welfare mix

Question 1

vertical equality

Answer 1

more favourable treatment of those with lower incomes than those with higher ones in order to avoid or reduce the depth of poverty or reduce inequalities in resources more generally.

Question 2

horizontal equality

Answer 2

compensatory treatment of those with similar incomes but greater needs of one kind or another (such as larger families or needs related to disability status).

Question 3

Life-cycle redistribution

Answer 3

allowing for cash and in-kind provision at times in people’s lives, particularly childhood and old age, when incomes from market activities are low, with net contributions made when market resources are higher.

Question 4

insurance in welfare

Answer 4

protection against loss of income in events such as unemployment, ill health, or greater than average life expectancy, and provision of services if needs for health or other care occur

Question 5

state can intervene without it being public provision

Answer 5

o Using public financing to meet a need for distributional reasons does not necessarily imply that state agencies should be the provider. Similarly, ensuring that children’s needs are met after divorce, for example, can be met through a public decision to enforce a private transfer without there being any necessary state provision or finance.

Question 6

typical pros of private provision

Answer 6

• Choice + competition
• State – is one size fits all the best way ? small organisations do better at fiiting in with local needs
• Voluntary and informal sectors give a chance to realise social citizenship- might promote local bonds and help you realise participatory ideal – doing things for each other. Not just realising rights through the state.

Question 7

the state and life cycle redistributions

Answer 7

• much of social security is concerned with life-cycle redistribution, with the majority of spending going on pensions and other benefits for the elderly. While some of this can be achieved through private savings or pension systems, the state remains dominant, reflecting both high costs of private retirement provision for those on low incomes, and the complexity and incentive problems created by attempts to limit its role through means-testing.

Question 8

a time and place for private provision?

Answer 8

• Private insurance market failures, that can justify a strong role for the state on efficiency grounds, are more important in some areas than others—particularly future health or social care needs affected by long-term uncertainties that are hard to quantify, such as the likelihood and cost of someone’s care needs for dementia 30 years after the point in their lives when earnings are highest, for instance.

Question 9

left and right on role of the state

Answer 9

• The left tends to favour a larger role for the state, while the right leans towards commercial, voluntary, and informal solutions, advocating for a welfare society over a welfare state

Question 10

• Social Division of Welfare (SDW)

Answer 10

1. Statutory/state
   -> most obvious and visible
   -> ‘public’
   ->Titmuss argued to be most progressive
   2. Occupational
      -> “the ‘fringe benefits’ of employment such as subsidised pensions, health insurance, mortgages, and company cars”7
      -> less obvious
      -> ‘substantial’ scale - eg. Employer contributions to social protection receipts 7% of GDP in UK 2000; statutory provision only 3.8% (Farnsworth, 2004)
   3. Fiscal
      -> “the benefits delivered through the taxation system such as tax reliefs and later on private pensions and health insurance”
      -> ‘very long but largely neglected history’
      -> ‘upside down benefits’
      -> can be regress (tax expenditures) or progressive (tx credits)
      -> relief of non-state pensions is biggest fiscal expenditure in UK
      -> controversial - has been considered ‘outside’ of the welfare state (Sinfield, 2016); or ‘second institutional ayer’ (Stebbing and Spies-Butcher, 2010)

Question 11

good v bad of public v private financing

Answer 11

when public is more distributively egalitarian. Questions of quality and efficiency are more debated. In terms of accountability debated- public financed eg healthcare in NHS is hidden – people don’t hold government to account for this so private financing alleviates issues of accountability.

Question 12

good v bad of public v private provision- health outcomes

Answer 12

some evidence that for-profit have worse outcomes eg private elderly care correlates to higher levels of death when they take over from state providers. Dependent on sector eg cataracts publicly provided is poorer and also facing cut crunches. In long-term care eg social and elderly care, for-profit tends to be worse. Some sectors work better when nationalised than others eg telecommunications v water

Question 13

good v bad of public v private control

Answer 13

also murky. Choice may increase satisfaction and some responsiveness and some private providers have innovated new ways. But also questions of accountability and can lead to segregation (church running schools) or ‘cramming and parking’

Question 14

Powell on criteria for privatisation

Answer 14

No ‘commonly accepted’ criteria for privatisation.

Question 15

Crouch on criteria for privatisation

Answer 15

• Crouch (2003: 15) argues that privatisation occurs when ownership of a previous public resource is transferred to private firms, while under contracting out ownership remains with the public sector.
• In his view, Labour reforms in health involve partnerships and sub-contracting rather than privatisation

Question 16

Young on criteria for privatisation

Answer 16

• Young (1986) presents a wide concept of privatisation, arguing that policies contain one or more of the following elements: current balance (size, scope, role); balance in the longer term by creating opportunities for the private sector to grow (e.g., by changing regulations); private resources to solve government problems (e.g., use of business practices); and increased market pressures to bear on the use of assets staying inside the public sector (e.g., internal and external competition).

