Care: A Critical Review of Theory,Policy and Practice

‘Care’ is a source of critical tension in current social theory, and the policy and practice implications of that tension are evidenced in its current prominence on the political agenda of developed welfare states. This article critically appraises current developments in the theory, policy and practice of care, drawing on interdisciplinary developments in political theory, sociology and social policy. Developing feminist and disability‐rights theories, it explores a critical synthesis of conflicting normative and theoretical positions regarding the giving and receiving of care, and of the ethics and justice of care. It examines case studies of current comparative policy developments across a range of different welfare regimes, including the marketization/commodification and de/re‐familiaization of care, exploring ideological and normative trends in the design of contemporary policies. It discusses the impact of theory and policy on the practice of care, looking particularly at the issue of long‐term care for disabled and older adults. Finally, the authors argue for the development of a citizenship‐based approach to care that decouples it from individualistic and paternalistic paradigms that disempower those who give and receive care.     

大学校园的诚信缺失及其解决对策

诚信是一种伦理德性,也是一种经济伦理原则和社会责任信念。但在现代社会功利、利益等因素的冲击下,大学校园的道德诚信出现了下滑,导致了“诚信缺失”,请“枪手”、考试舞弊、假文凭假学历等屡见不鲜。这与社会主义道德风尚、大学人文主义精神、大学生理想人格是相背离的。因此,我们不能忽视这一现象,要深入探究诚信缺失背后隐藏的经济的、伦理的、社会的、心理的原因,并从教育改革、提高个人素质、建立信用档案、加强法律机制的建设等方面寻找其解决对策,使诚信回归大学校园。     

‘Let the King Save the Poor’: The Discursive Mechanism Underlying the Under‐exercise of Social Rights in South Korea

This study was prompted by discrepancies observed between the quantitative expansion and the qualitative stalemate in social policy in South Korea. Despite a revamped social security system, changes in South Korean social policies have not led to significant coverage expansion or improved income and poverty distribution. The frequent appearance of the Korean proverb that ‘even the King cannot save the poor’ in policy participants' narratives reflects a lack of confidence in the Government's ability to address persistent social disadvantages and the prevalence of a fatalistic policy perspective. This proverb has a conceptual affinity with an individualistic approach and has effectively functioned as a governance tool to oppress the progress of welfare rights. This research shows that an expenditure‐based model could lead to actual policy situations being misrepresented. Further, institutional policy arrangements may not be a sufficient condition for improving policy performance. It is suggested that a rights‐based approach should be adopted for both theorization of the transition of the welfare regimes and discursive practice for a policy paradigm change.     

Public Satisfaction with the Health System and Popular Support for State Involvement in an East Asian Welfare Regime: Health Policy Legitimacy of Hong Kong

The legitimacy of social policies has gained increasing attention in the past decade, against the backdrop of fiscal austerity and retrenchment in many nations. Policy legitimacy encompasses public preferences for the underlying principles of policies and the actual outcomes as perceived by citizens. Scholarly knowledge concerning the legitimacy of health policy – a major element of modern social policy architecture – is, unfortunately, limited. This article seeks to extend the scholarly debates on health policy legitimacy from the West to Hong Kong, a member of the East Asian welfare state cluster. A bi‐dimensional definition of health policy legitimacy – encompassing both public satisfaction with the health system and the normative expectation as to the extent of state involvement in health care – is adopted. Based on analysis of data collected from a telephone survey of adult Hong Kong citizens between late 2014 and early 2015, the findings of this study demonstrate a fairly high level of satisfaction with the territory's health system, but popular support for government responsibility presents a clear residual characteristic. The study also tests the self‐interest thesis and the ideology thesis – major theoretical frameworks for explaining social policy legitimacy – in the Hong Kong context. Egalitarian ideology and trust in government are closely related to both public satisfaction with the system and popular support for governmental provision of care. However, the self‐interest thesis receives partial support. The findings are interpreted in the context of Hong Kong's health system arrangements, while implications for the territory's ongoing health policy reform are discussed.     

