The Choice Revolution: Privatization of Swedish Welfare Services in the 1990s

During the 1990s, the Swedish welfare state was declared by some to be in a “crisis”, due to both financial strain and loss of political support. Others have argued that the spending cuts and reforms undertaken during this period did slow down the previous increase in social spending, but left the system basically intact. The main argument put forward in this article is that the Swedish welfare state has been and is still undergoing a transforming process whereby it risks losing one of its main characteristics, namely the belief in and institutional support for social egalitarianism. 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. This resulted in a socially segregating dynamic, prompted by the introduction of “consumer choice”. As will be shown in the article, the gradual privatization and market‐orientation of the welfare services undermine previous Swedish notions of a “people's home”, where uniform, high‐quality services are provided by the state to all citizens, regardless of income, social background or cultural orientation.     

Hybridization in China's elder care service provision

Although the party‐state has embarked on a mission to increase elder care services, evaluating this development according to different sectors demonstrates certain challenges. Official statistics do not include sector‐specific information, and while provider websites suggest that elder care services are largely in public hands, Chinese experts argue that they are mostly “civilian‐run.” How can we explain these discrepancies in data on Chinese elder care? Drawing on the concept of hybridization and triangulating quantitative and qualitative data, I argue that the party‐state's efforts to “socialize” elder care provision has resulted in hybridization within the industry which blurs the line between care providers and obfuscates the stark role of the state in elder care service provision. During the implementation of state‐initiated hybridization, providers misclassify their ownership type to benefit from financial incentives or circumvent political control, resulting in even greater hybridization and fragmentation on the ground.     

Childcare policies and services in Hong Kong after the handover: Beyond a feminist critique

This article reviews the development of childcare policies and services in Hong Kong after the handover, gauging it with two standards: promoting the equal development of children and gender equality in our society. Statistics derived from data taken from multiple sources show that the government has been sticking to a “positive non‐intervention approach” to welfare development and that the male breadwinner/female carer model prevalent in this region was shaped and strengthened by current childcare policies and services. The current provision of childcare services is insufficient to guarantee the equal use of childcare among children of different socioeconomic backgrounds, or to ease the tension between the needs of childcare and job requirements in a family, or to emancipate married women from the domestic sphere. A “generative welfare approach” that collects fiscal resources and redistributes them strategically with a systemic mind‐set has been suggested for social policy and service planning, including spending the money in the right place, launching smart and practical policies that can achieve both pragmatic effects and ideological improvement in the area of gender equality, providing financial support or subsidies to a company for the provision of parental leave, and increasing the provision of quality childcare services.     

Decentring the NHS: A Case Study of Resource Allocation Decisions within a Health District

The aim of New Labour's health policy is to shift more of the balance of power and responsibility for services to the local level. But, while the government proclaims a new decentralized NHS, doubts exist about the extent to which the reality on the ground matches the tone of policy. This article reports empirical work examining the level of autonomy purchasers have over budgetary allocation. A case study analysis of purchasing within a single district was undertaken for the financial year 2001/2 which included semi‐structured interviews with key officers responsible for budget allocation. Purchasers approach a new financial year with a starting position that matches the previous year's allocation—the “baseline”, this is adjusted for inflation and, as has happened over the last few years, increased further in real terms by “growth funds” for service modernization and government initiatives. The analysis shows a clear dissonance between policy and practice; although purchasers have complete control over their “baseline budgets”, the study found that this does not “ring true” at the local level. Only about a fifth of growth funds were at the discretion of purchasers as most are taken by national priorities and pay and price inflation. Further decentralization is planned, which includes transferring more control of funds to primary care trusts by 2004, the extent to which these measures will change the perceptions of those working in the service remains to be seen—only then will the government be able to claim a truly decentred service.     

