The article emphasises the urgent need for a reconsideration of potential sources of income for the National Health Service which could supplement rather than replace those from general taxation. They include local taxation, earmarked taxes, patient charges (hotel, prescription and other charges for non-clinical items), a lottery, income generation, charitable donations and patient ‘opting out’ of the NHS with private insurance. Analysis is set within the position statement provided by the 1989 White Paper Working for Patients and within a more general analytical framework paying attention to equity, accountability, value for money, management incentives and other criteria.

Each funding method is considered in terms of its consistency with the criteria of both the analytical framework and the White Paper. The differences between some of the alternative sources are found to be more apparent than real. Rather than providing a panacea for the perceived funding and rationing problems of the NHS, the danger is that new supplementary sources of finance may simply replace one set of problems with another. The new set may pose even more intractable problems and involve considerable short to medium term disruption of NHS finances. The inescapable fact is that decisions about the levels and quality of public service provision and their financing are ultimately matters of democratic accountability, decisions which cannot and should not be sidestepped by the convenience of income sources.

Alan Deacon (ed.), From Welfare to Work, IEA Health & Welfare Unit, 1997, 155 pp., £8.00 paper.

Karen Gardiner, Bridges from Benefit, Joseph Rowntree Foundation, York, 1997, 60 pp., £11.95 paper.

Alex Bryson, Reuben Ford and Michael White, Making Work Pay, Joseph Rowntree Foundation, York, 1997, 89 pp., £11.95 paper.

Jane Millar, Steven Webb and Martin Kemp, Combining Work and Welfare, Joseph Rowntree Foundation, York, 1997, 59 pp., £11.95 paper.

For the new Labour government, employment is the key to the reform of welfare. While the same could be said of the first post-war Labour government, the words have a rather different meaning. It is true that Gordon Brown, the Chancellor of the Exchequer, has alluded to the concept of full employment that Keynes, Beveridge and, latterly, Attlee's government foresaw was essential to fund the development of the Welfare State. But the strategy that Brown set out in his first two budgets has a more narrow focus. Employment is to provide a route out of dependency, a mechanism for social inclusion, that enables expenditure on social security to be diverted to investment in education and health that is likely to attract a greater political dividend. More specifically, in his 1997 budget he used income generated from a windfall tax on the privatised utilities to fund the New Deal, a programme of counselling and work experience schemes with a large element of compulsion (Table 1), and supported this with a National Child Care Strategy and a commitment to introduce a minimum wage. He complemented these moves in his 1998 budget by increasing Child Benefit and announcing a Working Families Tax Credit, and one for disabled persons to replace Family Credit and Disability Working Allowance and also a Childcare Tax Credit.

The extreme dispersion of authority and power in the American political system fosters a politics of bargaining, negotiation, and compromise. Nevertheless, technical-rational analysis plays a major role in the identification of public problems and in the legitimation of official responses. We explore this apparent paradox through an examination of the interaction between politics, ideology and analysis in the current crisis of the American public retirement system. Two analytical approaches are employed: an interpretation of the historical evolution of the programme through three relatively distinct phases; and an evaluation of the reports of three recent national commissions which have studied the social security crisis. We argue that in the American system policy must be made through either subsystem or consensual politics. Social security has benefited from the unusual conjunction of these two conditions through most of its history. Policy has been made by a small subsystem dominated by the social security bureaucracy itself and the programme has received widespread bipartisan support. Analysis has been central to this process, but its impact has differed over time. Analysis exerted a decisive influence on the initial shape of the programme even in the absence of an ideological consensus because it enjoyed a quasi-monopoly position in the President's Committee on Economic Security. During the long expansionary phase of the programme, subsystem autonomy and bipartisan consensus together fostered the emergence of a technocratic policy style, but the independent effects of analysis were more apparent than real. The contemporary commissions fail to provide an adequate response to the crisis because their technically competent proposals no longer rest on an underlying consensus and because the institutional autonomy of the old social security policymaking subsystem has broken down.

This paper looks critically at a central notion of the Marxist analysis of social policy – the contradictions of welfare. Two main variants of the argument are identified: the ‘paradox’ and ‘opposite effect’ contradictions respectively. Serious doubts are raised about the viability of a Marxist analysis of social policy which relies on the concept of the contradictions of the welfare state.

