Children against parents? The politics of intergenerational recalibration in Southern Europe

Traditionally, Southern European countries displayed remarkably elderly biased social policy arrangements. This article introduces the notion of intergenerational recalibration to capture reforms aimed at rebalancing the generational profile of Southern European welfare states via the expansion of family policy and social assistance schemes—both monetary benefits and care services—and retrenchment in the field of pensions. Then, it elaborates theoretically on the political dimension of this policy strategy, focusing on the implications of the peculiar combination of expansionary and retrenchment reforms, to advance the hypotheses that domestic politics would prevent the realization of such an agenda, whereas the latter would be favored by a major role of supranational actors, especially the European Union. To test these hypotheses, we systematically analyze policy trajectories in the field of pensions and social assistance in Italy and Spain between the mid‐1990s and 2016. This allows, first, to argue that investment in “pro‐children” measures has not adequately balanced the reduction of pro‐parents expenditure and, second, to question the idea that domestic political incentives to expand “pro‐children” policies are necessarily too weak as well as the “enabling” role of external pressures in pursuing intergenerational recalibration.     

Unravelling the Politics of Activation Reforms: Exploring the Unusual Israeli Trajectory

Contemporary active labour market (ALM) reforms are pivotal in the reorganization of the welfare state as they challenge and threaten some of the fundamental achievements of labour in capitalist societies: social programmes and entitlements that compensate for unemployment, and governance arrangements in which the social partners share authority and responsibility with the state. Consequently, ALM reforms may give raise to social unrest and political struggle that involves the state (the main proponent of ALM reforms), trade unions and political parties. These conflicts are important in the politicization of reforms, i.e. raising public awareness of and engagement with controversies of welfare state change. In this article, we use a non‐European perspective to ask more generally how distinct historical institutions create separate ‘politicization trajectories’ of ALM reforms, which in turn produce different policy designs and outcomes. Centring on the case of Israel, in which historically ‘abnormal’ class politics fostered indifference to the reform in both trade unions and political parties, we maintain that the preliminary de‐politicization made it possible for bureaucrats to control the reform, leading to an intra‐state conflict between competing agencies over its design and implementation. The usurpation of the reform by the Ministry of Finance made it conspicuously unbalanced, provoking many grievances. Paradoxically, the de‐politicization of the reform advanced its re‐politicization, led by non‐governmental advocacy organizations in civil society. These uncommon political actors in the politics of ALM reforms were able to lead a counter‐coalition, delegitimize the reform, and mobilize politicians to eventually terminate activation     

New Models of Contracting in the Public Sector: A Review of Alliance Contracting,Prime Contracting and Outcome‐based Contracting Literature

The coordination of public services is an enduring challenge and an important policy priority. One way to achieve collaboration across organizational boundaries, which is being considered in public services such as the English National Health Service (NHS), is through the adoption of alliance contracting, prime provider contracting and outcome‐based contracting. This article reviews the cross‐sectoral literature concerning the characteristics of these new contractual models, how they function, their impact, and their relation to public sector governance objectives. These new contractual forms are characterized as models which, in line with the New Public Management (NPM)/post‐NPM agenda, seek to incentivize providers through the transfer of risk from the commissioners to the providers of services. Key findings are that the models are likely to incur high transaction costs relating to the negotiation and specification of outcomes and rely heavily on the relational aspects of contracting. There is also found to be a lack of convincing cross‐sectoral evidence of the impact of the models, particularly in relation to improving coordination across organizations. The article questions the reconciliation of the use of these new contractual models in settings such as the English NHS with the requirements of public sector governance for transparency and accountability. The models serve to highlight the problems inherent in the NPM/post‐NPM agenda of the transfer of risk away from commissioners of services in terms of transparency and accountability.     

