Contemporary Challenges to Welfare State Development

From Users and Choosers to Makers and ShapersRepositioning Participation in Social Policy1

“…Global social policy, as Deacon et al (1997) contend, faces a set of unprecedented challenges. As northern welfare regimes become increasingly embattled (Esping-Andersen 1996;Pierson 1998), southern countries face new challenges for social sector provisioning in the wake of economic reforms, globalisation and changing demography In a literature mainly concerned with northern and transitional economies, the absence of reference to poorer countries in the South is notable. Setting 'global social policy' in context requires that we move beyond debates that have conventionally focused on various types of welfare regimes, to take account of the complexities of welfare provisioning in countries where the configuration of state and non-state actors, and indeed the responsiveness and capacity of the state to deliver welfare services, is strikingly different.…”

A realistic evaluation of practice-based commissioning

“…The challenge to both medicalism and Keynesianism had caused something of a crisis of policy-making ideas (Pierson, 1998). As a result, the advocates of new solutions to the problems the government was suffering from began to vie for the attention of policy makers.…”

The new political economy of the UK NHS

“…We must therefore exercise caution in constructing narratives that analyse changing movements toward a neoliberalist discourse in economics and welfare generally, lest we simultaneously help legitimize those new ideas (Taylor-Gooby, 1997). The move toward a Schumpeterian welfare regime has meant that cost-containment, cost-reduction and productivity improvement have been high on the agenda for the NHS (Pierson, 1998a), again making policy-makers' preferences for United States-based ideas apparent.…”