Suchergebnisse

Processes of privatisation and liberalisation around the world would lead us to expect a growth in the private provision of health and social care services, which in turn we would expect to lead to a growth in the international trading of such services. However, the available data are not adequate to allow us to develop a clear and comprehensive picture of the scope and nature of this emerging world market. What data do exist may take a variety of forms and be pitched at different levels of analysis. Such data may be focused at the level of firms providing such services, at the national level; at the level of regional organisations and agreements; or at the level of international organisations and agreements. This article discusses the methodological problems and challenges of attempting to integrate such diverse forms of data and levels of analysis. It is concluded that a comprehensive analysis must not only include all of these levels, but take account of the ways in which processes at different levels may interact to reinforce the tendency towards trade in healthcare services.

Internationalized providers of care services face competing incentives and pressures relating to profit and quality. Case studies of corporate providers of long-term care in the UK demonstrate that their mode of organization has important implications for both user choice and the organization of care work. French Les fournisseurs internationalisés sont soumis à des pressions et à des incitatifs concurrentiels pour produire des profits et de la qualité. Des études de cas portant sur les fournisseurs institutionnels d'assistance à long terme au Royaume-Uni révèlent que leur mode d'organisation a d'importantes répercussions tant au niveau du choix des bénéficiaires qu'au niveau de l'organisation du travail d'assistance. Spanish Los prestadores transnacionales de servicios se enfrentan con incentivos que compiten entre sí y con la tensión entre calidad y ganancia. Se estudian unoscasos de prestadores de cuidados de larga duración en el Reino Unido. Estos demuestran que el modo de organización tiene consecuencias importantes, tanto para opciones abiertas al usuario como para la organización de los cuidados.

This article discusses the nature of, and links between, the academic disciplines of Social Policy and Political Economy. Two core concerns of mainstream Social Policy are identified: firstly, a focus upon the development and operation of the welfare state and, secondly, a concern with concepts such as equity. Political Economy is identified as a discipline based upon the understanding that the production and distribution of wealth can only effectively be studied alongside the operation of power. It is argued that the core concerns of Social Policy are best approached from a Political Economy perspective. Three contemporary trends make this a particularly opportune time to apply the Political Economy approach to the concerns of Social Policy. These are, firstly, the growing importance of processes of 'globalisation', secondly, the increasingly explicit linking of economic and social policies by governments and, thirdly, the emergence of new actors in the social welfare field, particularly for-profit corporations.

Two related concepts have been used to understand the welfare state – 'decommodification' and the 'workfare' or the 'competition' state, as it relates to processes of 'recommodification'. I show how these related literatures may be integrated in order to enhance our understanding of current labour market policies. Applying these concepts to an analysis of the ideas and policies of New Labour leads to the conclusion that state welfare services are being reconfigured to serve more effectively the needs of the market, through a process of 'administrative recommodification'.

The increasing trend towards the internationalization of the world economy coupled with the liberalizing agenda of international institutions and Western governments has profound implications for the delivery of health and other welfare services. As governments pursue policies which extend the scope for the involvement of private companies in the delivery of welfare services, processes of internationalization are likely to become increasingly important to such services as multinational providers emerge. This article begins the process of developing a systematic understanding of the relationships between the structure of welfare states, the social and economic policies of governments and international institutions, and the strategies and interests of private companies. It is argued that it is the particular mix of direct state provision, tax/subsidy, and regulation in the welfare state formation that provides the opportunities for, or barriers to, the expansion of internationalizing private providers of healthcare. This argument is illustrated through a case study of the current process of reform in the British healthcare system, where a relative shift away from direct state provision towards subsidizing and regulating private providers is facilitating a process of internationalization.

This article argues that work is central to Labour's social policy, and that understanding the government's attitudes towards work is a prerequisite of understanding much else that it does. The centrality of work in Labour's social policy is itself explicable in terms of two ideas which have been embraced by New Labour—social exclusion and globalization. The article examines these two key ideas and their logic, and some of their policy implications in two main areas—tax and benefit reform and education. Finally, it argues that these two policy areas also need to be linked to a third in order to fully understand their aims and outcomes— that of the promotion of flexible labour markets. Together, these policies form a strategy aimed at increasing labour market efficiency within the context of international economic competition.