Question 17

Young and complexity of privatisation in the UK

Answer 17

Young argues that seven different forms of privatisation are identifiable in Conservative policy since 1979 (although he gives few NHS examples):
o (a) selling off public assets
o (b) relaxing state monopolies
* (c) contracting
* (d) private provision of services
* (e) investment projects
* (f) extending private sector practices into the public sector
* (g) reduced subsidies and increased charges

Question 18

example of complexity of privatisation In the UK

Answer 18

• Even private schools have some tax benefits which mean they are at least somewhat intermingled with the state.

Question 19

Bozeman on privatisation

Answer 19

• Publicness Perspectives: Bozeman (1987: 17) and argues that political control is the essence of publicness: ‘all organizations are public because political authority affects some of the behavior and processes of all organizations’.

Question 20

Powell’s mixed economy of welfare - 4 main components

Answer 20

o State: Public service provision, addressing market failures.
o Market: Efficient alternative to state provision.
o Voluntary: Includes philanthropic and mutual elements, supported by the left.
o Informal: Involves family, friends, and neighbours, favoured by the right but criticized by feminists

Question 21

Powell mixed economy of welfare - dimensions

Answer 21

o 1-dimensional: Focuses on a single issue or sources of welfare.
o 2-dimensional: Examines provision and finance.
o 3-dimensional: Considers provision, finance, and regulation.
 In a pure public sector, a public actor makes choices about where spending goes and how much is spent, the opposite for private

Question 22

Powell and universalism

Answer 22

: Powell argues for universal access to social welfare benefits and protections, regardless of race, ethnicity, gender, socioeconomic status, or other factors. Universalistic policies ensure that all members of society are entitled to essential services and supports, reducing the risk of stigma, exclusion, and discrimination

Question 23

Powell and culture in welfare

Answer 23

Powell emphasizes the importance of cultural competence in welfare provision, ensuring that services are responsive to the cultural, linguistic, and contextual needs of diverse populations. This may involve providing culturally relevant programming, language access services, and community-based outreach efforts to engage underserved communities.

Question 24

Powell’s institutional changes

Answer 24

structural changes to social policies and institutions to address systemic barriers and inequalities. This may include reforms to address disparities in access to education, employment, housing, healthcare, and other social determinants of well-being, as well as efforts to dismantle discriminatory practices and institutional racism.

importance of participatory governance and community engagement- By involving affected communities in decision-making processes, policymakers can ensure that policies are responsive to the needs and priorities of those they are intended to serve.

Question 25

Wheels of welfare- scholars behind it

Answer 25

Buchardt + Hill

Question 26

wheels of welfare dimensions to analyse welfare provision

Answer 26

1. Provision- is the provider of the service a public- or private sector body?
2. Finance - does the public sector pay for the service directly through tax-financed public spending or indirectly through tax reliefs?
3. Decision - can individuals choose for themselves the amount of service used or whether the provider is public or private, or is this decided for them by the state?

Question 27

wheels of welfare pure public

Answer 27

o Pure public= tax-financed, provided by a publicly owned and run organisation, and with little or no choice on the part of the beneficiary about how much or from whom to receive the service. Emergency treatment in an NHS hospital is an example.

Question 28

wheels of welfare pure private

Answer 28

Pure private= activity undertaken by individuals at their own initiative and purchased in the free market, such as private medical insurance

Question 29

size of pure public in the UK

Answer 29

• In the UK for education, health care, and income maintenance, the ‘pure public’ still represented more than half of total activity in 2007-8, but for personal care it was two-fifths and for housing less than a tenth.

o The share of the “pure public” sector (fully funded and controlled by the government) decreased slightly, falling from 50.3% to 48.2%. Despite this decline, the real value of the “pure public” sector still grew by 50%,

Question 30

size of Private provision of publicly financed and publicly controlled services

Answer 30

‘contracting out’ and its equivalents—was around a fifth of total activity within education and health care, and a third for personal care, but much less important for housing and almost absent for income maintenance.

Question 31

size of publicly financed but privately controlled and provided services

Answer 31

were more than a tenth of all income maintenance activity—representing the value of tax advantages of private pension contributions- but small in the other areas.

o Public finance for private provision and decision declined, influenced by the abolition of mortgage interest relief for owner-occupiers and the decreased importance of “contracting out” of the state second pension

Question 32

size of pure private

Answer 32

• The ‘pure private’ sector, while growing, was a fifth or less of activity in four of the areas, but was dominant—three-quarters of the total- in housing.

o private spending on private education increased, while health care saw rapid growth in private medicine and over-the-counter medicines. Housing saw a significant rise, mainly due to increased owner-occupiers’ imputed rents.

Question 33

relative decline of our public and relative growth of pure private

Answer 33

• one prominent feature has been the steady fall in the share in the ‘pure public’ sector from 52 per cent in 1979-80, to 50 percent in 1995-6, and again to 48 per cent in 2007-8. Meanwhile the ‘pure private’ sector grew from 24 to 27 %

Question 34

public provision but private finance in the UK

Answer 34

• Public provision but private finance - declined due to the transfer of housing to housing associations, resulting in less rent paid by tenants. + The sector of public provision but private finance and decision remained small, with some offsetting factors such as the end of “pay beds” in NHS hospitals and growth in other health services provided to the private sector.