The emerging role of Financial Counsellors in supporting Older Persons in financial hardship and with management of Consumer‐directed Care packages within Australia

The role of financial counsellors as providers of information, support and advocacy for those in financial difficulty is a well established mechanism in the mainstream welfare landscape in Australia. In general, the role of financial counsellors is in helping people alleviate or resolve their financial difficulties through improvement of their financial literacy. It is recognised as an important component of policy responses to assist low‐income households and individuals in financial stress. The use of financial counsellors for older persons (i.e., those aged 65+ years), however, appears to be underutilised. Financial hardship and abuse of older persons within our community are becoming key issues as the population of Australia “ages”. Existing evidence also suggests that service providers alone do not have adequate skills to address these issues. This paper firstly examines the development of financial counselling in Australia. It then examines the newly emerging role of financial counselling in supporting older persons in addressing barriers to financial literacy and then in navigating the complex landscape of aged care service provision. The current financialisation, marketisation and complexities of consumer‐directed care are identified as key contextual factors. The paper will then discuss an evaluation study of the provision of financial counselling to the older person population designed to support financial hardship and navigation of the complex aged care services system. The findings of the paper are based on an evaluation of the Financial Consumer Rights Council (FCRC), Victoria: Dignity and Debt Financial Difficulty and Getting Older initiative. This pilot initiative included older persons from both community‐based and aged care residential facilities in one regional area of Victoria. The initiative, conducted over 2016, was designed to assess the effectiveness of one‐on‐one financial counselling sessions with older persons that provided consumer advocacy and information about support services and entitlements (including hardship protections) associated with ageing. The evaluation found that the provision of financial counselling to the older person population could be a key mechanism in improving overall financial literacy, avoiding periods of financial hardship and in maintaining financial well‐being, quality of life and positive ageing. Findings also demonstrated a need for an expanded outreach financial counselling model to better service older persons in more isolated living environments and/or with mobility impairments living in the community, and the potential to situate offices of financial counsellors within medical centres (a space often visited by the ageing population), to co‐situate financial health check‐ups as an overall element of health and well‐being. As such, financial counselling was viewed as well placed to support older persons in improvement of financial literacy and in supporting navigation of the increasingly complex marketised and consumer‐directed care (CDC) landscape of aged care service provision in Australia.     

Secular Trends in Substance Use: The Conflict and Young People in Northern Ireland

The resolution of political conflict has led some to suggest that Northern Ireland will now face a range of social problems that have been ignored or suppressed by the Troubles. One such area is adolescent drug use. In this article, a review of a range of data sources shows that drug use, with few exceptions, has increased since the emergence of the ongoing peace process. Social and political changes and enhanced paramilitary involvement in the drugs trade appear to have somehow created an environment where drug use has flourished. In reviewing current drug policy and practice, the article highlights the lack of prevention, treatment, and harm reduction services established in Northern Ireland as a cause for concern .     

Policy Style and Governing without Consensus: Devolution and Education Policy in Northern Ireland

Devolved government was established in Northern Ireland in 1999 at the same time as Scotland and Wales with a varying range of powers, particularly over the major areas of social policy including education. Devolution in Northern Ireland was set up on the basis of statutory power‐sharing in the core executive with a number of mechanisms to promote involvement by all sections of the community through their political representatives. This marked a departure from the traditional majoritarian and hierarchical model of UK government. The operation of devolved government in Northern Ireland requires a consensus on major policy items requiring legislation. The main aim of the article is to assess whether or not there is a devolved policy style in Northern Ireland and to compare this policy style with the findings of similar analysis in Scotland and Wales. Consideration is then given to the impact of both the distinctive policy processes which reflect the consociational nature of the Good Friday Agreement and wider social, political and administrative factors. Decision‐making on education policy is a totally devolved function and thus serves as an important example of autonomous policy formulation and policy‐making. The three main topics of current policy debate in education are selected for analysis to determine the nature of the decision‐making process and the existence of a distinct devolved policy style.     

Partnership Working and Eligibility Criteria: What Can We Learn from the Implementation of Guidance on Continuing Health Care?