Balancing Efficiency and Legitimacy: Institutional Changes and Rural Health Organization in China

The aim of this article is to contribute to the understanding of the institutional arrangements within which China's rural health facilities are embedded and of the contribution of policy to the creation of these arrangements. Information collected through field observations and in‐depth interviews with the managers, staff and patients of a township health centre indicates that with the gradual evolution of markets, encouraged by state policies, health care in rural China took on more of the characteristics of a commodity. In order to adapt to this change, the health centre and its employees are adjusting their behavioural norms and reconstructing an institutional network within which daily activities of simultaneously fulfilling public health responsibilities and pursuing economic gain are legitimized. This article focuses on the interwoven relationship between politics and markets at the micro level and examines the negotiations between stakeholders in constructing new institutional arrangements. It also describes how health sector managers are creating regulations to influence the performance of their facility. The article argues that while government policies play a crucial role in shaping the direction of development, institutional arrangements strongly influence the attempts by rural health organizations to implement them. It concludes that it is critical to take institutional factors into account in analyzing China's rural health‐care reforms.     

Welfare and Democratization – Comparing Croatia,Serbia and Macedonia

The article discusses the main determinants of welfare transformation after the regime change from communism towards democracy. The states of the former Yugoslavia, notwithstanding a common welfare state structure, albeit at different quality levels, after departing communism developed diverse trajectories. In response to the wars, war‐related consequences and growing economic pressures, the national political elites in Yugoslav successor states initially extended welfare provisions and thus thwarted popular mobilization. The international actors' agenda gained ground in a setting characterized by nationalistic resentments, popular disorientation and elite capture. What the analyzed country cases suggest is that democratization has contributed to making reforms more responsive to public concerns. On the other hand, ‘defective’ systems continue to impede economic development and compromise the welfare state's redistributive role.     

Straddling Two Continents: Social Policy and Welfare Politics in Turkey

There has been an increasing academic interest in understanding the dynamics of social policy in the Middle East and developing a conceptual ‘model’ to account for the particular characteristics of welfare arrangements in the countries of the region. While part of this framework, Turkey represents an exceptional case due to the Europeanization processes the country is undergoing in various policy areas, including social policy. The influence of the European Union on the shape of Turkish social policy, as illustrated by the government's recent reforms in the labour market and social security domains, is hereby used to outline the position of Turkey vis‐à‐vis both the Southern European welfare regime and the Middle Eastern pattern. This article seeks to assess the dynamics of Turkish social policy in light of the country's political, and socio‐economic dynamics, as well as the external influence exerted by the EU and international financial institutions. The aim is to examine Turkish welfare arrangements in a comparative manner and consider its suitability with reference to either of the two models. Looking at major trends in social security and the labour market, the article argues for a Turkish ‘hybrid’ model embodying the characteristics of both. Subject to EU explicit pressures for reform absent elsewhere in the Middle East, the data nevertheless show that Turkey has yet to make the qualitative leap forward that could place it firmly within the Southern European welfare group.     

The Role of Non‐profit Organizations in the Mixed Economy of Welfare‐to‐Work in the UK and Australia

This article charts the development of welfare‐to‐work policies and compares and contrasts the traditions of delivery in the UK and Australia. We find that in the UK, employment services and social security benefit administration have been dominated by the central state, traditionally affording a key role to civil servants as direct delivery agents. However, in federal Australia, mixed economies of welfare‐to‐work operate in the different states, there is a far greater role for social services and non‐profit organizations are firmly established as key providers of frontline employment services. Since the late 1990s, UK welfare reforms have been gradually following the Australian lead in contracting non‐state actors as delivery agents. As this trend seems set to continue and intensify, we examine the Australian experience in order to reflect on the role of non‐profits in policy reform.     

Policy Change at a Time of Retrenchment: Recent Pension Reform in France, Germany, Italy and the UK

Two influential recent approaches to social policy in Europe imply (for different reasons) that the reforms currently on the agenda, which typically involve cost-containment, are peculiarly difficult to achieve. Esping-Andersen sees much of Europe as set in a "frozen welfare landscape", due to the power of the interests advantaged by the status quo. Pierson sees retrenchment as a peculiarly difficult problem for all governments, regardless of their political ideology. This paper reviews recent pension policy in France, Germany, Italy and the UK. It argues that developments in Germany indicate that it is possible to achieve appropriate policy change in the country which is often used as the paradigm of entrenched interests without major restructuring of the system. Conversely, recent reforms in the UK (seen by Pierson as the country which has achieved the most rapid changes) appear disproportionate to the scale of the problems faced and may have damaged pensioners' interests. This indicates that the capacity to achieve substantial reform is not necessarily in itself a virtue. The real issue is the quality of reform achieved.     

