Book contents
- Frontmatter
- Contents
- Preface and acknowledgements
- Introduction
- 1 Before the market
- 2 The emergence and consolidation of the market
- 3 Dilemmas in the commissioning of adult social care
- 4 Dilemmas in the provision of adult social care
- 5 State or market?
- 6 Context: funding and administration
- 7 Looking ahead: an ethical future for adult social care
- 8 COVID-19: the stress test of adult social care
- 9 Conclusion: making it change – morals, markets and power
- References
- Index
2 - The emergence and consolidation of the market
Published online by Cambridge University Press: 23 December 2021
- Frontmatter
- Contents
- Preface and acknowledgements
- Introduction
- 1 Before the market
- 2 The emergence and consolidation of the market
- 3 Dilemmas in the commissioning of adult social care
- 4 Dilemmas in the provision of adult social care
- 5 State or market?
- 6 Context: funding and administration
- 7 Looking ahead: an ethical future for adult social care
- 8 COVID-19: the stress test of adult social care
- 9 Conclusion: making it change – morals, markets and power
- References
- Index
Summary
Introduction
Developments in adult social care in the 1980s did not emerge in isolation from wider policies in the public realm. Although the public sector has always bought goods and services from the private sector, the influence of neoliberal ideas in the 1980s opened up the debate on whether this should go further than hitherto. In the 1979 Conservative government's first legislative programme, the principle of compulsory competitive tendering for building work was introduced by the Planning and Local Government Act 1980; this principle was later extended to most local authority direct labour work under the Local Government Act 1988. In the same year, the Housing Reform Act encouraged council tenants to ‘opt out’ of local authority control by choosing new landlords (termed ‘housing action trusts’) in the not-for-profit sector. Meanwhile, changes in the NHS were not dissimilar, with organisational responsibility for funding and managing service delivery separated through a ‘purchaser–provider split’.
Underpinning these ideas was the emergent concept of ‘new public management’ (Hood, 1995). This also proposed a quasi-market structure, whereby public and private service providers competed with each other in an attempt to provide better and faster services. Other core themes included: a strong focus on financial control, value for money and increasing efficiency; introducing audits at both financial and professional levels to review performance; greater customer orientation and responsiveness; increasing the scope of roles played by non-public sector providers; deregulating the labour market; discouraging the self-regulatory power of professionals; and handing over power from management to individuals. If neoliberalism provided the ideological framework, new public management offered the means of delivery.
In the social care context, a key landmark was the speech in 1984 by the then Secretary of State for Health, Norman Fowler (1984), extolling the virtues of the ‘enabling role’ of local government. He suggested that social services departments should switch their focus from the direct provision of care to the funding and facilitation of the delivery of care. Accordingly, he set out three roles for social services departments and the wider local council remit:
• a comprehensive strategic view of all available sources of care;
• a recognition that social services were only part of the local pattern; and
• a recognition that social services should support and promote the fullest possible participation of the other different sources of care that exist or can be called into being.
- Type
- Chapter
- Information
- Clients, Consumers or Citizens?The Privatisation of Adult Social Care in England, pp. 15 - 30Publisher: Bristol University PressPrint publication year: 2021