Social security provision for young people has been cut back by a succession of reforms since 1980 culminating in the almost complete withdrawal of income support from 16 and 17 year olds by the Social Security Act 1988. Conservative government policy seems to indicate a desire that families assume greater responsibility for young people until either they find work or reach their mid-twenties. It is assumed that until young unemployed people reach this stage they are dependants, to be treated as such by the social security system (and, to a large extent, by the training schemes). But the twentieth century has seen a progressive growth of young people's independence and expectations of it among young people and their families. The enforced dependency produced by recent government policy runs counter to this trend. More importantly, it may be having a profound effect on the progress of the transition to adulthood.

Social services in China nowadays are increasingly coproduced by both government and non-profit organizations (NPOs). However, we still know little about how NPOs perceive their government partners in social service delivery. Using a Q methodology, this study remedies this gap and identifies three profiles – namely, government as a distant facilitator, government as a hands-off collaborator, and government as a prudent principal. Also, it has been found that two conditions – namely, NPOs’ development stage and funding resources – influence their perceptions on government in social service delivery. These three profiles provide new insights into NPOs’ perceptions of their government partners in social service delivery, and they add new building blocks to existing literature, specifically on the government–NPO relationship in China.

Family is one of the major principles of welfare state redistribution. It has, however, rarely been at the centre of welfare state research. This contribution intends to help remedy the research gap in family-related redistribution. By examining the German welfare state which is known to be both redistributive and family-oriented, we want to answer the question of how and how far the German welfare state institutionalises family as a redistributive principle. Our case-study of German welfare state regulations in terms of family is based on the tax-benefit microsimulation model EUROMOD and its Hypothetical Household Tool (HHoT). We differentiate 54 family forms to adequately reflect our three theoretical assumptions, which are: (1) redistributive logics differ across family forms, and in part markedly; (2) these differences are not the result of one coherent set of regulations, but of an interplay of partially contradictory regulations; (3) family as a redistributive principle manifests itself not only in terms of additional benefits to families, but also in terms of particular obligations of families to financially support family members before they are entitled to public support. These aspects have hardly been analysed before and combining them allows a clear evaluation of family-related redistribution.

A. Figueroa, T. Altamirano and D. Sulmont, Social Exclusion and Inequality in Peru, International Institute for Labour Studies Research Series, No. 104, ILO, Geneva, 1996, 96 pp., 17.50 Swiss francs.

M. H. Hashem, Goals for Social Integration and Realities of Social Exclusion in the Republic of Yemen, International Institute for Labour Studies Research Series, No. 105, ILO, Geneva, 1996, 116 pp., 20 Swiss francs.

P. Appasamay, S. Guhan, R. Hema, M. Majumdar and A. Vaidyanathan, Social Exclusion from a Welfare Rights Perspective in India, International Institute for Labour Studies Research Series, No. 106, ILO, Geneva, 1996, 133 pp., 22.50 Swiss francs.

P. Phongpaichit, S. Piriyarangsanan, and N. Treerat, Challenging Social Exclusion: Rights and Livelihood in Thailand, International Institute for Labour Studies Research Series, No. 107, ILO, Geneva, 1996, 122 pp., 20 Swiss francs.

N. Tchernina, Economic Transition and Social Exclusion in Russia, International Institute for Labour Studies Research Series, No. 108, ILO, Geneva, 1996, 103 pp., 17.50 Swiss francs.

F. Kaijage and A. Tibaijuka, Poverty and Social Exclusion in Tanzania, International Institute for Labour Studies Research Series, No. 109, ILO, Geneva, 1996, 202 pp., 25 Swiss francs.

(All published for the International Institute for Labour Studies/United Nations Development Programme by the International Labour Organisation, Geneva, Switzerland.)

These volumes were commissioned as part of an International Labour Organisation/UN Development Programme research series to explore the relevance and the value of the notion of social exclusion in a global context.

During the years following the Boer War, infant mortality became an issue of national importance, and increasing emphasis was placed on the provision of infant welfare clinics and health visitors. The infant mortality rate declined steadily throughout the period, and officials attributed the improvement to the new services. But just as the causes of infant mortality were complex, so were the reasons for the decline in the mortality rate. What needs explanation therefore is why health officials concentrated so exclusively on one particular form of solution. It is argued that this was a consequence of, first, the way in which infant welfare was perceived as a problem of mortality and especially as a problem of diarrhoeal mortality and, secondly, the philosophy of the infant welfare movement, which held that responsibility for infant mortality rested with the individual mother. Infant welfare services were thus compartmentalized as a set of personal social services, and kept separate from broader socio-economic issues.

