Introduction
As late as 1965, T.H. Marshall could write that there was consensus around the viability of the welfare state, and the remaining problems were those of social engineering rather than ideology (Marshall 1965). It could easily be argued that is no longer tenable. The liberal certainties of the decades of the welfare state, the general consensus about the search for social justice, the faith in the ability of society to work towards humanitarian goals, have run into severe attacks from both extremes of the political divide. Indeed, the 1981 OECD pamphlet, The Welfare State in Crisis, seems to have highlighted the problem of the structure of welfare states throughout the world which has dominated political thinking ever since. Accordingly, achievements such as improvements in housing conditions, increased educational opportunities, enhanced health care provision are counterbalanced by shortcomings like the persistence of poverty and the failure to counter class inequalities. Deakin and others, therefore take the view that the welfare state has found it difficult to counter the five giants identified by Beveridge not least because of their intractable nature (Deakin and Page 1995).
Industrialisation in the Western countries has been associated with a number of fundamental social changes, among which are the increased size and changing age structure of the population and the concentration of that population in urban areas. The institutions of the welfare state emerged as a response of these new pressures and the need for quality and quantity of the labour force to be maintained and enhanced. Social services such as health, education, housing and welfare provision, which have compensated for some of the negative effects of industrialisation such as accidents and unemployment, have represented the welfare response to the requirements and consequences of industrialisation in its early to middle stages. Much analysis of industrial society has tended to emphasise the development of the liberal democratic state in Western countries and to suggest that the rights of citizens have become an important focus. From this perspective the welfare state has been closely associated with the definition and extension of citizenship rights.
Traditionally, many definitions of the welfare state have emphasised an altruistic element. Over thirty years ago, for example, Thoeres offered the following definition: âA form of society characterised by a system of democratic, government-sponsored welfare âŚ.. offering a guarantee of collective social care to its citizens.â As already mentioned, views may of course differ about the validity of such definitions however cautiously proffered. Firstly, it is argued, by some using Marxist analysis for the most part that the welfare process, far from mitigating the worst effects of capitalist exploitation is in fact designed to facilitate it and to accommodate the objectives expressed in the whole process of social manipulation. From this point of view welfare states are not so much to guarantee social care to their citizens as to guarantee the continued viability of some vested interests. A further idea made particularly explicit in the work of Illich is that welfare can be, and has been, translated into a common good to be distributed through the economic, political and social markets.
On the other hand, representatives of the âNew Liberal Rightâ advocate an entirely new approach to state involvement in social welfare. This approach has achieved considerable political success in Scotland, the UK and in other Western European nations. Central to this critique is the idea that the relatively unfettered play of market forces is capable of providing for the needs of majority; the state then requires to do no more than provide at a minimum level for the needs of those unable for various reasons to provide for themselves. The proponents of the New Liberal Right have called for an increase in private enterprise and a larger role for the principle of âmixed economyâ, that is, the partnership of private and statutory sectorsâ involvement in the promotion of social welfare.
Where do all these viewpoints leave the welfare state and social provision? The present Scottish Executiveâs strategic agenda is to work across boundaries to combat social exclusion, encourage welfare to work, tackle inequalities between men and women and black and white people and improve health in local communities. All social service provisions, especially health and social services will need to be built around the needs of those who use them. It has been argued, with some justification, that all too often the traditional boundaries that exist between these services can be a major obstacle. The new policy shift here emphasises the notion of a âjoined upâ approach so that the frustrations and distress people experience in trying to organise the kind of care they want, or the kind of support they need as a carer can be fundamentally addressed. In order for this approach to be effective, both in cost and service terms, work needs to be carried out at three levels. First strategic planning, that is, agencies need to plan jointly for the medium term, and share information about how they intend to use their resources towards the achievements of common goals. Secondly, service commissioning which means securing services for their local populations, agencies need to have common understanding of the needs they are jointly meeting, and the kind of provision likely to be most effective in terms of the principle of âbest valueâ. And thirdly, service provision which would involve the delivery of coherently integrated packages of care, regardless of how of services are purchased or funded so that the user and their families do not face the anxiety of having to navigate a labyrinthine bureaucracy.
This modernisation agenda in social services comes after years of growth. Despite, the publicâs perception of cuts in welfare provision, there has been a real increase in spending every year (Hill 2000). Politicians have grown increasingly frustrated at the failure to translate these increases into visible improvements in service provision and thus are issuing more directives. First, the national priorities guidance sets joint priorities for health and personal social services with annual targets as highlighted earlier in this chapter. Then the setting up of targets for improvements in the lives of looked-after children. Couple these targets with the approach taken by the joint review process, with its naming and shaming of failing authorities, add in the best value agenda with its own programme of services and targets, and one has a truly daunting agenda for change. The national care standards commission will serve as a further check on local authority performance.
The focus for social services is meeting targets, bidding for new money and preparing the position statements and strategies to meet the demands of auditors and inspectors. Less time is spent on ensuring standards are maintained in homes for elderly people, day centres, and in home care. Yet that is precisely where some public agencies have failed to deliver.
The modernisation agenda and the determination of politicians to back policy objectives with extra resources and specific targets is worthy of recognition. However, there is also a need for consolidation. Government is about priorities. There could be a danger in the current torrent of initiatives that when everything is a priority, nothing really is.