Explaining Different Paths in Social Health Insurance Countries – Health System Change and Cross‐border Lesson‐drawing between Germany,Austria and the Netherlands

The issues of ‘policy diffusion’ or ‘policy transfer’ and ‘mutual learning’ have become important topics in comparative research on social policy and health systems. In current debates on explaining reform in ‘Bismarckian’ social (health) insurance systems, however, these issues have been neglected. In particular, the role of ‘negative lesson‐drawing’ in the sense of avoiding mistakes of others has not often been considered. This article compares health system change in Germany, Austria and the Netherlands, three countries with health systems of the social insurance type. In contrast to the existing literature, our analysis stresses that these countries have taken different reform paths since the 1990s. By applying a most similar systems design, we analyze how far cross‐border lesson‐drawing has contributed to health system divergence in the three countries. The empirical basis of the analysis is semi‐structured qualitative expert interviews, a method appropriate for tracing processes of lesson‐drawing. We argue that in order to fully understand the diverging reform trajectories, we need to take into account how political decision‐makers refer to (negative) experiences of other countries. Generally, national driving forces for health system change were at the heart of many crucial reforms during the period studied. Nevertheless, we claim that it was the German bad practice role model that kept the reform paths of Austria and Germany apart in the Austrian health reform discussion between 2000 and 2005.     

Is Personalization the Right Plan at the Wrong Time? Re‐thinking Cash‐for‐Care in an Age of Austerity

As personalization has dominated the policy agenda for reform in social care, its roll‐out as a mainstream option has coincided with global programmes of austerity which have targeted services for disabled people. Was this simply bad timing or was its implementation always part of the agenda for reform? Whilst the principle of cash‐for‐care schemes drew strongly on promoting the independence and autonomy of disabled people, early incarnations of direct payments policy in the UK were initially at least in part rolled out in light of potential cost savings to social care budgets. This article explores these and other issues in light of evaluations of the Scottish government's self‐directed support (SDS) test sites (2009–11) and implementation of subsequent legislation enforcing models of SDS in Scotland from April 2014. Discussion draws on the authors’ recent book (Pearson et al. 2014) to reflect on what the evidence can tell us about radically transforming social care at a time of global austerity.     

Public–Private Partnerships in European Old‐Age Pension Provision: An Accountability Perspective

Over the last few decades, the boundary between public and private responsibility in old‐age pension provisions has been redrawn throughout Europe. A new, public–private mix has emerged, not only in pension policy, but also in pension administration. The purpose of this article is to map and conduct a comparative analysis of the administrative design of public–private partnerships (PPPs) in European pension regimes, with a specific focus on how accountabilities are institutionally enforced within the PPP design. Previous literature has recognized accountability as an important factor in promoting trust in mandated pension schemes. However, as the literature on PPPs suggests, institutional arrangements of accountability are more complex in the case of PPPs than has been suggested by previous studies on pension administration. Thus, there is a need for further elaboration of existing comparative models. This study's analysis examines 19 old‐age pension schemes that existed in 18 European countries at the beginning of 2013. The findings suggest that significant variations in accountability structures exist, even among schemes that are similar in terms of their pension policy targets. It is concluded that various schemes suffer from ineffective accountability structures that may compromise the legitimacy and sustainability of PPP‐type pension schemes.     

Promoting workplace‐based training to fight youth unemployment in three EU countries: Different strategies,different results?

During the economic crisis, youth unemployment grew exponentially in many European countries. It was argued that countries with a high level of firm involvement in the provision of initial vocational training were better equipped to address this problem. Boosting workplace‐based training was therefore seen as the right strategy to tackle unemployment. Using Denmark, Spain and the UK as case studies, this article analyses how countries with different skill formation systems have improved this type of training. While the UK reinforced the voluntaristic character of its training regime, Denmark improved the quality of its vocational education, and Spain made reforms to the training and apprenticeship contract. Interestingly, the countries achieved different results. To explain this divergence, it is argued that while the reforms made in the UK and Denmark were compatible with the national institutions and coordination mechanisms, this was not the case in Spain, where reforms were implemented in a non‐complementary way. Key Practitioner Message:

• After the economic crisis it was argued that countries with a high level of firm involvement in the provision of initial VET were better equipped to fight youth unemployment.
• The study analysed how countries with different skill formation systems improved this type of training and assessed their relative success.
• The article shows that when implementing reforms policy makers must take into account the institutions and mechanisms of coordination that prevail in each country. Otherwise, reforms may be unsuccessful.

