Do cutbacks pay off? Perceived changes in the standard of municipal services and attitudes towards services among citizens and municipal decision makers in Finland

One common aim in the Nordic countries during the last decade has been to lessen state control over municipal affairs and to increase the local community's influence over the development of (welfare) services. These reforms happened to coincide with the economic depression of the 1990s, which especially hit Finland and Sweden, and enforced extensive cutbacks that negatively influenced the standard of services in a number of ways. However, according to some indicators the cutbacks also made public services more efficient. This article – utilizing Finnish data from 1995 – focuses on a comparison between how the general public on the one hand and leading municipal politicians and administrators on the other hand perceived the development of services and, further, whether these perceptions influence the groups' attitudes towards future changes in the system. Results show that decision makers, in contrast to a significant proportion of citizens, have a quite positive view on the development of services as well as on the continuation of cutbacks and a reduction of the municipalities' responsibilities for service provision. The study also indicates that citizens' views on the decline of various services are related to negative attitudes towards further decrease or changes in the municipalities' responsibilities. Among the decision makers, those politicians who think that (particularly efficiency aspects of) services have developed favourably also exhibit the weakest support for the prevailing system. The results raise questions concerning the role of citizens' attitudes in the development of services in the municipalities.     

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.     

Keeping the Faith: The Impact of Human Services Restructuring on Catholic Social Welfare Services

Church related agencies are major providers of community services in Australia (Lyons, 2001:34‐35). While the history of church related welfare service provision is not well known in Australia it is asserted that many have a long tradition of outreach and service provision to marginalised groups regardless of the government social policy of the day (ACSWC, 2000; Mendes, 2003). This paper examines the current environment of human services restructuring and the impact of the shift to contractualism on one church related provider: Catholic social welfare provision in Australia. It explores the significance of the church's social teachings and history on concerns that service innovation, diversity and advocacy are currently under threat. Finally it calls for greater appreciation of the distinctive contribution of church related agencies and what they have to offer in service delivery and as contributors to the social policy discourse.     

A Preliminary Approach to Defining Social Service Outputs for Auditing Service Distribution

An accurate evaluation ofthe effectiveness of social services requires that the unit of output be clearly defined. The problem, which has never really been solved, has become more important with the passage of Title XX of the Social Security Act. The Title XX Amendments to the Social Security Act decentralize planning for social services to state and local governments. Title XX goals do not easily translate into measures of achievement. This paper describes a standardized framework that discriminates among the elements of service output. Data on the services provided by one social service agency are used to support the feasibility of proposed frameworks. The concept of a unit of service output was used in this study for the purpose of developing standardized categories to measure service provision. Two measures of service activity were developed: One measures service intensity, and the other relates to consumers' need for and utilization of services. The study was conducted at a local social service district in an urbanized county of 400,000. The sample of cases consisted of 120 new applicants accepted for public ossistance during the first 3 months of 1964. A retrospective longitudinal analysis of services provided was performed. All components of service provided to each sample care during the period of 1964-19 71 were coded from agency records in units of service output.     

Towards Understanding Variations in Social Care for Older People in England

Indicators of the public provision of old age social care are routinely recorded in England and have been used for diverse purposes including performance monitoring. Despite long‐term policy guidance promoting more homogeneous service provision, large variations can still be observed between local authorities (the providers of state‐funded social care). Our aim is to better understand such variations in a small selection of key aggregate indicators. Drawing on multiple data sources and pursuing a two‐step strategy, we first assess the explanatory power of a set of structural predictors and then add to the models a set of specific care management ‘process’ predictors. We find that structural factors beyond the control of local authorities explain a considerable share of the observable variation. The additional explanatory power of care management characteristics is small in comparison. Therefore, our findings suggest that caution must be taken when aggregate indicators of service provision are used for performance monitoring purposes, as a degree of autonomy over outcomes may be implied which in light of the empirical evidence is unrealistic. Past attempts to influence the aggregate pattern of service provision – apparently seeking greater ‘territorial justice’– are likely to have had adverse implications for service users and the uniformity of service delivery across England. Questions are raised about the adequate role of central government in a policy environment characterized by longstanding local government responsibility.     

Study on a resource allocation formula for social services in Finland

This article considers how a specific need-based resource allocation formula for children's day care, income support, child welfare and other social services was developed. The formula is needed for the municipal allocation of state subsidies for social services, and the work was performed for the Ministry of Social Welfare and Health. Cross-sectional data were collected from the 436 Finnish municipalities and 37 small areas within the six largest cities. Because of the simultaneous relationship between supply and demand of services, two-stage least-square estimation and structural equations models were used in the analysis. After the effect of supply was removed from the service utilisation data, group-need factors (municipal variables) were found for these services. The new formula is financially and administratively feasible, transparent and reasonably simple.     