Public Opinion against Markets? Attitudes towards Market Distribution of Social Services – A Comparison of 17 Countries

This article studies how citizens view the appropriateness of market criteria for allocating services commonly associated with social citizenship rights and welfare state responsibility. The article focuses specifically on a potential role for the market in the provision of social services. The relationship between welfare policy institutions, socio‐economic class and attitudes is explored by comparing attitudes across 17 countries of the Organisation for Economic Co‐operation and Development, using multilevel modelling and data from the 2009 International Social Survey Programme. Results show that public support for market distribution of services is relatively weak in most countries, a result suggesting that public opinion is unlikely to pose a driving force within ongoing processes of welfare marketization. Still, attitudes are found to vary a lot across countries in tandem with between‐country variation in welfare policy design. First, aggregate public support for market distribution of services is stronger in countries with more private spending on services. Second, class differences in attitudes are larger in countries with more extensive state‐led delivery of services. Together, these results point to the operation of normative feedback‐effects flowing from existing welfare policy arrangements. The theoretical arguments and the empirical results presented in this article suggest that future research exploring the relationship between welfare policy and public opinion from a country‐comparative perspective is well advised to place greater focus on the market institutions that, to varying extents in different countries, act as complements to the state in the administration of social welfare.     

Assimilation,control, mediation or advocacy? Social work dilemmas in providing anti‐oppressive services for Traveller children and families

This paper explores dilemmas facing social work in England in providing anti‐oppressive services for Travellers, particularly those who lack secure sites. A context is provided by outlining the conflict between Travellers and the majority society, and its expression in oppressive legislation, policy and practice. The implications of the corporate local authority role for relationships between Travellers and social services, and the specific history of Travellers and welfare, are also explored. The remainder of the paper draws on findings from a Nuffield‐funded study of policy and provision by English social services departments for Traveller children and families. Provision is undermined by mutually difficult relationships between Traveller communities and social services, and competing demands on social services in relation to professional values and support of Travellers’ rights, and their simultaneous contribution to local authority control of unauthorized camping. However, newer developments in some social services departments may be able to generate more positive relationships with Travellers, to promote their individual and cultural rights, and build partnerships with voluntary agencies which have a significant role in work with Travellers. The implications for social services departments wishing to develop their policies and practice with Traveller families are outlined.     

Social Policy in Greece: Rhetoric versus Reform

This paper reviews the major social policy developments in Greece during the 1980s and 1990s, focusing on social security, health and employment policies. It argues that the concept of social policy and the practice of politics have been distorted in this country. Social policy reflects the legacy of a heavily politicized and centralized policy‐making system, an impoverished administrative infrastructure and poorly developed social services. Its emergence is characterized by the pursuit of late and ineffective policies. It lacks continuity, planning and coordination, being oriented towards short‐term political expediency. It is largely insurance‐based, reproducing huge inequalities and institutional arrangements which are behind the times. It provides mainly cash benefits, low‐quality but rather expensive health services and marginal social welfare protection. Moreover, the lack of a minimum income safety net confirms the country's weak culture of universalism and social citizenship. By implication, complex policy and interlocking interest linkages have tarnished the “system” with a reputation for strong resistance to progressive change. At the same time, sources of change such as globalization, demographic developments, new household and family/gender patterns, unstable economic growth, fiscal imperatives, programme maturation, as well as persisting unemployment, changing labour markets and rising health care costs, have produced mounting pressures for welfare reform.     

The vicious layering of multilevel governance in Southern Europe: The case of elderly care in Italy and Spain

Aging and changes in family arrangements and female employment have brought about important policy developments in long‐term care (LTC). Southern European countries have relied for a long time on family care and residual social care for the dependent elderly. Two paradigmatic cases, Italy and Spain, have shown two apparently different trends during the last 15 years: while in Italy, reforms seem to have been persistently blocked, in Spain, an ambitious reform has fallen short of expectations. Based on data on services and institutional arrangements, the article shows that a complex and inconsistent allocation of responsibilities across government levels, a sort of “vicious layering” of multilevel governance, may be playing a key role in this situation. The article discusses the dysfunctional effects of such arrangements, namely territorial inequalities, cost‐shifting between government levels and towards users, and misallocation of resources. We suggest that the development and reform of LTC in Southern European countries must address these problems if they want to avoid getting marooned by a complex network of vetoes and resource allocation problems.     

个人征信中私人权益与社会整体利益的协调

市场经济是信用经济,征信制度由来已久。我国的个人征信还处于起步阶段,需要不断完善和发展。在个人征信中,信息个人享有充分的权益,如知情权、隐私权等。对此,应采取法律措施给予充分保护,并注意处理好私人权益与社会整体利益的矛盾,在尊重、维护私人权益的前提下,促进社会整体利益的持续稳定发展。     

Beyond Continuity? Understanding Change in the UK Welfare State since 2010

One approach to identifying policy change stresses policy instruments, settings and policy paradigms, while another also considers the process and culmination of various shifts and consequent outcomes. This article illustrates the debate through an examination of how far developments in social security policy between the 1997–2010 New Labour and 2010–15 Coalition Governments in the UK constituted real policy shifts. It shows that, despite continuities in instruments and approach, there have been substantial changes in the impact of welfare state policies related to short‐term benefits, employment and housing. The article identifies new policy directions leading to a different kind of welfare state, concerned less with living standards and equality and more with individual responsibility and paid work. It suggests that this has been achieved without the need for radical changes in instruments and their settings.     