Question 35

Hill- the effect of housing on welfare expenditure

Answer 35

• the decline in the role of the public sector was somewhat less marked once housing is excluded. Indeed, over the Conservative period between the first two dates, it was only in terms of its role as a provider that the public sector declined, with no fall in the share of public finance, a rise in the proportion under public control, and a slight rise in the share of the pure public sector. In these terms, the ‘privatization’ of the Conservative years can be seen as being concentrated on the state’s role within housing.

Question 36

from 2007 by early coalition - rise in public spending

Answer 36

• total public spending rose by more than had been planned in nominal terms and by 11% in real terms … the real increase in health spending was exactly as planned and that in education slightly lower. It was the 13% real increase in social security and tax credits that contributed most to the overshoot in total spending above plans. Given the fall in GDP, however all three elements contributes to the rise in spending as a share of GDP

Question 37

difference in real spending on services 2010-11/2014-15

Answer 37

difference in real spending set to be £43 billion lower, yet with health spending £2 billion higher and state pensions £6 billion higher- non pensions social security and tax credits intended to fall by £12 bill and education by £10 b

Question 38

increased privatisation of healthcare under Coalition

Answer 38

increased by APQ

o publicly funded, independently provided healthcare (including GPs and dentists) now accounts for 25% of total health spending, compared to 22% in 2007/08. Within this, however, NHS purchase of non-NHS- provided healthcare grew by 65% in real terms between 2007/08 and 2013/14. ‘Pure private’ spending on healthcare has also continued to increase in real terms (by 9% between 2007/08 and 2013/14),

Question 39

income maintenance- public spending under coalition

Answer 39

o Pure public (benefits and tax credits) and pure private (private insurance against loss, private pensions etc.) make up 55% and 20% of total spending respectively.
o Spending on the basic State Pension (pure public) makes up just over one- third of total pensions spending (34%).

• Policies in relation to income maintenance other than pensions under the coalition have been dominated by cuts in benefit levels in real terms and restrictions on benefit eligibility, accompanied by the rhetoric of austerity, however in reality these changed have had a net zero effect on public finances

Question 40

voluntary sector role in social welfare

Answer 40

o Voluntary sector- eg In 2013/14, food banks provided an estimated 20 million meals in the UK, a total value of perhaps £40 million. This is small fraction of total spending on income maintenance (1/100th of a percentage), but nevertheless significant in its impact on recipients and on public debate.

Question 41

Education spending under coalition

Answer 41

o the share of total education spending that is public finance and public provision has fallen only slightly, from 61% to 60%.(2013/14)

o There has been a 76% increase in out-of-pocket spending on education – including on further and higher education – in real terms between 2007/08 and 2013/14. This segment now accounts for one-fifth (22%) of all education spending.

Question 42

Hill on overall changes to welfare state under coalition

Answer 42

more than meets the eye- The selective nature of the cuts will mean that the structure of public spending on the welfare state will have changed, even if its overall scale in relation to national income returns to what it had been before the crisis. Healthcare and pensions are becoming more important, but non-pension social security, housing and non-school education less important.

Question 43

social care spending under coalition

Answer 43

• Social care - Public spending began to fall in the late 2000s, despite increasing demand from the growth in the older and disabled population. A significant part of this was spending in the ‘pure public’ segment, which fell by nearly a quarter in real terms between 2007/08 and 2013/14. At the end of the period it accounted for just 26% of overall (public and private) expenditure. Meanwhile, contracted-out care (independently provided services commissioned and paid for by the local authority) grew in real value, and increased its share of overall spending, and at 35% is now the largest segment in this figure.

Question 44

housing expenditure

Answer 44

• The proportion of total current spending on housing in the ‘pure private’ segment was 82% in 2013/14, similar to the proportion (81%) in 2007/08.

Question 45

decline in voluntary sector provision under coalition

Answer 45

been affected by cuts to grant income from central and local government – down from £3.1 billion in 2009/10 to £2.2 billion in 2012/13. But, rates and mean hours of volunteering have been steady.

Question 46

Evers- the 3rd sector of the welfare mix

Answer 46

otherwise made up of the market the state and the informal private household sphere

nuanced understanding of the third sector as an intermediary area within a mixed welfare system.

the importance of third sector organizations in balancing and integrating various social, economic, and political dimensions in modern societies.

Question 47

Evers on which welfare policies are optimal

Answer 47

emphasizes the shift towards policies of ‘welfare pluralism,’ which prioritize synergistic mixes of resources and rationales over simple substitution processes between different sectors of provision. This approach seeks to make planned use of non-state resources to ensure welfare and well-being while managing the costs of public welfare.

