The chapter focuses on the implementation of de-institutionalisation in care for older people in the Czech Republic and Slovakia. The principles of de-institutionalisation were incorporated in the national strategic documents of both countries after the 2004 accession to the European Union. First, the question of how this concept influenced the Czech and Slovak national strategies, legislation and organisation of social services for older people is tackled. Subsequently, the chapter looks at the ‘responses’ of regional and local authorities and providers of care services for older people. Two case studies are then presented, which illustrate the ambivalent nature of the de-institutionalisation process. Particular attention is paid to the new role played by domiciliary care since this service form takes a central role as a ‘substitute’ for outdated or expensive institutionalised care. The chapter highlights how, even though a de-institutionalisation strategy was introduced at the national level in both countries, it was implemented without guaranteeing a constant and steady flow of financial resources, and the transition of national policy priorities to a ‘new’ conception of care for older people at the regional and local levels has been rather slow. As the case studies suggest, the implementation of the national strategy can actually lead to the exact opposite outcome than originally intended, with significant policy implications.
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Kateřina Kubalčíková, Gábor Szüdi, Jaroslava Szüdi and Jana Havlíková
José Luis Gómez-Barroso, Stefania Barillà and Ivan Harsløf
This chapter aims at assessing the EU’s emergent policy framework – the agendas, regulations and discourses – concerning social services within the larger field of social protection. At the turn of the millennium, it seemed that the conditions for a leap forward towards a more social union were in place, not only externally, by shifting its borders to the east, but also internally, by building up a more cohesive entity. In the latter respect, social services were given a prominent role. While it soon became clear that the EU would still be travelling essentially on economic rails, indeed social services are integral to the current strategy, as represented by the Social investment package and the Platform against poverty. In particular, a relevant part of the structural and investment funds to pursue social policy goals of promoting social services has been earmarked, marking a slight change in the mode of governance towards ‘harder’ law mechanisms. Yet beyond the very ambitious discourses and goals, an ambivalent stance and a number of structural tensions permeate the EU social policy framework and in particular the initiatives more specifically geared to social services. The very ambitious goals are not supported by actual financial means; a tension remains between the attempt to set up a European regulatory framework and national sovereignty in the social domain. Moreover, there seems to be a contradiction between competition policy applied to services and the right to welfare involved in social services. These unsolved tensions are likely to be the result of compromises in a geopolitical region accommodating different welfare state models, entailing different approaches, goals and interests.
Bettina Leibetseder, Anneli Anttonen, Einar Øverbye, Charles Pace and Signy Irene Vabo
Welfare pluralism, in its initial conceptualisation, sought to bring together the best welfare providers, including families and the community, while lowering expenditures. Ideally, a plurality of providers would ensure better quality, consumer choice, and universal but at the same time more individualized services. In this chapter, we raise questions about recent transformations in the welfare mix, which we call the ‘re-mix’ of social care, based on the empirical material shared within the COST Action IS1102, which points to a high degree of disarray. Compared to earlier decades that had witnessed a stable or growing level of state intervention, the current re-mixing among service providers is characterized by fragmentation and differentiation, while there is no attempt to address the question of how best to provide social care. In the end, we argue that: (1) the current organisation of care services is reinforcing inequalities between less and more affluent users; (2) the current division of responsibility in the provision, regulation and financing of care services is favouring for-profit and self-employed caregivers, without enabling collaboration and synergies among providers; (3) the current re-mixes are hindering both equality among service providers and universal provision.
Peter Brokking, Marisol García, Dina Vaiou and Serena Vicari Haddock
The chapter addresses the impact of market-oriented reforms, the financial crisis of 2008 and the resulting austerity measures on housing and neighbourhood services within the already changing trajectories of welfare states. We discuss the shifting boundaries of social groups whose needs remain unanswered and the resulting patterns of exclusion. The focus of the chapter then shifts to the response to these changes, in the form of local initiatives that attempt to address these needs and to further social inclusion. These initiatives highlight the increasingly important role of neighbourhoods and civil society actors in filling the gaps when the welfare state no longer provides basic services or when households can no longer afford to pay for services at market prices. In the final section, challenges for governance are identified and discussed. They include the definition of flexible arrangements between civil society, local public institutions and market actors and a new role of the central state in supporting the social right of access to housing.
Anneli Anttonen and Olli Karsio
The last thirty years have witnessed a significant change in the ethos and organisation of public services. There has been a profound market shift in the provision of publicly funded services in different types of welfare states. This chapter looks at the avenues and mechanisms through which in the Nordic countries an increasing proportion of publicly funded care services for older people is being removed from the entirely public sphere of state and municipal provision and is increasingly shifted to private for-profit providers. There are clear signs of intensified marketisation developments, most particularly in Finland and Sweden. Marketisation refers to the growing presence of private for-profit providers and the increasing influence of market ideas, logics and mechanisms within public service delivery. In this chapter the concept of ‘marketisation from within’ is used to characterise the marketisation shift typical of the Nordic countries, as the state and municipalities are important actors in the marketisation process by regulating and financing services that are outsourced to for-profit providers through competitive bids and customer choice models.