During the second half of the 1970s, the practice of the closed shop became widespread in some parts of the British public sector, but was resisted in others. This paper examines the issue in relation to the National Health Service, where trade unionists made frequent demands for the closed shop and where many managers were apparently not unwilling to concede it. Yet very few closed shops actually resulted. The paper examines the origin and patterns of these demands, health authority policies towards them, and their outcomes in terms both of the operation of the closed shops which were agreed, and the reasons for failure to agree. The conclusion is that although NHS industrial relations had apparently matured very rapidly between 1973 and 1977, the trade unions were neither strong enough nor united enough to enforce the closed shop; nor were industrial relations so far developed as to make the practice a natural next step.

The article examines the impact of the redundancy payments legislation on women workers. The legislation's adequacy and appropriateness for women is assessed and the assumptions and values enshrined within it are analysed. The article demonstrates that the provisions of the legislation are disadvantageous to women in comparison to men, and that they in effect discriminate against them both directly and indirectly. Moreover, it is suggested that women's particular vulnerability to unemployment and redundancy may be partly explained by the actual mechanics of the redundancy legislation. It is argued that the legislation is based upon a male-dominated conceptualization of work and so fails to consider the position of women in the labour market — a market which by its very nature leads to gender inequalities.

This article discusses the particular characteristics of men with schizophrenia or personality disorder and it compares these two categories with one another and with the destitute population as a whole. On a number of variables, no significant differences are discerned, the category as a whole sharing a background of considerable material and social deprivation. However, with reference to place of birth, loss of mother, and father's occupation, significant differences do appear. The two categories also show distinctly different patterns in the process of becoming destitute and they use existing agencies differently. Finally, the type of service most suitable for these men is discussed together with other issues raised by the question, ‘How can we improve the lot of the homeless single person?’

The scholarship on state-building has devoted a significant amount of attention to the role of taxation in building state institutions and capacities. It has also emphasised the crucial role of taxation in driving state-society relations. Scholars have argued that the linkage between taxation and state building also applies to the area of social policy. In this paper, we draw on a fiscal-centred perspective on welfare state development that highlights the fiscal policy role of social insurance as a revenue raising institution to study the fiscal relationship between social insurance and state-building in Israel and Canada – two ‘most dissimilar cases’ that nonetheless feature strikingly similar patterns with regard to this relationship. As our findings show, in both cases, social insurance programmes were introduced, designed, and utilized to advance fiscal and economic policy capacity and thereby promote state building. Using these programmes and the commitments they created, political actors could legitimize the generation of revenues, build institutional infrastructure for tax collection, and create capital reserves for investing in the economy.

Policymakers in liberal welfare states like the UK have prioritised extending the reach of compulsory activation to target vulnerable jobseeker groups, such as lone parents. However, such interventions – especially when combined with intensified welfare conditionality – appear to have had limited positive effects on lone parents’ employability, while often negatively impacting wellbeing. This article argues that the problem is a disconnect between the complex barriers to employability faced by lone parents (including their need to balance work and caring) and the content of ‘work-first’ activation favoured by successive UK Governments. We report positive findings from in-depth interviews with lone parents and key stakeholders involved in more person-centred, non-compulsory local employability services. Multi-agency service delivery, collaborative governance and a clear role for user voice in programme design were important facilitators of positive experiences. Our analysis points to the need for services that empower lone parents to make choices to progress towards employment while supporting family life.