Current government policy places great importance both on clinical governance and on partnership working between health and social services. Separately and together, these policy emphases require greater clarity in and between organizations about who should provide what care where than has often been achieved in the past. A study of the implementation of continuing health care policies suggests that clarity about appropriate long–term health and social care provision was difficult to achieve in the 1990s quasi–markets, because there were too few financial and structural incentives for agencies to cooperate in developing and implementing precise and comprehensive eligibility criteria. This problematic interplay between financial and structural factors is being addressed by a number of government initiatives designed to stimulate joint working, although the difficulty of drawing a clear boundary between health care (free at the point of delivery) and social care (which can be means–tested) remains.     

The Integration of Health and Social Care: The Lessons from Northern Ireland

Mechanisms for the integration of social services with health have come to dominate the debate on providing a more seamless provision of health and social care. Working together at the health and social care interface has been strongly promoted and endorsed in government documents since the late 1990s. Moves towards integration have been treated with suspicion and scepticism in the academic literature, with many authors highlighting the many barriers and challenges presented by this method of working. Yet these proposals do not represent a paradigm shift in culture in all parts of the United Kingdom, as Northern Ireland has had an integrated health and social care system for over thirty years. Based on an empirical study of senior health care professionals in Northern Ireland, this study identifies and discusses the key issues associated with integration. It concludes that the experiences in Northern Ireland have to date been overlooked or misrepresented and could prove extremely valuable in gaining an understanding of the challenges and benefits of integrated arrangements.     

Social Work, Sectarianism and Anti-sectarian Practice in Northern Ireland

Correspondence to Dr Jim Campbell, Department of Social Work, The Queen's University of Belfast, 7 Lennoxvale, Belfast BT9 5BY, Northern Ireland. Jim Campbell lectures in the Department of Social Work, The Queen's University of Belfast. His doctoral thesis was on the concept of violence in social and political thought. His current research interests include social policy in Northern Ireland and mental health social work Summary This paper addresses a subject relatively unknown to the Britishand international social work audience—that of trainingfor anti-sectarian practice. In doing so, it points to someof the complex, even dangerous issues raised by such trainingfor social work students and practitioners in Northern Ireland.The paper comments upon the limited but significant ways inwhich social work educators and practitioners have tried tochallenge sectarian discrimination in Northern Ireland, andproposes methods in train ing and research which might facilitatea better understanding of these processes.     

Health and community services for trafficked women: an exploratory study of policy and practice

The trafficking of women has attracted considerable international and national policy attention, particularly since the UN Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children (2000), of which the Australian Government has been a signatory since 2005. The provision of health and community services for trafficked women is a central feature of this Protocol, but in Australia service provision is made difficult by how trafficked women are understood and treated in policy and legal terms. This study aimed to explore the provision of health and community services for trafficked women in the Greater Sydney region through a series of interviews with government and non‐government organisations. The findings reveal that services have been inaccessible as a result of sparse, uncoordinated, and poorly funded provision. The major obstacle to adequate and appropriate service provision has been a national policy approach focusing on ‘border protection’ and criminalisation rather than on trafficked women and their human rights. We conclude that further policy development needs to focus on the practical implications of how such rights can be translated into the delivery of health and community services that trafficked women can access and be supported by more effectively.     

Truth,partial truth,and irreconcilable truths: Reflections on the prospects for truth recovery in Northern Ireland

