.
We need new understandings of time in working life, understandings that recognise and allow time for care and recognise time as something collective and relational within the welfare sector. Developing and exploring new understandings and distributions of time would not only strengthen the resilience of welfare but also give people greater opportunities to live sustainable lives – both at work and outside of work.

Duvander and Lundgren:

Without taking into account how the labour market and family responsibilities have changed, there is a risk of underestimating the challenges of a heightened state of alert within planning for medical care and nursing.
Who is responsible for ensuring that healthcare and other care needs are met? Who is even able to get an overview of these needs?
Who is expected to work during a heightened state of alert and how are they able to balance family responsibilities with increased demands on service?
How can realistic planning take into account the fact that most people working in healthcare and other care are women, who also have significant responsibilities in their private lives?