过渡治理情境下的中国社会服务困境:基于Z市社会工作服务的研究

社会工作近十年来在创新社会治理的推动下发展迅速。本文将重点关注于社会服务组织的服务供给过程及其导致的社会服务困境。通过对治理情境的拓展分析,引入过渡治理情境概念,分析我国社会服务供给。在此情境下,本文以Z市家庭综合服务中心为例,围绕自由裁量权这一概念讨论社会服务组织的服务供给策略及其所导致的服务困境。在过渡治理情境中,消极的自由裁量权与社会工作的半专业化发展结合在一起,社会服务组织选择了“活动化”和“指标化”的服务供给,令社会服务处于创新和碎片化之间,而导致社会服务陷入困境。社会服务困境根源的解决在于建立合作的治理情境、强化本土化社工专业力量以及充分发挥第三方的社会服务供给效力。     

Practice Evaluation of Community Initiatives for Social Service Delivery in a Deprived Neighborhood in Scotland

ABSTRACT

Improving social service in local communities is a complex undertaking. Over the past few decades, the performance and sustainability of community initiatives have been questioned, while such factors as a lack of funding, insufficient community involvement, unsatisfactory community service, and lack of awareness of the impact of community initiatives have restricted community development. From a case study of community operations in Scotland, this article provides insights into how social service delivery is organized in the absence of public capital. This study utilized data from semi-structured in-depth interviews with a sample of 76 participants from a deprived area in Scotland, including community management team members (n = 6), local residents (n = 52) and community partners (n = 18). The findings illustrated how participants of all ages, local organizations, policy makers, funders and media came together to create a cohesive and responsive community environment. Residents' needs and funders' demands were identified. Results further revealed that a Community Partnership Mechanism helped strengthen the social service network and create flexible social services. Service benefits included improved resident wellbeing in the context of less government intervention. Future implications include suggestions for government and other stakeholders involved in community reform to focus on service recipient skill building and tracking changes between the indicators and service provision.     

Vulnerable children's rights to participation,protection, and provision: The process of defining the problem in Swedish child and family welfare

This study addresses the relationship between children's participation and the protection and provision offered to them by social services in Sweden. It applies a theoretical framework for analysing child welfare that is anchored in the United Nations Convention on the Rights of the Child. How child participation may affect child protection and provision is examined empirically using case documentation from 2 municipalities. The main finding is that when children are not given voice or opportunity to influence the framing of what “the problem” is, the design of protection and care tends to be poorly matched to the actual problems documented in the child investigation and vice versa; when children can influence framing, this is associated with well‐matched protection and care. This suggests that traditional child welfare ethos, to the effect that protection should be of such overriding concern that children even should be protected from participation, is misguided. The study further illustrates the intrinsic problems with the family orientation of Swedish social services and its reliance on partnership with parents, which makes it difficult to live up to the Convention on the Rights of the Child. Incorporating child participation into existing service models can transform Swedish social services to an augmented child‐focused system that by ensuring participation also promotes protection and provision.     

The new privatized market: A question of ideology or pragmatism within the Swedish addiction treatment system?

Given its traditions of universal welfarism and social democracy, Sweden had already scored unexpectedly high on New Public Management by the 1980s. Health and welfare services remain primarily tax‐funded, but the production of care is increasingly transferred to a competitive quasi‐market. To what extent can this development be understood in terms of right‐wing governments, and to what extent in terms of other, socioeconomic and pragmatic factors? We examined this question through official statistics on providers of institutional addiction care since 1976, and through the total expenditure and purchases by local‐level municipal social services of interventions for substance users in Sweden in 1999, 2004, 2009, and 2014. We have analyzed the distribution across public and private providers within the addiction treatment system, and whether national developments and local differences across the 290 municipalities—which bear the major treatment responsibility—can be understood in terms of local‐level political majority, population size, and local wealth. The share of purchased services has remained stable, but the treatment system shows increasing financial turnover and an increasing share of for‐profit providers among producers of purchased care, especially in outpatient treatment. While venture capital enterprises emerged as a new actor, non‐governmental organizations lost out in importance. Bourgeois government correlated with larger shares of purchasing and purchases from for‐profit providers. However, purchasing on a market dominated by for‐profit providers has also become the “new normal”, regardless of ideology, and recent years have shown a reversed effect of left‐wing municipalities purchasing more services than right‐wing governments. Pragmatic reasons also influence local‐level purchasing.     