     

Ideas and Social Policy: An Institutionalist Perspective

Since the beginning of the 1980s, historical institutionalism has emerged as one of the most influential theoretical perspectives in social policy studies. Although their work is insightful, most institutionalist scholars tend to relegate policy ideas to the back of their theoretical constructions dealing with welfare state development. The objective of this paper is to show how institutionalist scholarship can pay greater attention to ideational processes without abandoning its core assumptions about the structuring impact of political institutions and policy legacies on welfare state development. If institutions truly influence policy‐making, policy ideas matter in and beyond the agenda‐setting process. Related to existing policy legacies, perceived problems mesh with policy alternatives grounded in a specific paradigm. When stressing the need to reform, and promoting new alternatives, policy entrepreneurs draw on existing ideological repertoires to frame these alternatives. The ability to successfully frame policy alternatives can become a decisive aspect of the policy process. A discussion of recent European and North American policy debates illustrates these claims.     

Devolution and Patient Choice: Policy Rhetoric versus Experience in Practice

Background: market reforms in England have been identified as making a clear distinction between English health policy and health policy in the devolved systems in Northern Ireland, Scotland and Wales. Patient choice is a high profile policy in the English National Health Service that constitutes significant changes to the demand side of health care. It is not clear what national differences this has led to regarding implementation of policy. This article presents the findings from a large UK‐wide study on the development and implementation of policies related to patient choice of provider. The findings reported here relate specifically to the policy development and organizational implementation of choice in order to examine the impact of devolution on health care policy. Aim: this study examines patient choice of provider across all four countries of the UK to understand the effect of differences in national policies on the organization and service how choice of provider presented to patients. Methods: at the macro‐level, we interviewed policymakers and examined policy and guidance documents to analyze the provenance and determinants of national policy in each UK nation. At the Primary Care Trust or Health Board level, we interviewed a range of public and private health service providers to identify the range of referral pathways and where and when choices might be made. Finally, we interviewed ear, nose and throat, and orthopaedics patients to understand how such choices were experienced. Findings: while we found that distinct rhetorical differences were identifiable at a national policy level, these were less visible at the level of service organization and the way choices were provided to patients. Conclusion: historical similarities in both the structure and operation of health care, coupled with common operational objectives around efficient resource use and waiting times, mediate how strategic policy is implemented and experienced in the devolved nations of the UK.     

Activation Reform and Inter‐Agency Co‐operation – Local Consequences of Mixed Modes of Governance in Sweden

Organizational reform has become a recurring solution to problems of social exclusion and unemployment. In Europe, and other parts of the world, there is a trend towards policies of ‘activation’ in employment and social policy. The idea of flexible, individualized and tailor‐made services is coupled with managerial and market‐based reforms as well as collaborative governance. In these complex structures of service provision, coordination and inter‐agency co‐operation have become key concerns. Based on a study of a recent reform of programmes for newly arrived refugees in Sweden (Etableringsreformen), this article seeks to contribute to the literature on governance of ‘activation’ by examining the consequences of mixed modes of governance (market and collaborative) on local inter‐agency co‐operation. Drawing on data from in‐depth case studies in two municipalities, it is demonstrated how the coupling of managerial practices and quasi‐markets with existing collaborative arrangements has created barriers for inter‐agency co‐operation. The results indicate that institutional tensions between governance forms represent an important factor for explaining governance failure in this policy area.     

