Martin Powell

New Labour and the third way in the British welfare state: a new and distinctive approach?:

The Labour government elected in May 1997 has seen the reform of the welfare state to be one of its major tasks. Its big idea to achieve this is the third way, which is said to be a new and distinctive approach that differs from both the old left and the new right. It is argued that the third way is best summarized by a new acronym—PAP—pragmatism and populism. It appears to be neither distinctive nor new, leaning to the right rather than the centre or centre-left, and having some roots in the New Poor Law and the mixed economy of welfare of Beveridge.

Markets, Bureaucracy and Public Management: The NHS: Quasi-market, Quasi-hierarchy and Quasi-network?

It has been argued that the British National Health Service (NHS) has moved from a hierarchical and bureaucratic organization to a market and, more recently, towards a network. The authors believe that this view is too simplistic: the three organizational forms have co-existed and continue to do so. It is more accurate to view moves over time as a changing mix between quasi-hierarchies, quasi-markets and quasi-networks.

Territorial justice: A review of theory and evidence

Abstract This paper evaluates the theory and evidence on territorial justice. The problems of defining and measuring service needs and service provision are outlined, and the statistical criteria for territorial justice are analysed. The empirical evidence on the spatial relationship between needs and provision is critically reviewed for four services in the U.K.: health care, education, housing and the personal social services. Several shortcomings in the evidence suggest that the extent of territorial justice has been underestimated. In particular, the empirical studies have not recognized that the statistical condition for territorial justice depends on the dimensions of needs and provision which are compared.

Welfare State and Welfare Change

Welfare state The classic welfare state The restructured welfare state The modern welfare state Economic explanations Political explanations Organizational explanations Social explanations Welfare change Further Reading References Index.

The spatial strategy of equality and the spatial division of welfare

In this paper we argue that little is known about either the geographical objectives or the spatial outputs of the welfare state. Conclusions of geographical inequality are problematic for three main reasons. First, the geographical aims of the welfare state, “the spatial strategy of equality”, are unclear. Second, the geographical distributional paradigm is rarely placed in the wider context of local and national welfare states, and the tension between spatial equity and local autonomy is ignored. Third, the geography of welfare, “the spatial division of welfare” is often based on simplistic and confused evidence. Much of the existing work implicitly takes a centralist perspective, assuming that all geographical inequalities are defects. Issues of local government, local politics and local welfare states are ignored. All detected inequality may not be “bad”, and greater spatial equity may not necessarily be “good”. The spatial division of welfare should not be examined in an analytical vacuum, isolated from the wider contextual issues of national and local services and the trade-off between local autonomy and territorial justice. If the “default value” is that all detected geographical variations are assumed to be defects, then the arguments for localism are doomed to failure.

New Labour's partnerships: comparing conceptual models with existing forms

The establishment of partnerships has been a central feature of British social welfare policy since 1997 when the New Labour government came to power. Although the academic attention given to partnership working since then has grown considerably, there have been few attempts to link conceptual models of partnerships with existing forms. This paper addresses this gap and finds that, while there are links between actual and model partnerships, there is little evidence that actual partnerships have been designed or structured to meet their particular tasks.

On the outside looking in: medical geography, medical geographers and access to health care

Abstract Access to health care is an area of interest for a number of disciplines and sub-disciplines in, for example, medical sociology and health policy. However, an examination of texts in these areas shows that the sub-disciplines are mainly aspatial. When space is addressed, it is often problematic in that earlier geographical work is not cited. By tending to ignore the existing literature and proceeding to reinvent the wheel, it has reproduced some of the conceptual and methodological problems associated with some of the earlier literature. This paper reviews the spatial work in medical sociology and health policy texts and journal articles on the theme of access to and utilization of health care, paying particular attention to the contribution of medical geography and medical geographers. It then examines the potential contribution of medical geography, by attempting to locate space in its wider context.

The End of the Welfare State

This paper critically examines claims of a new consensus on welfare and the end of the welfare state. We first review the concept of welfare consensus, concentrating on the idea of welfare pluralism, in particular the relatively neglected distinction between national minimum (base) and extension ladder (superstructure). We then examine these concepts in the 1990s under Conservative and New Labour governments. Important changes to welfare pluralism are noted. There have been changes in the character of means-tests, with the national minimum replaced by a series of residual minima, which represent fundamental changes to structural incentives governing the social division of welfare and work. The line between state and non-state provision has been blurred and there have been moves to achieve universalism in the private sector. It is possible to tentatively classify Labour’s principles and fledgling policies into three categories: essential continuity with the Conservatives, reversing Conservative policies and extending Conservative policies. However, it is difficult to detect the degree of consensus because a new flexible language is beginning to pervade social policy, with the result that the welfare state is being redefined, notably in areas of full employment, citizenship and conditionality. It is possible to detect, in our terms, moves towards turning Beveridge inside out and from the “Marshall” towards the “Beveridge” welfare state. It is clear that the welfare state is being redefined, but reports of its death have been much exaggerated.

The changing governance of the NHS: Reform in a post-Keynesian health service

This article suggests that the central problems of examining governance change in the National Health Service (NHS) are located in the changing relations between the state and the professionals it relies upon for the delivery of health services on the one hand, and its positioning of the users of public services on the other. These relations are explored in depth in terms of the question as to whether market-based governance can be adequately implemented in the NHS, examining the implications of this analysis for welfare governance reform more generally.

Environmental Change, Leadership Succession and Incrementalism in Local Government

A theoretical model of strategic budgetary choices in local government is developed and tested. The model assumes that expenditure decisions are a function of changes in environmental circumstances and the characteristics of local leaders. Environmental change is operationalized through measures of workload, munificence and regulatory controls. Leadership succession is defined as the turnover in managerial and political elites. These environmental and leadership variables are included in a multivariate statistical model of budgetary incrementalism. The model is tested on the spending decisions of 402 English local authorities from 1981 to 1996. The empirical results suggest that the extent of budgetary change is influenced strongly by environmental change but weakly by leadership succession. Furthermore, environmental constraints became tighter during the study period. The characteristics of public sector organizations that impose limits on the strategic choices of new leaders are identified.