Fairness, Equality and Legitimacy: A Qualitative Comparative Study of Germany and the UK

The pressures of globalization and shifts towards post‐industrialism are producing policies that increasingly emphasize the common themes of activation and of individual responsibility for outcomes. Such approaches suggest normative principles of equality of opportunity rather than of outcome, and of individual rather than collective responsibility for the outcomes achieved. Does this imply a shift towards a common normative framework for European welfare states, with implications for future policy developments? This article reports a recent qualitative study examining ideas about fairness and social provision in the very different regimes of Germany and the UK. The analysis shows that while respondents in both countries value equality of opportunity as a normative principle, those in Germany are much more likely to argue that an equal opportunity approach requires government to guarantee equal access to basic services. They are also more likely to express concerns about market freedoms which allow those who can afford it better access to health care and education. Real differences in welfare values remain, loosely following differences of regime type, despite the greater emphasis on activation and individual responsibility across European welfare states.     

Australian Welfare Reform: From Citizenship to Supervision

This paper examines the implications of welfare reform for the meaning of social citizenship in Australia. Australian welfare reform has been under way since the late 1980s, and reflects the themes of activity and participation that are shaping social policy in many advanced industrial nations. The paper suggests that Australian welfare reform is following a liberal trajectory of change which places a continuing emphasis on market and family as the preferred institutions for social support with a newly salient appeal to moral ideas about the responsibility of citizens to be self-sustaining. The paper argues that welfare is being transformed from a limited social right to support provided on condition, and from treating the claimant as a sovereign individual to a subject of paternalistic supervision. Together, these changes are redefining the meaning of equality in Australian social citizenship.     

The influence of faith‐based organisations on Australian social policy

This historical overview explores the crucial and changing relationships between faith‐based organisations and governments, not only in the implementation of social services but also in the formation of social policy. Historically Australian governments have left large areas of social provision to the non‐government sector. For example, income support for the unemployed was not taken up by governments until World War II and income support for sole parents remained largely a responsibility for non‐government organisations (NGOs) until the 1970s. Prior to governments taking responsibility for income support, most of these NGOs were religious organisations surviving on donations, philanthropic support and limited government funding. It is argued that the dominant, semi‐public role of religious organisations in service delivery and social policy formation is an important but largely overlooked aspect of the Australian historical experience.     

The role of the social innovation and entrepreneurship development fund in fostering social entrepreneurship in Hong Kong: A study on public policy innovation

Creating an enabling environment for social entrepreneurship in tackling complex socio‐economic challenges is at the forefront of government policy agendas globally. Although several policy mechanisms have been proposed to this end, whether and to what extent those policy mechanisms may (re)shape the social entrepreneurship environments have rarely been explored. By examining the Social Innovation and Entrepreneurship Development Fund (SIE Fund), a recent policy project aimed at fostering social innovation in Hong Kong, this article presents a rare empirical exploration to illustrate how public policies can potentially drive social innovation. We explore first the impact of the SIE Fund in fostering innovation among its funded social enterprises, and second, how the SIE Fund may have influenced Hong Kong's social entrepreneurship environment. Results show that the projects under the SIE Fund exhibit characteristics distinct from the social enterprises prior to the inception of the SIE Fund. In addition, evidence of innovations in terms of product, process, marketing, and innovation in developing new or improved social practices were also identified. This study illustrates how specific public policy mechanisms may potentially facilitate the diversification, inclusion, innovation, and expansion of the social entrepreneurship environment. Findings carry substantial policy implications, in particular to neighbouring East Asian societies typically characterized by a strong government, and face similar structural, demographic and socio‐economic challenges that necessitate innovative solutions.     

Renewing the Social Vision of Care

Care is a fundamental condition of human existence, an inherently social activity. Yet surprisingly, care has only recently begun to receive serious attention from social researchers and the public. Despite the fact that care has become a public issue over the past twenty‐five years or so, current thinking in policy and advocacy for carers has developed an overtly narrow and self‐limiting focus with a strong emphasis on the plight of primary or sole carers, with care being seen predominantly as a burden. From looking at Australian policy on carers, it may be concluded that care is essentially understood as a private, individual concern, a one‐way activity in which the active agent, the carer, does something to the other, passive, recipient. The challenge posed in this paper is to move beyond this approach to that of a more social conception of care. Following a review of the uses of the terms ‘care’ and ‘carers’ in the current Australian policy context, a discussion of the meaning of the term ‘care’ is presented and an alternative understanding of the term, with the potential of recognising and promoting care as a complex, social outcome is advanced.     