Trans people1 – those whose gender identity does not match that assigned to them at birth – are at considerably elevated risk of homelessness, reflecting their marginalized legal, bureaucratic and socio-economic status2. Recent substantial international expansion to the medico-legal rights afforded them operates in tension with cisnormative welfare structures. Based upon a Critical Discourse Analysis of interviews with 35 trans people with experience of homeless in Wales, UK, alongside 12 workers in the system, I argue that anti-discrimination legislation is insufficient in its current form to prevent discrimination against trans people. I suggest that, without addressing deeper structural cisnormativity, service provision for trans people experiencing homelessness and other forms of social marginalisation will remain inadequate. This argument rests upon the following findings. (1) Failing to consider exclusion at a structural level leads to system-gaps and misunderstandings, producing poor service experiences. (2) The specific needs of trans applicants are under considered in system planning, reducing scope for meaningful homelessness interventions. (3) An equalities approach can produce a reductive and potentially pathologizing focus upon trans identity, diverting from specific individual needs. I conclude that provision of inclusive services necessitates consideration of the impact of deep cisnormative assumptions in service design and delivery, and their resultant exclusion of trans people.

The COVID-19 pandemic of 2020 was one of the rare events that shocked almost every world government simultaneously, thus creating an unusual opportunity to understand how political institutions shape policy decisions. There have been many analyses of what governments did. We focus instead on what they could do, focusing on the institutional politics of agency – how institutions empower rather than how they constrain, and how they affect public policy decisions. We examine public health measures in the first wave (March-September 2020) in Brazil, India, and the U.S. to understand how the interplay of institutions in a complex federal context shaped COVID-19 policy-responses. We find similar patterns of concentrated federal executive agency with limited constraints. In each case, when federal leadership failed public health policy responses, federated, subnational states were left to compensate for these inefficiencies without necessary resources.

This paper examines the incomes of men retiring before age 65, using FES data for years 1970–77. The findings are that such men generally rely on state benefits for most of their income. In particular, it seems that many of the early retired are receiving benefits related to ill-health which suggests that early retirement decisions are attributable more to poor health than to any voluntary desire for increased leisure by those who can afford not to work. It is found that the incomes of the early retired improved over the 1970s relative to average eararnings, but this may be due to a rise in levels of state benefit rather than private sources of income. Incomes of this group have generally been lower than for men over age 65. There is, however, a small number of early retired men with very high incomes and extensive private support, but this is only about ten per cent of the group.

This article illustrates how the term “social innovation” is used in the public policy domain in Hong Kong in relation to the new public management (NPM) reform of the social service sector, which originated in the early 2000s. Through document reviews and interviews, the role that social innovation policy has played in instigating changes in the contemporary social service field in the post-NPM era is identified. This includes facilitating emergence of “new” forms of social entrepreneurial activities to fill unmet social needs, empowering new actors in entering the social service sector, and reinforcing the government’s position in the NPM reform. Adopting historical institutionalism as the analytical framework, multiple path-dependent characteristics arising from the historical legacies of the incumbent social service environment – such as the longstanding partnership between the state and non-profits – are highlighted. These historical factors have weakened the efficacy of the policy efforts aimed at enacting institutional change. Overall, this article demonstrates how historical context matters in the emergence and framing of social innovation policy. It contributes to the theorisation of the role of social innovation in social service sector development in East Asia.

Employment subsidy programs have experienced considerable expansion across Europe in recent decades. To date, most studies analyzing this policy shift have assumed that these programs are largely equivalent in terms of their designs, effects, and explanations. In contrast, this article argues that employment subsidies are best understood as versatile multi-purpose tools that can be used as means to rather different distributional ends. Using Multiple Correspondence Analysis to explore novel data from hundreds of employment subsidy programs across Europe, this article develops a new typology based on two overarching trade-offs. The typology highlights that employment subsidies may be designed to counteract as well as to sustain insider/outsider divides in the labor market, and that they may be designed to tackle either structural or cyclical labor market problems. In a first empirical evaluation of the typology, programs with different designs are found to vary systematically in terms of distributional outcomes and starting conditions.

The aim of this article is to investigate the argument that choice and competition will unleash entrepreneurial innovation in free schools. Free schools were introduced as a subset of the Academies by the Conservative–Liberal Democrat Coalition government, following the general election in 2010. The government made it possible for non-state providers to set up their own independent, state-funded schools in order to create more choice, competition and innovation. We conclude that a higher level of substantive innovation is taking place in regards to management practices than in respect of curriculum and pedagogical practices. Innovation in curriculum and pedagogical practices is very limited. Creating a free school offer that seems to differ from other schools appears to be done through marketing and branding rather than innovation. We argue that parents, OFSTED, and the relative isolation of free schools constrain innovation from taking place.