Leaving the European Union (so-called ‘Brexit’) is a ‘critical moment’ for health policy reform which can pave the way to different pathways, including, a ‘critical juncture’. Given that Brexit cannot be undone without a second referendum, it opens up opportunities to elude European constraints for reform along the lines of equity, employment rights and patient choice. Brexit deepens the financial crisis of the National Health Service (NHS) by increasing hiring costs and imposing new transaction costs to accommodate patient cross-border mobility and international public health needs. Given the weak sustainability of the NHS, it could lead to major system reform.

Unemployment strongly influences a person’s economic resources and life chances. Especially for unemployed individuals who have to rely on means-tested benefits, episodes of unemployment often go along with substantial material restrictions. Therefore, from a policy perspective, measures or regulations that might shorten unemployment episodes and reduce overall unemployment are particularly important.

In this paper, we analyse whether concessions regarding the characteristics of the job searched for influence an individual’s unemployment duration. In doing so, we focus on a particular aspect of availability requirements in Germany. This is the fact that for unemployed recipients of means-tested benefits almost all types of jobs count as suitable employment and, therefore, recipients are obliged to make job-related concessions if offered a job requiring such concessions.

The results indicate that there is no positive effect of making concessions regarding qualification requirements or status on employment chances. In contrast, there are positive effects of wage concessions. However, searching for a job in a different occupation (that does not necessarily imply a concession) has a comparable, positive effect on finding employment. Thus, it appears that being generally flexible regarding one’s future occupation might be at least as important for employment chances as making concessions.

The concept of autonomy is essential in the practice and study of gerontology and in long-term care policies. For older adults with expanding care needs, scores from tightly specified assessment instruments, which aim to measure the autonomy of service users, usually determine access to social services. These instruments emphasise functional independence in the performance of activities of daily living. In an effort to broaden the understanding of autonomy into needs assessment practice, the province of Québec (Canada) added social and relational elements into the assessment tool. In the wake of these changes, this article studies the interaction between the use of assessment instruments and the extent to which they alter how older adults define their autonomy as service users. This matters since the conceptualisation of autonomy shapes the formulation of long-term care policy problems, influencing both the demand and supply of services and the types of services that ought to be prioritised by governments. Relying on focus groups, this study shows that the functional autonomy frame dominates problem definitions, while social/relational framings are marginal. This reflects the more authoritative weight of functional autonomy within the assessment tool and contributes to the biomedicalisation of aging.

The large and generous income transfer system in the Netherlands has caused increasing tax burdens and deficits in a period of sluggish economic growth. Confronted with this situation, the present Dutch government is trying to cut back the scope of the system substantially by reducing benefit levels. The distributional impact of this policy is simulated on a micro data set. It is found that the effects of the transfer cuts on overall income distribution are not very large: from 1983 to 1986, inequality as measured by the Gini or the Theil index increases by 3 per cent. However, inequality between working and non-working people as measured by the Theil index between groups is simulated to increase by as much as 50 per cent. On the other hand, people can be hypothesized to increase their work effort when benefit levels are lowered. Using a behavioural model, it is estimated that from 1983 to 1986 the working population might increase, ceteris paribus, by 0.5 per cent yearly as a consequence of the transfer cuts. This would imply second-round distributional effects mitigating the increase in overall inequality by one-third.

The objective of this paper is to take the published Mental Health Service objectives of the British Government and to assess the extent to which these objectives had been attained by 1970. Our measures are those of input and the criteria by which we judge the services are those which were set forth in the White papers, the Hospital Plan for England and Wales (1962), and Health and Welfare (1963). By and large we find that the objectives were not met. Simple linear extrapolation of some of the trends in the data make us pessimistic about their attainment prior to 1980. These lessons should condition any optimism about the inevitability of more recent objectives (Department of Health and Social Security [1971] - the Keith Joseph proposals) being attained in the prescribed time period.

The Netherlands recently experienced a crisis in childcare benefits, leading to ‘unprecedented injustice’ for many parents falsely accused of defrauding the childcare benefit system. This crisis highlights multiple barriers in parents’ ability to access childcare already evident prior to the crisis, including the far-reaching digitalisation of social policies and childcare benefits in particular. Digitalisation can make parents feel childcare services are less accessible, thereby creating or exacerbating existing inequalities in childcare use. Parents may also lack the skills needed to navigate complex application procedures, which can affect their perceived access to childcare benefits, particularly in market-led systems with greater reliance on government benefits to cover the high costs of childcare. Extending recent research on childcare capabilities, we investigate the extent to which digital and functional literacy affect parents’ perceived access to childcare benefits in the Netherlands. The results from our exploratory quantitative analysis provide a starting point for understanding the understudied relationships between digitalisation, parents’ abilities to navigate complex childcare or other policy systems, and their (perceived) ability to access childcare benefits. We use these findings to develop multiple future research recommendations in the childcare policy literature.

Recent changes in the law have made it possible to pay adopters in certain circumstances for the upkeep of their children. This is a policy change which has been controversial since it challenges values concerning not only the nature of adoption but also the boundaries between State and parental responsibility. It also represents a significant extension of local authority powers with regard to income maintenance. This raises issues of equity in relation to central government benefits for the maintenance of children and other forms of help available to disadvantaged families.

Does governmental intervention in the form of occupational training and retraining and other forms of assistance improve immigrants' occupational opportunities both as self-employed and as salaried employees? These have been longstanding research and government concerns in societies that face large waves of immigration. This study reports on the research findings of a longitudinal study which sought to examine the effects of governmental support mechanisms on the incorporation of a large immigrant inflow from the former Soviet Union (FSU) high in human capital into the labour market. Three types of public support programmes were investigated: occupational retraining, subsidised salaries for immigrants and support for immigrants in business creation. The research population consisted of 910 new immigrants from the FSU who arrived to Israel in the 1990s; they were interviewed in-depth in 1992 and again in 1994/5. The findings show that the three support mechanisms differ in their contribution to the transferability of human capital of immigrants and their earnings from jobs. They also affect men and women immigrants differently. The question ‘what worked?’ is discussed from three viewpoints: accountability of public programmes, knowledge basis and implementation. A training system approach is used to explain differences in the effects of the three policy instruments on the occupational incorporation of the immigrants.