The issues facing truth recovery work in Northern Ireland arise in the context of a peace process in which there has been no clear winner, where several key issues, such as policing and criminal justice remain unresolved, and where there is a lack of trust between the parties to the conflict. Yet there is a demand for processes that have the potential to uncover the truth about unresolved killings and disappearances. The South African Truth and Reconciliation Commission is often cited in Northern Ireland as a model for truth recovery processes, in spite of its shortcomings and the contextual differences between South Africa and Northern Ireland. While there remains a demand for truth about human rights violations and contested killings, the compromised nature of the Northern Ireland settlement and the culture of silence that prevails within Northern Ireland institutions are obstacles to the progress of truth recovery work there. Nor is Northern Ireland ready for the rewriting of its history, although some argue that truth recovery work could provide an important disincentive to those who would return to violence. The assumption that truth recovery is always a prerequisite for healing is challenged, and painful effects of truth processes in reopening the wounds of the past are pointed out. Yet the role of truth recovery in improving public awareness of the wrongs of the past, and in providing new opportunities for forgiveness and reconciliation is acknowledged. However, truth recovery can inadvertently reinforce a dis‐empowered and unhealthy “victim culture” and may also prejudice future judicial processes. The paper concludes by summarizing the recommendations for truth recovery in Northern Ireland of the Healing Through Remembering Project. They suggest that a range of mechanisms, including some community‐based self‐help processes, are the preferred paths for this work in Northern Ireland.     

Pensioners and the Minimum Income Guarantee: Observations from Recent Research

This article summarizes some of the data collected via the 1999/2000 Northern Ireland Life and Times Survey. The absence of any counterpart in Northern Ireland to the British Family Resources Survey has resulted in a dearth of basic information on the financial and allied circumstances of pensioners in this part of the United Kingdom. The authors review the data obtained on levels and sources of income, health and receipt of core disability benefits and the extent of non-take-up of the Minimum Income Guarantee. The authors locate the data within the broader debate about the new directions of pension policy in the UK.     

Varieties of marketisation in the UK: examining divergence in activation markets between Great Britain and Northern Ireland 2008–2014

This article examines the sub-national diversity in activation quasi-markets in the United Kingdom (UK). Through comparison of four active labour market programmes in Great Britain and Northern Ireland between 2008 and 2014, the article clarifies and maps intra-UK diversity in employment service governance and unpacks the shifting configurations of market structures in each jurisdiction to reveal a temporally and spatially distinct patterning of marketisation. Drawing on Gingrich's approach to analysis and classification of quasi-market variation, the article proposes that between 2008 and 2014, Great Britain rapidly evolved a provider-directed activation market. In contrast, the activation market structure in Northern Ireland, up to late 2014, is better characterised as state directed. A recent reconfiguration of the activation market in Northern Ireland does however indicate some (modified) convergence on Great Britain's approach. One common and consistent feature of the configuration of activation markets in each jurisdiction is the few powers given to direct users of employment services to shape contracted out provision.     

Metagovernance,political demand and policy advice: a case from Brazil

ABSTRACT

There has been a call for a “second wave” of scholarship on policy advice to expand our understanding of the relational dynamics within a policy advisory system (PAS). In this article, we use a case from Brazil to address two key gaps in the PAS literature – the lack of attention to systems of network governance and the current predominance of “Westminster” empirical cases. To better understand the impact of policy advice within a system of networked governance, we apply the frame of “metagovernance” – the steering of governance networks. We then introduce and employ the concepts of funnelling, political brokering and gate-keeping to better understand how policy advice is shaped, modified and then either rejected or accepted. The contribution of the article is that, while much of the existing PAS literature describes the contours and key actors within an advisory system, we develop new conceptual scaffolding to better understand the trajectories and impact of policy advice, and the interplay between actors and agents, within a broader system of metagovernance.     

Taking social policy personally: How does neuroticism affect welfare state attitudes?

The role of the “Big Five” personality traits in driving welfare state attitudes has received scant attention in social policy research. Yet neuroticism in particular—a disposition to stress, worry, and get nervous easily—is theoretically likely to be an important driver of welfare attitudes precisely because welfare states deliver social “security” and “safety” nets. Using cross-sectional data from the German Socio-Economic Panel, we study three distinct attitude types (dissatisfaction with the social security system, feelings of personal financial insecurity, and preferences for state provision) and multiple social need contexts (including unemployment, ill health, old age, and nursing care). Controlling for established explanations such as self-interest, partisanship, and socialization, neuroticism does not systematically affect support for state provision. But it robustly increases general dissatisfaction with social security, as well as financial insecurity across various need contexts. Neurotic people are thus less happy with welfare state programmes across the board, yet they also appear to need these programmes more. This trait may be an important deeper layer driving other social attitudes.     