Flavia Martinelli, Anneli Anttonen and Margitta Mätzke
Publicly provided in-kind social services are a key component of the welfare state in most of Europe, albeit their development trajectories, coverage and legal status still vary considerably among countries. The way such services are provided and made available to people bears significantly on social and territorial cohesion, on the gender balance and, ultimately, on the wealth of any society. On the other hand, while much is discussed and written about social policy and welfare systems, social services are somewhat neglected. Although they have progressively gained a stronger foothold in national legislations and social policy agendas, their status remains weaker compared to health or education services. Moreover, because of the austerity measures brought about by the 2008 financial crisis, they have been the primary object of cuts and reorganisation. And yet, from a social capital and social investment perspective social services should earn much more attention. Cuts in the social service systems have, in fact, very severe consequences on older people and people with disabilities, as well as on households – women – with small children or living in poverty, i.e. on people whose labour market position is weak. The public provision of in-kind services, more than monetary transfers and benefits, represents a social investment that not only generates welfare, social inclusion and jobs, but also reduces future social risks. The theoretical debate on social policy and welfare states needs thus to be enriched by comparatively informed research on the restructuring of social services. This is also a field where national, regional and local variations are large and greater empirical evidence is needed.
Liisa Häikiö, Laurent Fraisse, Sofia Adam, Outi Jolanki and Marcus Knutagård
Social innovation in the context of social services is generally portrayed as a way of doing things better by directly involving individuals and communities in the design and co-production of such services. In this chapter, we argue that social innovation has an ambivalent character. We identify mainstream and radical policy discourses on social innovation that share the view that social innovation is a positive social phenomenon but differently outline the meaning of social innovation. Four case studies on local welfare initiatives for the provision of social and health services in Finland, France, Greece and Sweden highlight how the values and aims of social innovation that have been mobilized are flexible and vary according to the context in a pragmatic manner. In addition, the four cases show how institutionalization and up-scaling are a major challenge, with sustained societal change remaining partial and somewhat unreachable for local welfare initiatives. We conclude that social innovation can be differentiated on the basis of who the key actors are and what the role (and power) of citizens is in relation to institutional actors and the dominant social order.
Margitta Mätzke, Anneli Anttonen, Peter Brokking and Jana Javornik
There is great diversity in social service arrangements across countries. Some offer broadly accessible social services for their citizens, while in others social transfers and social services are fragmented and not available to everyone. Some care services are targeted or conditional, and therefore selective, while others are universally available. Institutional features such as these shape the extent and the ways in which citizens access care services and affect people’s well-being and way of life. They have a part in defining what role public policies play in societies and how states relate to their subjects. The design of social services is in that sense normatively consequential, and this chapter seeks to identify their overall character and conceptual underpinnings. It explores the core ambitions and policy goals underlying social service designs and identifies differences in normative commitments across policy fields and countries and over time. Ideal-typical policy conceptions are identified, which capture the goals and priorities informing the design of social service institutions. Two evaluative dimensions are then introduced, which map the diversity of public policy conceptions: priorities and core commitments and main orientation and targets. The framework is then put to use by analysing social service developments in three different policy fields and countries: care for older people in Finland, childcare in the UK, and housing services for asylum seekers in Sweden. These illustrations show that political rhetoric often strays far from institutional realities and underscore the need to investigate deeds, rather than words.
This chapter reflects on major trends in social service design, as identified and described in the previous chapters. All these chapters underscore significant changes in the role of the public sector in social service provision, and they are all keenly attentive to the potential drawbacks and problematic aspects of the changing outlook of public policy engagement. This concluding chapter seeks to understand the reasons why the contributors to this volume lean towards critical conclusions about the developments they have observed and have a hard time conceiving of potentially positive aspects and opportunities that come with ongoing social service developments. The chapter argues that trajectories of social service innovation are often measured against the yardstick of an ideal-typical model of citizenship-based rights and privileges, which has left its mark on the assessment of the trends identified. In this social citizenship-based perspective on social services, public involvement plays a major role in securing inclusive access to social services, a more or less even distribution in terms of their qualitative aspects and the scope of services available, and an orientation of social services as tools for supporting self-determination and empowerment of citizens making use of social services. When appraising the role of the state in social services, it is then important to consider the details of implementation, the specific institutional settings and the contextual factors of social service design.
Rosa Mas Giralt and Antonella Sarlo
Existing research from migration studies and comparative social policy has highlighted the need to develop better understandings of immigrants’ social rights and their inclusion/exclusion from welfare systems. This chapter contributes to this literature by exploring to what extent the UK and Italy, two countries very different in terms of immigration histories, management of integration and structure of their welfare states, have come to converge in the last 15 years in relation to the social inclusion of (documented) immigrants. To fully understand the social rights of immigrants we need to consider the intersection of the policies which regulate immigrants’ social rights (welfare, immigration and immigrant policies) with the systems of governance (national, regional and local actors, both statutory and non-statutory) that implement these policies and mediate access to social services. The chapter analyses the trajectories of immigrant and immigration policy in the UK and Italy while paying attention to the ‘vertical’ and ‘horizontal’ divisions of labour within the two states and the role of non-governmental organisations in complementing or substituting for retrenching public provision in this area. We argue that there are important similarities between the two countries: (1) national governments concern themselves largely with immigration policies (quotas and restrictions on newcomers’ social rights) while transferring responsibility (but not resources) for immigrant integration to local governments; (2) actors from the third sector ‘compensate’ for insufficient public provision at the local level while facing a lack of funding and institutional support. In both countries these features lead to a growing territorial differentiation in services for the social inclusion of immigrants.