Welfare Reform, Welfare Rights and the Hybrid Nature of the British Welfare State. By Alex Robertson University of Edinburgh

Transcription

1 Welfare Reform, Welfare Rights and the Hybrid Nature of the British Welfare State By Alex Robertson University of Edinburgh

2 The British Welfare State Single insurance fund, administered by state. Covers sickness, old age, unemployment, etc. Social security: Liberal system (Esping-Andersen). Burkhardt et al (2011): Germans are solidaristic; for British, social security fits round edge of the market system. Health: Social democratic system: strong public support.

3 Politics & Welfare Social security: value of individual benefits not guaranteed. Increases agreed by Parliament in response to changes in cost of living. Savings often made by altering entitlements of socially-marginal groups. (Public also more punitive towards poor.) Health: universally popular. Politicians careful not to be seen as undermining principles of NHS.

4 Recent Developments Presentation will concentrate on: Social security Health Conclude with an analysis of what has been happening since the creation of devolved legislatures in Scotland and Wales.

5 Social Security Relatively stable post-war conditions. Social changes since the 1980s: Increase in single-parent families. Move to flexible work. Increase in early retirement. Wages at lower end of job market often not enough to sustain a family For those on benefit, move to fulltime work can mean a lower income.

6 Trends since the 1980s. New Right thinking: Benefits argued to be too generous. Claimants could enjoy a good standard of living without working. Creation of a dependency culture. Policy responses (Conservative & Labour): Help people to find & remain in work. Active labour market policies: sticks & carrots to increase benefits of work Enhanced work training programmes.

7 Current Reform Conservative/Liberal-Democrat coalition. Move beyond simple cost savings: Permanent reduction in government expenditure on welfare. Reduce welfare dependency and government involvement in provision. Taylor-Gooby (2012): aim is to set the UK on a trajectory of permanently lower spending, lower debt and market-led growth. Shift responsibility from state, to private providers, citizens or community.

8 Policy Measures Limit rights to benefit Reduce social-security budget by 3.5% between 2012 and Limit increases to out-of-work benefits to 1%. (Below level of inflation.) Stricter work and disability tests. Expand child-care facilities. Link entitlement to population ageing.

9 Conclusions Measures seen as likely to cause a reduction in living standards of society s poorest groups (SPA, 2011). Inevitable increases in poverty and social inequality. Substantial body of research shows democratic governments are unable to press retrenchment programmes through to a successful conclusion (Swank, 2005). Thus, success of these changes remains to be seen.

10 Health Surveys consistently show NHS to be widely popular in the British public. Governments have thus been careful not to make changes undermining the principle of a universal service, free at the point of access. NHS consumes low proportions of GDP while providing a high-quality service. Costs increase annually (population ageing; technological advances, etc.). Savings through increasing efficiency & effectiveness of services.

11 1) Management Approaches Three phases: Administration: support and facilitate work of professional staff (early NHS). Internal market: belief that competition would reduce costs and improve quality. New Public Management: techniques imported from commercial sector. (League tables; payment by results ; targets : designed to reduce waiting times, number of operations cancelled at short notice, etc.)

12 Problems of New Public Management Low morale: innate tension between professional authority of doctors and bureaucratic authority of managers. Vaughan, 2007: Those with power have no responsibilities and those with responsibilities have neither power nor resources. ( Interference in work.) Target setting: e.g. managers focus on waiting times led to 33 of 334 patients dying from a hospital-acquired infection. (Perverse incentives.) Unreliable quality of data for measuring performance (Smith 2007; Clover, 2012).

13 Governance Change of emphasis ( soft management). Four main elements: Policy aims & priorities set at centre. Programmes to achieve aims are worked out at local level. Decentralised regulation: based on relationships set by provider units. Performance monitored through systems of self-assessment in worker networks.

14 Criticisms Vagueness of governance concept. Implementation problems: resistance from established interest groups. Leaving decision-making in hands of local networks will strengthen and perpetuate social inequalities.

15 An Evaluation Coleman (Manchester, 2007): officials were most influential in decision-making. Public and user voice almost entirely absent from decisions. Fenwick (2012): bureaucratic actors remain dominant in mainly formal systems of partnership. But: other studies in Germany, UK and Netherlands suggest governance leads to improvements in social & civic capital; encourages involvement of excluded groups; and makes decision-makers and providers more sensitive to user needs.

16 Social Policy and Devolution 1999: Scottish Parliament & Welsh Assembly. Health & social services, education & housing. Not social security. (In contrast to England) free eye & dental checks; prescriptions; long-term elderly care; university education. Greater emphasis on health promotion: healthy eating strategy; smoking ban; current attempt to price drinks on basis of alcoholic strength. Additional resources allocated to tackle health inequalities. But disappointing results (Audit Scotland report of 2012).

17 Policy-Making Process: 1. Bochel (2012): parliament set up with emphasis on seeking views from outside. Keating (2011): lack of one-party control encouraged negotiation and compromise. Smaller civil service necessitates search for views & reactions from interested parties in the policy community. Smaller population. Individuals often know each other personally: fosters a style of consultation & consensus, though falling well short of social partnership.

18 Policy-Making Process: 2. Keating & Mcewen (2005): there remain strong forces for convergence. Baggott (2007): there are pressures towards both convergence & diversity. Scotland: more centrally-coordinated approach to health services, as opposed to market approach in England. But (Peckham et al, 2012): differences at national policy level; less apparent at level of service organisation & delivery. Shared history & concerns over efficient use of resources limit divergences. Keating (2012): unless the devolved governments are given power to raise their own finances it seems unlikely policy divergences will increase by much.

19 Conclusions UK now attempting to move beyond cost savings and reduce state involvement in welfare. More stringent rules on entitlement; removal of certain entitlements; shift provision from state to voluntary, private and informal sectors. Move to active labour market policies. In health, stress has been on making services more efficient, rather than changing entitlements to services. Future course of devolution?