Question 48

evers- role of third sector organisations

Answer 48

the intermediary role played by third sector organizations, which not only interact with states and markets but also with the informal sphere, including families, social networks, and community building. These organizations act as connectors rather than setting clear boundaries around a sector.
A distinct pluralist approach in social policy should respect the specific rationales of different realms, acknowledge the polyvalent role of third sector organizations, and be concerned with securing the foundations of these organizations.

Question 49

Need for the third sector

Answer 49

• Evers discusses the tension and interdependence between different social spheres, such as the state, the market, and the informal sector, within the third sector. This interrelation influences the landscape of third sector organizations and exposes their public space to constant tensions.

Question 50

demographic challenge to welfare production and provision

Answer 50

• UK declining fertility rate, fluctuating but low mortality rate and shift from UK as a country of emigration to a country of inward immigration.
• The UK today can be described as an aged society, where the proportion of older people (aged 65 and over) increasingly represents a greater part of the total population.
• as life-cycle patterns change and lengths of lives expand, we would expect to see income maintenance and health and personal care change - likely increase personal pension contributions, preventative healthcare etc.

Question 51

challenges to welfare - economic context

Answer 51

• Economic growth underpins the development and sustainability of social policy, but equally social policy is crucial to the achievement of economic growth.
• Problems arise for the sustainability of social policy when there is a mismatch between the raising of tax revenues, the levels of spending promised by governments, and the extent to which a gap between these is closed through government borrowing.
• Social policy played a key role in mitigating the social and economic effects of the 2008 financial crisis, but it is also threatened with reductions in spending and debt.
• as incomes rise, one would expect to see a general move towards services with the characteristics of ‘luxuries’: health care and education, in particular, are services that appear to be more important in more affluent societies

Question 52

economic context of the UK

Answer 52

• Since 2008, we have been witnessing what political economist David McNally has described as a global slump (2009, 2010). Triggered in 2007 by a wave of defaults on ‘subprime’ mortgages in the United States, the financial crisis has precipitated a slump in the so-called real economy
• While economic growth averaged 5.4 per cent per year between 1997 and the first quarter of 2008, since then output has grown by just 1.6 per cent per year on average. (2014)

again with cost of living crisis

Question 53

unemployment in the UK

Answer 53

• The data on unemployment reveal a similar picture: after 2007/8, the unemployment rate jumped three percentage points, from around 5 per cent of the labour force to roughly 8 per cent.

now 4.2%

Question 54

food price increases

Answer 54

The annual rate of UK food and non-alcoholic beverage prices inflation increased to 19.1% in the 12 months to March 2023

the Russian invasion of Ukraine in February 2022, which had a major impact on the global supply of grains and fertilizers, and on European energy prices
labour shortages, which left some crops unharvested
droughts and cold snaps in Europe and North Africa, which led to higher imported food prices

Question 55

median income in the UK

Answer 55

Median income for the poorest fifth of people decreased by 3.8% between FYE 2021 and FYE 2022 (Figure 3). This follows a 2.0% reduction between FYE 2020 and FYE 2021.

Median disposable income increased by 1.6% to £66,000 for the richest fifth of people

Question 56

youth unemployment in Britain

Answer 56

• the Confederation of British Industry, frequently complains about the ‘unemployability’ of Britain’s youth, from its 2004 warning against ‘slang’ and ‘poor language skills’ to its finding in 2012 that 71 per cent of employers ‘believe schools and colleges should be prioritising development of employability.

Question 57

Ethnic minorities and welfare

Answer 57

• Minority groups will constitute a larger proportion of the future population of western countries. Their current welfare therefore has long-run consequences.
• Social policy can impact ethnic minorities directly through immigration and race relations policies and indirectly through, for example, social security, housing and employment policies.

Question 58

Social spending under Thatcher/ Major

Answer 58

• Despite the Thatcher government’s intention in the 1980s to reduce state involvement, pressures from an aging population and increasing demands for services like healthcare and education led to an expansion of social spending. While total public spending was controlled, social spending’s share increased from 50% of all public spending in 1978-79 to 60% in 1996-97.

Question 59

spending on different sectors under Thatcher

Answer 59

Within this total housing spending fell–including housing-related benefits it had been over 4 per cent of GDP in 1974, but was half this by 1995. Over the same period, to 1995, public spending on the NHS rose from 3.8 to 5.7 per cent of GDP, and social security spending, dominated by state pensions, from 8.2 to 11.4 per cent of GDP.

Question 60

Marketisation of welfare

Answer 60

Brennan + others use the term marketisation to refer to government measures that authorise, support or enforce the introduction of markets, the creation of relationships between buyers and sellers and the use of market mechanisms to allocate care

Question 61

Market provision and promise of choice

Answer 61

Brennan + others- * Market provision promises empowerment through the exercise of choice and more efficient provision; higher quality services delivered for lower cost to the consumer, and ultimately to the taxpayer if services are funded wholly or partially by the state.

Question 62

conditions needed for marketisation to = empowerment

Answer 62

Brennan + others
certain conditions must be met: information about the price and quality of competing suppliers must be freely available to consumers; the costs of changing supplier must be low; and suppliers must operate in a competitive market.