“开禁”还是“飨宴”？--汉唐北宋赐酺举措缘起、背景与施行动因的再探讨

汉唐北宋时代的“酒禁”政策并不能直观地理解为“禁民饮酒”。“禁群饮”之举在当时虽有发生,却始终并非一项整体与长期的国家政策,在其已然宣布的时期之内,执行与贯彻的力度也大可存疑。笼统地以“酒禁”或“禁群饮”政策的存在来解释赐酺举措发生和存续的合理性缺乏说服力。酺会在汉唐北宋的不断发生、持续流行,根本原因在于其最为核心的内容与意义是飨宴欢会。其给民众带来更热烈的欢宴体验、更加丰富的公共活动内涵以及更为广大的社交活动平台,同时为统治者提供得力的政治工具。赐酺之举的丰富功能使得其能够横历不同王朝,长期存在。     

The Case of The School Meals Service

Since 1979 British social policy has witnessed a marked abandonment of the post-war principles of “universalism” inspired by the Beveridge Report. A deliberately residualist approach has been adopted and narrower criteria of selection have variously been imposed in areas of social welfare provision. This paper represents an attempt to assess and evaluate this trend in one area of welfare provision — the school meals service — by developing a historical analysis of an earlier period (1918–1939) when a residual model of welfare firmly held sway. From an examination of historical evidence relating to the inter-war years, it is suggested that in important respects the present situation with regard to the provision of food for children while at school recreates many of the circumstances which pertained during that pre-war period. Then as now selectivity, “targeting”, and fierce Treasury restrictions upon public expenditure were very much the order of the day. In the light of the problems of administrative fragmentation, and of the failures, inconsistencies and injustices of those policies which characterized school meals provision during that earlier period, it is concluded that contemporary developments within this service are disquieting, and a close scrutiny of the nutritional and other consequences is essential.     

ECONOMIC RATIONALISM VERSUS THE COMMUNITY: REFLECTIONS ON SOCIAL DEMOCRACY AND STATE CAPACITY

In the context of calls for a ‘third way’ which proposes the abandonment of many of the social democratic and statist commitments of the postwar era, this paper reviews both the responsibilities accepted by peak bodies such as ACOSS and those that ought to be retained by government. It is sceptical of claims that social policy debates in Australia lead to the conclusion that welfare state development here has been satisfactory. Social democratic objectives (derived from intellectual contributions in the 1940s and 1950s as well as from the comparative political economy of the 1980s and 1990s) emphasize more decommodified provision of services than can be readily admitted in Australia. If the demand for social welfare and social policy continues to increase to the extent suggested by past and present circumstances, serious implications emerge for both public and private providers.     

Policy Changes in Community Mental Health: Interventions and Strategies Used in Sweden over 20 Years

The deinstitutionalization of mental health care has changed the responsibilities of involved authorities and has led to a continuous need for new treatment forms and interventions. This article describes this development in Europe, and in particular how these new conditions have been handled in Sweden over the past 20 years at the level of governmental policy‐making. Three major policy documents from 1994, 2009 and 2012 were included in this study. To increase our understanding of the policies' contents, we have used theoretical concepts concerning governance, implementation and political risk management. Although our main interest was to find out how the government handles interventions for users of the mental health care system, we found that the policy work is progressing stepwise. The first document, from the deinstitutionalization era, did not discuss interventions clearly. Instead, it was mainly concerned with both practical and economical areas of responsibility. The second document, from the post‐deinstitutionalization era, was more focused on what services should be delivered to the users, while the most recently published document to a greater extent addressed the question of how the support is supposed to be designed. The trend in European community mental health policy has been to advocate services in open forms that are integrated into the society's other care systems. This is also the case in Sweden, and continuous work is being done by the government to find strategies to support the development, and to meet the needs at both political and local levels.