The growth of private home care providers in Europe: The case of Ireland

Abstract

Private for‐profit home care providers have grown unevenly in Europe and through varied processes. Yet, more research focusing directly on private providers is needed to identify and explain European patterns in their growth and in their modes of operation. This paper examines the case of Ireland, where private providers have grown significantly in recent years and transformed the national landscape of domiciliary care. First, it is shown that the amount of public funding received by private providers increased from €3 million in 2006 to €176 million in 2019, in contrast to amounts allocated to non‐profit and public providers that have increased only slightly. Second, those trends are explained through policy analysis and by drawing on in‐depth semi‐structured interviews ( n = 12) with private home care providers and government officials who have been central to the privatization of care. The paper gives a direct voice to key figures in private home care, and through a critical reading of interview materials, argues that the neoliberal nature of the Irish state has driven the growth of private provision, in particular, through policies of competitive tendering and fiscalization. Providers' own lobbying activities have also played a role, albeit a secondary one. Ireland has traditionally followed a laissez‐faire, family‐based system comparable to Southern European countries. Its experience is thus directly relevant to that region, but further research should also compare and contrast the development of private providers operating in other European long‐term care regimes.