Question 63

prevention of transparency in marketisation of care

Answer 63

Brennan + others

• Making use of market information requires skills that are not equally distributed: an increased focus on choice favours those with more resources and education, who have considerable advantages in navigating the system.

Question 64

choice for empowerment in marketisation of care

Answer 64

Brennan + others
* Further, for quality control through the market to work, consumers must be able easily to switch poor quality providers for higher quality ones – but continuity of care is important for both childcare and elder care – so exit is costly.

Question 65

satisfaction with markets of care UK

Answer 65

Brennan + others
* Data on user satisfaction shows lower scores among elderly users than younger disabled people for both ‘improvements in mental well-being’ and ‘getting the support they need’ from using personal budgets – UK.

Question 66

choice in social care in Australia

Answer 66

Brennan + others

since the mid-1980s, the exercise of choice by older people and their carers has been limited by supply-side constraints on service provision and block-funding arrangements under competitive tendering and contracting.

o In childcare, the rapid growth of for-profit providers in Australia, and especially the dominance of a single company, reduced the capacity of many families to choose a service of their preferred type. the diverse non-profit childcare sector that predated marketisation gave way to a smaller number of commercial providers.

Question 67

choice of care in Sweden

Answer 67

Brennan + others
* Sweden - full coverage of childcare - can be argued that parents have been empowered as they have got a greater scope for choosing between childcare centres with different auspices, but there is no empirical evidence that parents value such choice.
o Most parents choose a childcare centre close to the home irrespective of provider or profile

Question 68

costs and marketisation of care

Answer 68

Brennan + others

• Little empirical data with respect to eldercare in the three countries support the hopes for cost containment expressed by market enthusiasts.
  o In Sweden after the first years of competitive tendering, costs do not seem to have fallen.

Question 69

Quality and marketisation of care

Answer 69

Brennan +others
* Evidence about quality in childcare also shows that non-profit services are generally of higher quality than those offered by for-profit providers.

Question 70

quality of care in UK and marketisation

Answer 70

o An evaluation of the UK Neighbourhood Nurseries Initiative, reported that ‘maintained’ nurseries (that is, those funded by local authorities and not run for profit) had the highest level of quality.

Question 71

quality of care in Australia and marketisation

Answer 71

• An Australian study that measured childcare quality partly by the willingness of staff to place their own child in a service of a similar standard, suggested that quality is highest in non-profit services and lowest in those provided by large corporate providers, with independent for-profits in the middle, but closer to non-profits.

Question 72

Personal healthcare budgets in the UK - benefits

Answer 72

o The work of Jenny Morris and others has suggested that, of these groups of carers, the most satisfactory as far as disabled people are concerned are personal assistants, employed directly by care users. Such personal assistants, it is argued, are far preferable to traditional social service personnel who are often rule-bound, subscribe to the medical model of disability, and patronise their “clients”.

Question 73

community care bill - room for choice

Answer 73

o Breadth of community care bill 1996- Many people will want to use direct payments to employ or contract with their own personal assistants to provide the services they need. Others may want to buy their care from an agency rather than take on the responsibility of becoming an employer. Still others may decide to employ their own staff for some tasks, and purchase other services from an agency.

Question 74

personal health budgets- issues of vulnerability

Answer 74

o Although direct payments will be “monitored” by local authorities to ensure they are being spent properly in care services, there is nothing in the Consultative Paper that suggests that the market itself will be carefully policed. Hence, informal and illegal contractual arrangements, where the workers have no employment rights of any kind, are likely to develop- both purchasers and providers are poor and/or vulnerable to exploitation.

Question 75

Burchardt on availability of choice in care

Answer 75

• disabled people are more likely to experience constrained autonomy in all respects, while being from a low socio-economic group and/or lacking educational qualifications is a risk factor across several components.

Question 76

Buchardt - how to improve choice agenda

Answer 76

(1) adopting a more sophisticated concept of ‘choice’ such as the conceptualization of ‘choice as autonomy’ outlined here;
(2) developing a better understanding of existing inequalities in autonomy, such as we begin to explore in our empirical results; and
(3) tackling these inequalities through, for example, the removal of obstacles to active decision-making by providing effective support and advocacy, especially for disabled people, and addressing the major structural barriers – poverty, ill health and geographical inequality – which place significant restrictions on the autonomy of those who are already disadvantaged.

Question 77

Buchardt- issue of focus on choice in care as it stands

Answer 77

• Overall, instrumental motivations for promoting choice have dominated policy-making leading to the concentration on services rather than outcomes as the locus for choice: we are invited to choose between hospitals, schools, care agencies and pension providers, but all such services are a means to an end rather than ends in themselves.
• The degree of control we may or may not be able to exercise over the outcomes that we actually value – our health, education, daily life and security in old age – is mostly overlooked or ignored by this approach.

