The Changing Welfare State in Europe
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The Changing Welfare State in Europe

The Implications for Democracy

Edited by David G. Mayes and Anna Michalski

The welfare state in Europe has been reformed gradually over the past two decades, with the intensification of the economic and monetary union and the addition of fifteen new members to the EU. This book explores the pressures that have been placed on the welfare state through a variety of insightful and thought-provoking contributions.
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Chapter 7: The rise of the unelected. The UK health system and the rise and fall of arm & #x2019;s length bodies

David G. Mayes and Zaidah Mustaffa


Over recent years there has been a rapid increase in the number of agencies run by people who are appointed rather than elected, which help provide the major services of the welfare state. While these agencies may be working for the public sector, they are not necessarily staffed by public sector employees and may be purely private concerns. This could be a growing and insidious threat to democracy, as not only are elected ministers responsible directly for a diminishing share of activities in the field but it may be very difficult to affect their behaviour by democratic means. Frank Vibert (2007), however, argues that this view may be incorrect and that the creation of these bodies may lead to a better balance of democratic monitoring.While agencies for the delivery of welfare services may be more efficient than government departments, this is not necessarily the case. Moreover, some agencies are deliberately designed to make sure that the new enterprises are highly accountable in a way which was not the case beforehand. Monitoring agencies, ombudsmen and independent assessors may all help ensure that the agencies behave fairly, respond to customer interests and more generally conform closely to their objectives. Properly implemented, such a system of agencies may enable democratic accountability to be exercised more effectively.

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