Integrating Health and Social Care at the Micro Level: Health Care Professionals as Care Managers for Older People

A common problem in the provision of coordinated long‐term care is the separation of health and social care. The present government has been increasingly concerned with promoting convenient, user‐centred services and improving integration of health and social care. One arrangement that could contribute to this for some older service users is for health care staff to act as care managers, coordinating the provision of both health and social care. This paper presents the findings of a survey of arrangements in place in local authorities for health staff to work as care managers for older people. This was designed to provide details about the range and scope of care management activities undertaken by health care professionals. Key areas of enquiry included: which kinds of health care staff undertook care management and in what settings; how long the arrangements had been in place and how widely available they were; whether there was a distinction between the types of cases and care management processes undertaken by health care staff compared with their social service department counterparts; and what management and training arrangements were in place for the health care staff.     

Community service provision for the elderly under the context of competitive contracting in Guangzhou

Contracting is a prevalent trend in the delivery of public and social services around the world. International experience shows that contracting has positive and negative impacts on service provision. While local experiments on social service contracting are currently emerging in China, the implementation and effects of contracting are worthy subjects of examination. This study delves into this area by focusing on community service provision for the elderly in the context of competitive contracting. A street community which is located in Guangzhou, Guangdong Province of China serves as a case study to show the implementation of competitive contracting, the provision of community service for the elderly, and the implications of contracting for care.     

From Official Supervision to Self‐monitoring: Privatizing Supervision of Private Social Care Services in Finland

In October 2011, a new Act on Private Social Care Services came into force in Finland. The Act included a provision on a ‘self‐monitoring plan’. According to the provision, providers of private social care services are required to draw up a self‐monitoring plan and to follow its realization. The plan must be kept publicly on view so that clients and their relatives can also keep an eye on the realization of self‐monitoring. In this article, self‐monitoring is first explained and then briefly analyzed against the background of a wider theoretical discussion on accountability. It is argued that the introduction of client involvement in the supervision of private social care services represents a new mechanism of accountability that is typical of the Post‐Keynesian welfare state. Because public authorities are no longer able to supervise the growing number of private social care service providers, the responsibility has been partly shifted to service providers themselves as well as to clients. However, it is argued that the idea of self‐monitoring lends itself poorly to ‘delegated’ private social care services, i.e. to services that are outsourced to private service suppliers. Supervision of private social care service providers should not be too eagerly delegated to service providers themselves, or to clients, because we are here dealing with the constitutional right to adequate social care services. Client involvement also involves numerous practical problems, as shown at the end of the article.     

Putting the ‘public’ into public service delivery for social welfare in South Africa

Mubangizi BC, Gray M. Putting the ‘public’ into public service delivery for social welfare in South Africa Int J Soc Welfare 2011: 20: 212–219 © 2010 The Author(s), International Journal of Social Welfare © 2010 Blackwell Publishing Ltd and the International Journal of SocialWelfare. The privatisation of some essential services in South Africa has raised severe difficulties for those for whom the idea of fees for services is quite foreign and who, in any case, cannot afford to pay for services. The government has developed several initiatives to educate people about the need to pay for services provided by local government, the largest of which was the Masakhane fees‐for‐services campaign. This article describes two recent initiatives that seek to engage local citizen participation, namely, Integrated Development Plans and izimbizo (or traditional forums). These are examined along with the challenges faced by local government in promoting citizenship participation in service delivery within a decentralised system of governance. The article concludes with some recommendations on how citizen participation can be enhanced so as to make the ‘public’ visible in public service delivery and thus improve social welfare services.     

Ageing and Family Dependency

The ‘graying’ of Australia's population has generated much debate within government, demographic, health and social service circles in recent times. Current and projected shifts in population structure towards greater numbers of ‘dependent’ populations raise a number of complex issues in regard to resource allocation in both income support and service provision. Service issues revolve around questions of whether public or private provision will resolve the care issues for dependent elderly people. It is argued that contrary to popular opinion, family care is well entrenched within the framework of social care, and that the solution of community care, posited in relation to the rising levels of chronic illness and dependency within the elderly population, is actually an attempt to place more responsibility of care on to the family. It is further suggested that family care is, in fact, care by women who themselves are in a state of dependency. Citing evidence from a study conducted by the authors, the paper argues that family care imposes heavy burdens upon women and families and suggests that social policy should, firstly, actively bolster family care through the provision of supportive and supplementary services; and secondly, broaden its intent by exploring other options of care for elderly people. The latter response is important because without it, family care will only help to reinforce and sustain the dependent status of women.     

