Public, private or hybrid? Providing care services under austerity: the case of Italy

Abstract

PurposeThe paper examines the different trajectories of externalisation and the development of different kinds of welfare mix in three different sub-sectors of socio-educational services: long-term care for the elderly, early childhood services and kindergartens. By integrating the industrial relations and comparative public administration literatures, it analyses the different rationales underpinning contracting-out decisions of Italian local governments.Design/methodology/approachThe paper adopts a multi-method, multi-level approach: quantitative data on the provision of socio-educational services and the nature of the providers are combined with the analysis of 12 case studies of municipalities through 80 semi-structured interviews and documentary analysis.FindingsThe paper argues that differentials in labour regulation across the public/private divide and the consequent possibility to access labour markets characterised by cheaper labour and higher organisational flexibility are a key explanation in local governments' decisions to outsource. Despite labour market factors playing a prominent role, their relevance is significantly tempered by political and social factors and particularly by the strong opposition of citizens, personnel and trade unions to pure market solutions in the provision of such services. However, the centrality of these factors depends on the nature of the services: political sensibility against privatisation proved to be stronger in kindergartens, while services for the elderly were more frequently and less contentiously privatised.Originality/valueThe main contribution is the integration of the two research traditions to analyse patterns of outsourcing in the socio-educational services in Italy, showing that neither of them is able, alone, to explain the different private/public mix characterising different social and educational services.

Regulating domestic and care work in Italy: Assessing the relative influence of the familistic model today

“…Although cooperatives certainly represent an important player in social and educational service provision in Italy (Dorigatti et al, 2020), not many such actors currently operate in the sphere of domestic and care work; the few that do are those licensed by municipalities/regions to provide training. The professional training segment is still heavily dependent on the ability of individual regions or municipal administrations to allocate resources by issuing calls for tenders to contract out a series of services.…”

Discussion of citizen behavioural change using the nudge effect: a perspective based on social policy interventions

“…These studies stress the importance of close interaction, trust and empathy between the sender and receiver of information as well as that of a positive attitude and mindset on the part of the receiver. This approach and idea have been supported by Dorigatti et al (2020), who proposed a new perspective based on a hybrid relationship. Rather than discussing the public and private sectors as being in opposition to each other, they discuss a pathway for combining them and confirming their legitimacy.…”

‘Intended’ and ‘unintended’ consequences of the privatisation of health and social care systems in Italy in light of the pandemic

“…The presence of different employment agreements created unequal conditions for workers. In terms of pay and other components of the employment relationship (such as working hours, holiday, time off and leave), the most unfavourable agreements are those in the private for-profit and non-profit sector (Dorigatti et al, 2020;Mori, 2020).…”

“…Special firms, personal service firms and foundations are subject to different kinds of monitoring and control systems by municipalities and other local government authorities, but they have managerial autonomy from public bodies and, in the case of foundations, private legal status. Given the pressures to reduce public spending and to apply for new funding, the spread of these public-private organisations impacts on both relations between public and private providers in the social care market, and the workforce employed in social and long-term care services, further worsening pay and working conditions (Dorigatti et al, 2020;Neri, 2020).…”