Fear of the Brown Envelope: Exploring Welfare Reform with Long‐Term Sickness Benefits Recipients

This article presents qualitative data taken from in‐depth interviews with 25 long‐term sickness benefits recipients in the north east of England, UK. A key theme emerging from the research is the importance of listening to the narratives of long‐term sick and disabled benefits recipients, particularly in relation to the formation of policy responses and in terms of practice. The findings also illustrate how stigma associated with claiming benefits can deter people from accessing the support they need, leading to under‐claiming and the risk of amplified financial strain and hardship. Further, the importance of evidence that emerges from research which focuses upon the lived experiences of sickness benefits recipients to provide evidence in the framing of disability and welfare policy is crucial. Lastly, the article discusses how the narratives presented have implications for social policy and practice, alongside the potential implications for sick and disabled people themselves.     

Externalities,Prospect Theory,and Social Construction: When Will Government Act,What Will Government Do?*

Objectives. Political theories of agenda setting and policy choice are still limited in predicting when an issue will become salient and, once it has, what policy option will be used to address it. This article illustrates that for a large class of externality problems, perspectives from three other social science disciplines can refine those predictions. Methods. A synthesis of implications from economics on assignment of property rights, loss aversion from prospect theory, and image of the policy target from social construction is used to determine the conditions under which issues gain attention and the likely policy solutions. Results. Assignment of property rights establishes a baseline used to assess any further government actions, with losses from that base more likely to generate political attention. The assignment of rights also determines if a problem is defined as a negative or positive externality, which restricts the type of policies used to address the problem. This initial allocation of rights is in turn affected both by the political power and social construction of the groups involved. Conclusions. The result is a bias in policy attention and outcomes strongly influenced by the norms used in assignment of property rights, which typically favor those generating the negative externality.     

论我国个人信用法律制度体系建设

建立个人信用法律制度体系是当前一个热门话题。中共中央十六届三中全会提出要建立健全社会信用体系,形成以道德为支撑、产权为基础、法律为保障的社会信用制度。关于对信用的理解学者们各抒己见,但在探讨个人信用法律制度体系建设中必须给信用一个合理的定位,才能进一步探讨我国个人信用法律制度体系建设的构架,从而提出一些设想。倡导和培育现代信用观念和信用文化,建立个人信用征集制度,完善信用公开披露制度,加强信用监督制度,加大失信惩戒机制,建立健全个人信用法律制度,制定一些与个人信用有关的法律,修改完善现行法律。政府应为建立个人信用法律制度体系创造良好的外部环境。     

Mothers at the Service of the New Poverty Agenda: Progresa/Oportunidades, Mexico's Conditional Transfer Programme

This article considers some of the changes and continuities in social protection in Latin America through a focus on the ways in which motherhood is positioned as key to the success of the new anti‐poverty programmes that have followed structural reform. It examines a flagship cash transfer programme known as Progresa/Oportunidades (Opportunities) established in Mexico in 1997 and now being widely adopted in the region. Characterized by some commentators as a quintessentially neo‐liberal programme, it is argued that Oportunidades represents a novel combination of earlier maternalist social policy approaches with the conditional, co‐responsibility models associated with the recent approaches to social welfare and poverty relief endorsed by international policy actors. In the first section, the gendered assumptions that have governed Latin American social policy are described; the second outlines social policy provision in Latin America and identifies the key elements of the new approaches to poverty; and the third critically examines the broader implications of the Mexican programme's selective and gendered construction of social need premised, as it is, on re‐traditionalizing gendered roles and responsibilities.     

The ambiguity of social return policies in the Netherlands

Social procurement policies, which aim to create employment opportunities for vulnerable groups, such as the long‐term unemployed and the disabled, have become increasingly popular in recent years. Despite their growing popularity, empirical research on this topic is limited. Combining insights from the social policy and public administration literatures, we explore the development and implementation of “social return” policies by the Dutch government. These policies are a form of social procurement that require private employers to spend a percentage of public tenders to hire individuals far removed from the labor market. Social procurement appears, by definition, to be a form of social investment. However, our analysis of the ideas underlying its use in the Netherlands suggests that significant contradictions exist, with evidence of neoliberal New Public Management tendencies, social investment, and the more recent form of public administration, New Public Service. Using extensive document analysis of parliamentary documents, discussions and evaluative reports from 2008 to 2014, we reveal the tensions inherent in the Dutch approach and discuss possible implications for our understanding of social policy and administration as well as social protection.