Martin Knapp
- Published in print:
- 2007
- Published Online:
- March 2012
- ISBN:
- 9781861349583
- eISBN:
- 9781447302742
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781861349583.003.0008
- Subject:
- Social Work, Social Policy
This chapter examines fundamental changes that have developed in the delivery of some parts of social care to individuals, aimed at both increasing their choice over service providers, but more ...
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This chapter examines fundamental changes that have developed in the delivery of some parts of social care to individuals, aimed at both increasing their choice over service providers, but more recently their control over that choice. It argues that for such policies to succeed requires four elements: a range of services that offers meaningful diversity; accessible and understandable information for service users to make choices between options; empowerment of users and carers to select between services; and control — in some cases with support and monitoring — over those selections. It traces the development of first ‘direct payments’ to people entitled to support for personal care of different kinds since 1996, and more recently the pilot experiments with ‘individual budgets’, where service users are using combined resources from a variety of funding streams within what becomes a real, rather than a ‘quasi’-market.Less
This chapter examines fundamental changes that have developed in the delivery of some parts of social care to individuals, aimed at both increasing their choice over service providers, but more recently their control over that choice. It argues that for such policies to succeed requires four elements: a range of services that offers meaningful diversity; accessible and understandable information for service users to make choices between options; empowerment of users and carers to select between services; and control — in some cases with support and monitoring — over those selections. It traces the development of first ‘direct payments’ to people entitled to support for personal care of different kinds since 1996, and more recently the pilot experiments with ‘individual budgets’, where service users are using combined resources from a variety of funding streams within what becomes a real, rather than a ‘quasi’-market.
Ian Greer, Karen Breidahl, Matthias Knuth, and Flemming Larsen
- Published in print:
- 2017
- Published Online:
- August 2017
- ISBN:
- 9780198785446
- eISBN:
- 9780191827365
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780198785446.003.0006
- Subject:
- Business and Management, Organization Studies, HRM / IR
Marketization creates four dilemmas that lead to change in governance. (1) Cost versus quality: squeezing prices siphons resources out of services that could be used to employ qualified workers on ...
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Marketization creates four dilemmas that lead to change in governance. (1) Cost versus quality: squeezing prices siphons resources out of services that could be used to employ qualified workers on the front line, and the prescription of services that price-based competition requires drains the capacity of providers to innovate. (2) Payment by results versus equal access to services: while payment by results is consistent with the ethos of market governance it bears the risk of “creaming and parking.” (3) User choice versus user compulsion: NPM principles of consumerism are difficult to reconcile with the principles of compulsion built into the work-first welfare state. (4) Openness/transparency and transaction costs: openness, transparency, and equal treatment require costly administrative capacity. Insourcing provides one solution by taking services out of the market, but it is not a panacea.Less
Marketization creates four dilemmas that lead to change in governance. (1) Cost versus quality: squeezing prices siphons resources out of services that could be used to employ qualified workers on the front line, and the prescription of services that price-based competition requires drains the capacity of providers to innovate. (2) Payment by results versus equal access to services: while payment by results is consistent with the ethos of market governance it bears the risk of “creaming and parking.” (3) User choice versus user compulsion: NPM principles of consumerism are difficult to reconcile with the principles of compulsion built into the work-first welfare state. (4) Openness/transparency and transaction costs: openness, transparency, and equal treatment require costly administrative capacity. Insourcing provides one solution by taking services out of the market, but it is not a panacea.