This article uses administrative data to explore benefit dynamics for children in Britain's second largest city, Birmingham, over the period January 1998 to June 1999. As the benefits in question (housing benefit and council tax benefit) are means tested, the dynamics are also informative about moves in and out of low income. The article is original in its use of quarterly data to provide a comprehensive picture of benefit dynamics, in treating the child rather than the benefit claimant as the unit of analysis, and also in including ethnic group differences in its analysis of benefit exit and re-entry. It provides a picture of substantial ‘welfare dynamics’: that is, movements in and out of benefit support. Living in a low-income family in receipt of benefit can be seen to be a part, and sometimes a recurring part, of the experience of a large proportion of children. It argues that policy needs to investigate and take account of the impact of insecure income as well as poverty when considering the welfare of children.

Catholics are urged to show a ‘preferential option for the poor’. For the most part debate about the exercise of such an option is primarily in terms of a justice model—righting the twin wrongs of the ‘exploitation’ and ‘oppression’ of the poor. But there is another, largely untheorised approach to helping strangers in need—Samaritanism. This paper provides an exposition of Samaritanism and a defence of its role in the modern Welfare State. In doing so it seeks to challenge non-Christians to put their rationale for helping the needy on an equally secure footing as that provided by Christianity.

Over the years during which Israel has occupied the West Bank and the Gaza Strip, the Palestinian economy has become heavily dependent on wages earned in Israel. Yet Israel has done relatively little to modernise these territories' social security arrangements, or to enable Palestinian frontier workers to benefit from its own social security system. This article compares the occupational welfare, public assistance and health insurance programmes in the three entities, and suggests how they could be better organised to protect Palestinian workers and their families against daily contingencies which can decimate their economic security.

For the last ten years, the Australian system of services for frail elderly people has been undergoing significant reforms. Prior to that time, a series of government reviews and inquiries had repeatedly identified the same problems, including the dominance of institutional care, the inadequate supply of home and community based services, the lack of co-ordination, the inefficiency, and the unequal distribution of services by geographical area. Changes since the implementation of the Aged Care Reform Strategy in 1985 have been considerable, particularly with regard to the residential care sector. This article is concerned with the policy responses which emerged under the Strategy, and their impact on aged care service delivery in Australia.

Introducing individual savings accounts into the system of social security may be an innovative way to reorganise European social security systems. This article examines the merits and drawbacks of this modernisation strategy using the Transitional Labour Market approach as a frame of reference. On the basis of normative criteria derived from this approach, we perform an evaluation of the Dutch life-course scheme (‘Levensloopregeling’). This scheme is a unique and pioneering arrangement that offers employees a fiscally facilitated option to save money to finance periods of unpaid leave. Following the assessment of the Dutch case, we identify several pitfalls of reforms based on individual savings accounts. Finally, we put forward some proposals to overcome these shortcomings.

Homeless individuals often find that welfare services are inaccessible, despite being designed to meet their needs. This frictions with access which is a fundamental principle in western welfare states. Adaptations in social policy and service delivery are therefore made to deal with the problem of inaccessibility to services and welfare rights. One such adaptation is outreach work and is often developed to engage with homeless people and link them up with available services. This raises questions on the transformative potential of outreach work to deal with those mechanisms which result in inaccessibility. We argue that in a context in which accessibility is increasingly guaranteed by rights-based frameworks, exclusion management is also increasing. This is due to hybrid developments in social policy and welfare ideology. Nonetheless, the initial transformational potential of outreach work never really vanished.

There is a large discrepancy in European countries between the measured impact of immigration on the welfare state and how this impact is perceived by citizens. This study examines the determinants of individuals’ perception of the impact of immigration on the welfare state. A number of hypotheses at both the individual and contextual level are tested using a multilevel model with data from the European Social Survey. I find that the institutional features of welfare states are associated with different views on the impact of immigration on welfare states: generous contributory social welfare benefits are associated with more favourable attitudes about immigrants, while generous non-contributory benefits, by contrast, are associated with more pessimistic assessments about the fiscal impact of immigration. I argue that this can be because the latter potentially signals to natives that migrants could access generous benefits without any requisite work history. At the individual-level, the results indicate that subjective risk and general opposition to immigration are powerful individual-level predictors: people who feel more economically insecure or who are generally opposed to immigration are more likely to think that it constitutes a burden for the welfare state.

Previous studies have documented that crisis trends are associated with negative changes in healthcare satisfaction. Yet, most research has focused on the role of self-interest and little is known about the ideological dimension of these changes. The article investigates this underexplored topic by examining the ideological divide in satisfaction with healthcare in two countries strongly hit by the recent economic crisis, Portugal and Ireland. The results of the empirical analysis based on the European Social Survey data from 2008 to 2015 show that ideology played a role in shaping healthcare satisfaction in both countries. In Portugal, healthcare satisfaction declined more for the left- than for the right-oriented, while in Ireland the right-oriented demonstrated a stronger decline in satisfaction than the left-oriented. In addition, the results identify an interaction between ideology and self-interest, showing that ideology trumps self-interest among the low income, but the opposite is true among the high income groups. Overall, these findings suggest that there is a substantive ideology-driven dimension in public satisfaction with health systems and point to the need for theoretical integration of different approaches in the analysis of healthcare attitudes in the crisis context.