Question 78

Unequal distribution of autonomy - disabled people

Answer 78

Buchardt
o The most striking association is that with disability: disabled people are significantly less likely to be ‘able to do the things that are important’ to them.
o Disabled people are more likely to experience constrained autonomy in all six respects: lack of self-direction, fatalism, pressure from others, ill health, lack of money and constraints as a result of where they live.
o Among disabled people, those in a low socio-economic group and/or lacking educational qualifications are at significantly greater risk of fatalism, and of experiencing constraints due to ill health than those in a higher socio-economic group with qualifications.

Question 79

unequal distribution of autonomy- low socio-economic background

Answer 79

o For the population as a whole, being in a low socio-economic group and/or lacking educational qualifications is a risk factor for fatalism, and constraints on autonomy due to lack of money and ill health.

Question 80

Autonomy as multi-dimensional

Answer 80

Buchardt

autonomy is inherently multidimensional- An adequate concept must encompass the internal (mental) and external (situational) aspects of autonomy, and the interaction between them.
Thus to focus solely on the act of choosing, the dominant approach in the ‘choice’ policy agenda, risks missing much that is important in constraining the broader idea of ‘choice as autonomy’.
Simply ensuring that options are on the table is not going to be sufficient to ensure that everyone can make an active decision.

Question 81

what individuals need to exercise choice

Answer 81

Buchardt

Prior to the point of choosing, it is also important that person has been able to form, and reflect on, an idea about what he or she wants – based on a rich understanding of what might be possible.

Question 82

Key Message of welfare under coalition in election

Answer 82

• A key message from the leader of the Conservative Party in the 2010 UK general election was that the financial crisis in public expenditure meant that there were new and stronger reasons for the voluntary or Third Sector, rather than the state, to deliver change and provide services to the community.

Question 83

Big society

Answer 83

• The Big Society made its first appearance in David Cameron’s Hugo Young Lecture in November 2009 and became a key part of his party’s election campaign a few months later… regime. According to the ideology of the Big Society, not only was Britain ‘broken’ and mired by moral decline, it was also burdened by the albatross of ‘big government’ – devolving power from the state so communities could be more involved in the organisation and delivery of previously public services.
• The discourse of a Big Society thus sought to mobilise citizens’ affective capacities for empathy and concern for their fellows in order to take on health care, child care and elder care, to run local libraries and deal with unemployment, to tackle poverty and inequality, and, generally, to increase overall well-being in the context of further welfare state retrenchment and privatisation

Question 84

Big society as a departure form Thatcher

Answer 84

• Under Thatcher had been ‘there is no such thing as society’
• According to the Big Society’s exponents, violence, greed and atomisation were the result of 30 years of neoliberalism that rewarded selfish behaviour at the expense of a sense of community, with the result, they argued, that there was now widespread alienation and disenfranchisement.

Question 85

big society as a response to social distress

Answer 85

• in the face of multiple crises and an austerity regime evidently reliant on households and communities to pick up the state’s tab for bailing out the banks, the socially regressive nature of the ‘Big Society’ was obvious. ‘Broken Britain’ served as a rhetorical device with which to identify and decry a moral crisis exemplified by the pro liferation of anxiety-fuelled figures deemed responsible for the situation - ‘feral youth’, ‘benefit scroungers’, ‘greedy bankers’ and ‘tax dodgers’

Question 86

Big society -role of the state

Answer 86

• In the new Big Society model, it is envisaged that where the state steps back, a mixture of private and voluntary sector organisations will step forward in its place. As we shall see in the next section, the state is itself active in engineering this profound economic and social, restructuring of economy and society

market failure and unequal access require government intervention in the form of subsidies for disadvantaged individuals and communities, however this kind of assistance is supposed to take a very specific form orientated towards financialisation, namely as financial support to enable those who are disadvantaged to participate in the market.

Question 87

three tiers of big society policy

Answer 87

. First, at the level of individual services, there will be an emphasis on performance-related provision, continuous improvement, transparency and accountability.

Second, through the Localism Act (discussed below), neighbourhoods and local communities will be enabled to bid for, buy assets and run services, as well as take advantage of the implementation of community budgets

Third, the government’s role will shift from a provider of services to a commissioner (at most), conditional upon the creation of a diverse range of independent providers, as well as a facilitator of investment (by private investors) in such services premised upon payment by results.

Question 88

autonomy of organisations in big society

Answer 88

• The White Paper makes clear the government’s desire to foster the development of autonomous organisations, operating on a level playing field, in which the logic of competition to offer the best service operates a disciplinary device. Large contracts are to be divided up, such that individual elements can be serviced by different enterprises, with the long-term goal of financial self-sufficiency. Public sector staff are promised greater autonomy and independence through employee ownerships schemes across the entire sector.

Question 89

localism act

Answer 89

2011
sets out a number of policy changes intended to facilitate the implementation of the framework set out in the Open Public Services White Paper- number of ‘community rights namely the right ‘to buy’, ‘to build’ and ‘to challenge’… these processes put communities at the helm of the further prioritisation process, while at the same time relying on the notions of mutual and social enterprises with an ethical as opposed to purely profit-orientated motivation.