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.     

Is Sweden Being Torn Apart? Privatization and Old and New Patterns of Welfare State Support

This article examines the potential impact of institutional change on popular welfare support. The encompassing welfare state of Sweden provides an interesting case where the privatization of social service delivery has been widespread over the last decades. We use survey data from five rounds of the Swedish Welfare State Survey (1992, 1997, 2002, 2006 and 2010) in order to study how public preferences for the financing and organization of welfare services have changed over time. Based on a theory describing an ideal‐typical pattern of public support for an encompassing welfare model, we derive three types of public preferences: support for a pure state model, a pure market model and a mixed model (welfare services are funded by taxes but provided by private firms). We begin by tracking the development of these ideal‐typical attitude patterns between 1992 and 2010. We then investigate how preference patterns vary across municipalities displaying different degrees of privatization of social service delivery. Our results show that welfare support among Swedes over the last decades is better characterized as dynamic rather than stable. Swedes seem to take an overall more ideologically based position on the role of the welfare state over time. The share of respondents expressing such ideologically based preferences has increased from 54 per cent in 1992 to 78 per cent in 2010. This change is principally manifested in increased support for the state and mixed models. This trend seems to be parallel to the increasing share of private welfare service providers over the last decade. We also find a link between the municipal degree of privatization and support for our three ideal‐typical welfare models. Public support for a mixed welfare model and, to some extent, a market model, is comparatively stronger in municipalities where welfare services to a large extent are carried out by private actors. Conversely, data shows that public support for the traditional Swedish state model is more widespread in municipalities having a low degree of welfare services privatization. Lastly, we discuss some theoretical implications of our findings.     

Central versus Local Service Regulation: Accounting for Diverging Old-age Care Developments in Sweden and Denmark, 1980–2000

In Sweden and Denmark, the development of old‐age care has followed markedly divergent paths over the past 20 years. In both countries, the level of old‐age care universalism was exceptionally high in the early 1980s. Since then it has dropped sharply in Sweden, while remaining constantly high in Denmark. These divergent trends are clearly irreconcilable with the common image of a coherent Scandinavian welfare state model, and they seem hard to explain with reference to traditional approaches of comparative social policy. This article attempts to account for the divergent developments by focusing on the balance of old‐age care regulation between central and local government. The main finding is that only in Sweden has the central regulation of old‐age care been weak and unspecific. As a consequence, Swedish municipalities have enjoyed sufficient autonomous, regulatory competence to exercise certain local retrenchment measures in times of austerity, thereby eventually causing a nationwide weakening of old‐age care universalism. By contrast, municipalities in Denmark have been much more tightly bound by central state regulations which have prevented them from imposing similar retrenchment measures in the old‐age care sector; consequently, Denmark's level of old‐age care universalism has remained comparatively high.     

Decentralization of decision making: the case of payment policies for children's daycare

To bring about equality, the Nordic welfare states have provided a broad range of services with as homogenous eligibility criteria as possible. This homogeneity of social benefits has been obtained by centralized decision making and a high degree of statutory regulation. Recent trends in all welfare states veer towards greater local independence and decentralization. This article examines how the decentralization of decision making in Finland has affected the realization of basic welfare state principles. The specific aspect from which the topic is examined are user fee policies for children's daycare. The analysis gives a rather inconsistent picture of possible explanations for the differences between daycare payment policies. Municipal decision making is influenced by economic rather than political or structural factors. However, logical economic explanations are found only in large municipalities. This study highlights that decentralization of decision making has put families in very different economic positions in different municipalities - municipal traps are emerging. The relationship between welfare services and income redistribution has become ever more complicated as decision-making powers have been localized. A family may, for example, be paying the highest daycare fees but at the same time be entitled to social assistance.     

我国社会工作“嵌入式”发展模式研究——基于深圳市的调查

深圳在全国率先启动了“政府购买,民间运作”的社会工作服务机制,初步形成具有本土特色的“嵌入式”社会工作发展模式。以深圳的实践经验为基础分析了“嵌入式”发展模式产生的背景,建立了政府购买服务的机制,开发设置了试点岗位,培育和发展了一批社工机构,开展专业服务积累了经验,但在社工管理、机构监督、队伍稳定、服务质量等方面存在发展困境。我国社会工作的发展模式必须在结合我国国情,不断创新与发展。