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Kelly Hall

Spain has become a popular retirement destination for British citizens; its warm climate, lower living costs and relaxed pace of life has attracted those looking for a more fulfilling retirement. Most retirees are fit and healthy when they move to Spain; however, growing old can bring increased vulnerabilities, especially vulnerability to ill-health, disability and frailty resulting in an abrupt end to the third age and the onset of the ‘fourth age’ of dependence and decline. This chapter focuses on the health and care issues facing retired British migrants in Spain who have grown old and frail. Drawing on research undertaken by the author and others, it explores rights and access to health and social care services. There are considerable differences in health and care services between Northern and Southern European countries that are often not anticipated by migrants when they move, resulting in a tension between expectations and reality underpinned by different cultural understandings of care. As such, older migrants often seek alternative routes to health and social care including through the voluntary sector in Spain and returning to the UK to access support in old age.

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Ross Millar, Kelly Hall and Robin Miller

Against a backdrop of the New Public Management (NPM) drive for quasi markets, provider diversity and business processes on the one hand, and the promotion of New Public Governance and co-production with citizens on the other (Osborne, 2006), much is being made of public service organisations becoming less distinctive. Established polarities between public and private sectors are being brought into question (Powell and Miller, 2013) with an increasing sense of ‘inter-sectoral blurring’ becoming apparent (Denis et al., 2015, p. 273). This situation is leading to range of discussions and debates about public service delivery needing to be reframed to capture the diversity of these organisational forms (Hall et al., 2016; Anderson, 2013). The concept of hybridity is one approach that has been tabled to make sense of such growing differentiation (Denis et al., 2015). Within the context of public sector reform, healthcare has come to represent a notable case in point with contributions that have looked to capture processes of hybridisation (Waring, 2015; Allen et al., 2011). The purpose of this chapter is to build on growing interest in the study of organisational hybridity in health and social care with a particular focus on social enterprise. Drawing on a case study of ‘Right to Request’ social enterprises in England, we aim to further understand the nature and impact of hybridity through the use of a multi-perspective approach (Denis et al., 2015).