Question 90

public services act

Answer 90

2012
government must take into consideration something called ‘social value’ in the tendering process that service providers undergo. Organisations must demonstrate the social value they produce and an organisations capacity to produce social value should be a central determining factor in the procurement of services – Social value denotes the positive non-financial impacts and outcomes of programmes, organisations and interventions.

Question 90

economic gain of organisations under big society

Answer 90

The newly established bank for social investment, Big Society Capital, states that social investors ‘will often accept lower financial returns to generate greater social impact’; however, they do nevertheless have the ‘expectation of some financial return’, as ‘social investment is repayable, often with interest

Question 91

employee led public sector mutuals

Answer 91

set out by big society

, 85 had been established, delivering over £1 billion of services

Question 92

who argues for role of voluntary sector in welfare

Answer 92

Danson and Whittam

Question 93

role of VCS in big society

Answer 93

• Alternative to private provision with new role of state as ‘enabler not producer’: Many policy documents can be observed to promote the VCS due to ‘market failure’, for example in providing goods and services in parts of the economy where it would not be profitable for private sector businesses to operate.
  “we will identify proven social programmes, franchise them to social entrepreneurs with a track record of success and fund them directly from existing state budgets to deliver public services”

Question 94

SNP on big society

Answer 94

from 2007 argued for similar state role

o Before 2007, this was complemented by large-scale housing stock transfer from council control to newly created top–down housing associations; by geographically based LECs (local enterprise companies) within the regional development agencies (RDAs) of Scottish Enterprise and Highlands & Islands Enterprise; and through community planning partnerships

Scotland now rejecting it - public sector domination with third sector support

Question 95

How to make VCS initiatives effective

Answer 95

• Much of this thinking can be traced back to the work of Porter (1998) where he argues that isolated initiatives have compromised inner-city regeneration initiatives and ‘have treated the inner city as an island isolated from the surrounding economy and subject to its own unique laws of competition’. The solution, therefore, is to (re-)connect the inner city to the competitive market economy through private sector businesses; Porter emphasises the role of small business enterprises, which can succeed due to ‘the competitive advantage of the inner city’.

Question 96

pros of VCS initiatives

Answer 96

Danson and whittam
As well as this urban focus, and the long-established role of the VCS in addressing the endemic problems of the inner city, such organisations have been promoted and seen as essential to the social and economic development of more rural and remote communities. While a degree of romanticism underlies some of this support and literature), it is undoubtedly the case that social capital is equally often integral to the sustainable development of fragile areas and this is nurtured and contained within the VCS locally.

Question 97

class issue with VCS

Answer 97

• The evidence demonstrates, however, that volunteering tends to have a strong class bias with higher income and socio-economic groups more likely to be engaged in both informal and formal activity, to reproduce other inequalities in opportunity and outcome and so to promote deeper divisions rather than to act to address them. It is known that non-volunteers are especially concentrated amongst the socially excluded, those on low incomes and benefits, the economically inactive and unemployed, residents of poorer neighbourhoods and members of unstable families.

Question 98

VCS and non competition as an issue

Answer 98

• VCS organisations rely on state funding as a major source of income. Much of this support arises from the winning of contracts from the state to deliver goods and services previously provided by the state. This in essence becomes a ‘contestable market’ approach, which involves competition for the market as opposed to competition in the market. Once the contract has been won by the individual social enterprise, they become a monopoly provider.

many smaller local organisations may be unlikely to secure such contracts and hence be put out of business. Once a contract is secured, the larger organisation can further enhance its position, by utilising the increased resource it has achieved through securing the contract, to further increase its scale and scope of activities and hence make it even more difficult for small local VCS bodies to compete

Question 99

welfare policy of 1991 government in Sweden

Answer 99

advocating for choice revolution

Question 100

share of private provision in Swedish welfare

Answer 100

• During the 1990s, the public welfare service sector opened up to competing private actors. As a result, the share of private provision grew, both within the health-care and primary education systems as well as within social service provision.
• the share of private providers is still relatively low (ranging between 5 and 15per cent),

Question 101

overall effect of welfare privatisation in Sweden

Answer 101

their existence has given rise to more socially stratified service-consumption patterns and a tendency among the well-to-do to leave the public sector for private alternatives.

undermine previous Swedish notions of a “people’s home” – universal coverage

Question 102

why has privatisation increased in Swedish welfare

Answer 102

• The critical public debate about the organization of the welfare services sector during the 1980s also reflected the growing problems of local governments in delivering services as their own financial situations deteriorated. As a result of attempts to ration services and reduce costs, waiting lists for health care and other social services (particularly childcare) grew, resulting in public discontent.

Question 103

the market in Swedish welfare

Answer 103

• virtually all publications from the ministry of finance came to advocate the introduction of various types of so-called “quasi-markets” in the social services sector. In a quasi-market, the provision of services is separated from direct political control, and the role of government is reduced to that of “purchasing” services on behalf of the public from a variety of competing “providers” on a contract basis. In the late 1980s, quasi-markets as a means to renew the welfare services sector came to be openly endorsed by the Social Democratic government.