Gender and proposed Auto‐enrolment in the Republic of Ireland: Lessons from the UK

The introduction of “soft” compulsion in the form of Auto‐enrolment into non‐state pensions has been seen as a key policy response to the challenges presented by an ageing population and concerns about under‐saving for retirement in the UK. Since its introduction in 2012, amongst eligible employees in the private sector, pension participation had risen by over 31 percentage points to 73% of eligible employees in 2016. Despite these trends, Auto‐enrolment in the UK has not been without criticism, particularly in terms of its exclusion of certain groups, including carers, amongst whom females are over‐represented. The Republic of Ireland (ROI) has recently announced its intention to implement an Auto‐enrolment pension scheme. As such, this article examines the UK's experience of rolling out Auto‐enrolment policy and considers lessons that could be learned by the ROI from the UK in its pursuit of Auto‐enrolment, with a particular focus on women's pensions. Initially it outlines the current Irish pension system, the gendered nature of pensions, and the proposed Auto‐enrolment system in ROI. Then it discusses the UK's experience of Auto‐enrolment, with a particular focus on gender, before examining the lessons the ROI can learn from the UK's Auto‐enrolment policy in relation to women and pensions. Finally, it concludes that Auto‐enrolment alone will not resolve the gendered nature of pensions in the ROI and calls for a gender‐based assessment of the proposed policy of Auto‐enrolment in the ROI.     

Disciplining Disability under Danish Active Labour Market Policy

This article explores how caseworkers are re‐constructing disability in the Danish welfare system and disciplining themselves and clients according to the active labour policy paradigm. Combining Foucault's ideas about discipline with Maynard‐Moody and Musheno's method of interpreting street‐level bureaucrats' stories ( Foucault 1977 ; Maynard‐Moody and Musheno 2003 ), we analyze caseworkers' stories about their clients, fellow caseworkers and themselves to understand how they practice the ideology behind active labour policy. Our analysis uses Møller's (2009 ) interviews with 24 Danish caseworkers who administer social welfare and sick leave benefits based on disability as the primary eligibility criterion. We selected stories told by caseworkers that exemplify archetypes of good and bad citizens, good and bad clients, and good and bad caseworkers. Through interpretative analysis, we elucidate how caseworkers make sense of active labour policy and internalize the pressures of managerial reforms to discipline both citizens and each other.     

Mixed accountability within new public governance: The case of a personalized welfare scheme in early implementation

We explore personalized funding schemes and associated changes for accountability within new welfare governance reforms. Using the case of the Australian National Disability Insurance Scheme as hybrid institution, requiring mixed accountability arrangements, we examine the implications for broader discussions of accountability in personalized welfare arrangements. Methods used were semistructured interviews with government actors and disability service providers in Australia. In describing how accountability structures emerge, we argue that the way that layers fit together during implementation are often imperfect because of the conditions under which they arise. As a result, critical gaps can emerge in layered systems, which can put end users at risk. We demonstrate that theories on accountability in new public governance welfare reforms must also be informed by context and history informed qualitative analysis of case studies.     

Turkey and the European Union: Modernizing a Traditional State?

This paper discusses the difficulties encountered when reforms are attempted to the administration of public policy in Turkey. This discussion is timely, since Turkey has recently stepped up its modernization agenda in its drive to gain membership of the European Union. The paper briefly examines the political and administrative structure of Turkey before discussing the influence of the EU on the country's modernization agenda.     

Portuguese healthcare reforms in the context of crisis: External pressure or domestic choice?

As a result of the recent economic crisis, in 2011, Portugal signed a Memorandum of Understanding with the European Central Bank, the European Commission, and the International Monetary Fund (the “Troika”). In exchange for Troika's financial assistance, the Memorandum required the implementation of a specific set of reforms targeted at the healthcare sector. The literature on policy reforms in the context of crisis and conditionality argues that governments have restricted room to manoeuver in responding to external pressure. We challenge this view, finding that even in cases of conditionality and strong external pressures, crisis can be used as a window of opportunity for reforms substantially shaped by domestic policy choices. In the case of Portuguese health reforms, these choices were based on pre‐existing reform plans aimed on resolving country‐specific deficiencies of the healthcare system and were enabled by the two main political parties' strategies of tacit cooperation and blame avoidance. The article emphasizes the need for more fine‐grained analysis of welfare reforms in the crisis that pays equal attention to the institutional characteristics and the political context of the affected countries.