Question 104

Swedish health - policy which increased privatisation

Answer 104

• Health 1990s- decentralization of regulatory power to the county councils, which made it legally possible for them to experiment with new organizational forms of service provision and to contract out regular health services to non-public actors. Public service providers were thus made organizationally independent and were funded on the basis of performance, rather than budgets.

Question 105

increase in health privatisation in Sweden

Answer 105

In 2000 some 85 per cent of the counties had private providers and this group accounted for over 25 per cent of all patient visits

• The share of privately employed health-care staff increased from 4.8 per cent in 1993 to 7.2 per cent in 2000. The greatest proportion of private providers is to be found in the bigger cities, where their share of total provision is about 15 per cent

Question 106

Private health insurance growth in Sweden

Answer 106

• the number of private health insurance holders grew during the same period from 23,000 in 1990 to 115,000 in 2000- While private health insurance is still rare in Sweden, it is significant that a market has been established for this type of insurance.

Question 107

Policies which have changed education in Sweden

Answer 107

• In 1988 the system was decentralized, as regulatory powers were transferred from the central state to the municipalities and the schools themselves
• introduction of a voucher system in 1992- established a system whereby privately operated schools could compete for students with public schools on an equal financial basis. It entitled all private schools approved by the National Agency of Education, including the confessional and commercially operated, to full public funding to be calculated on the basis of the number of enlisted students-

Question 108

Sweden private education growth

Answer 108

• The introduction of educational vouchers drastically improved conditions for private schools in Sweden and resulted in a rapid expansion of the non- public school sector. In 1991, there were a little over 60 non-public schools in the country; by 2000 their numbers had reached 475 and were steadily increasing
• In 2002 the share of students who attended private schools had grown from virtually nil (see above) to 5 per cent in primary schools and 6 per cent in secondary schools

Question 109

inequality and privatisation of education in Sweden

Answer 109

• As in the health-care sector, private providers tend to be over- represented in high-income areas.
• Some segregation issues - children of parents with high incomes and more education are over-represented among those who transfer to private schools and public schools of better reputation. Ethnic segregation, likewise, is furthered both by the establishment of privately operated (but publicly funded) schools catering to immigrants (on the basis of religion or language) as well as the observed tendency of parents of Swedish origin living in ethnically mixed areas to prefer schools with a low percentage of immigrant children

Question 110

elder care policy changes in Sweden

Answer 110

• In the 1990s, a majority of the municipalities left the previous system of direct administrative control over service provision and introduced a purchaser/ provider system. This implies that, while decisions about eligibility and the amount of care granted remain with the local authorities, the actual care services are provided by independent organizations

Question 111

size of private provision in elder care in Sweden

Answer 111

• In 2002, 92 of the 288 municipalities used private contractors.
• The share of private contracting as part of total elder-care costs quadrupled in the first half of the 1990s

Question 112

childcare policies in Sweden

Answer 112

• Universalist still - during the 1990s, as the municipalities were placed under a legal obligation to provide this service for all parents, including the unemployed.

the childcare sector had already been deregulated and municipalities given wider discretion to organize service provision as they saw fit

• the government introduced a (national) maximum fee for childcare services in 2002, regardless of provider

Question 113

share of private childcare in Sweden

Answer 113

• Between 1990 and 1999, the share of children in private (although publicly funded) care facilities rose from 5 per cent to 15 per cent

Question 114

issue with private sector childcare in Sweden

Answer 114

• Children of the highly educated were clearly over-represented within the non-public sector, whereas children of immigrant families were under-represented

Question 115

Issue with public sector provision in Sweden

Answer 115

• In the public sphere - public resources became more restricted in this area during the 1990s. This was most clearly evident from the increase in average child-group size, by 20 per cent in pre-schools and 65 per cent in leisure-time centres. Questions over quality

Question 116

Potential of self perpetuating state privatisation

Answer 116

• Creates its own political supporters+ some stand to gain materially from it + will be disproportionately resourceful and influential. Privatising creates entirely new political actors.
• privatization may be accelerated by the dynamics set in motion by consumer choice- is likely to create ever-increasing demands for more exclusive and culturally “distinct” service alternatives

Question 117

private provision of welfare leads to private financing

Answer 117

• privatization of the provision of welfare services may result in increased pressure for the privatization of their financing as well. If a commercial market for high-quality private social services develops, the better-off might be inclined to pay for these services privately rather than wait for public authorities to “purchase” them on their behalf. This will, by definition, undermine political attempts to maintain a universal, egalitarian welfare services sector

Question 118

issue with Powell’s MEW

Answer 118

ignores choice- wheels of welfare typology
regulation is hard to measure - no obvious common metric
voluntary sector is not a separate sector (Evers)- hybrid between the other 3 mies in the welfare mix