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Public Values and Public Trust: Responses to Welfare State Reform in the UK

  • DOI:
  • Published online: 01 July 2009

The welfare state faces a number of challenges. Recent reforms in the UK appear broadly successful in attaining targets and improving cost-efficiency, but are nonetheless confronted by public disquiet and unease. This article argues that one difficulty with the new directions in policy is that they rest on a particular and limited understanding of agency. Reformers tend to operate within a theoretical framework that understands behaviour as driven by individual and predominantly rational incentives and pays little attention to the expressive and normative aspects of social action. The problems that arise in these areas when a competitive market logic is applied in social provision tend not to be recognised. Such a logic may contradict established values of social care and commitment to user interests. A qualitative survey of 48 members of the general public is used to examine perceptions of and responses to the NHS reforms, and to show how public discourse in this area is at variance with the instrumental and individual assumptions of policy-makers. The result is that the reform programme damages the legitimacy of the service and that those responsible for the new policies fail to recognise that the individual instrumental agenda is eroding public trust.

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C. Atman , A. Bostrom , B. Fischoff and M. Morgan (1994), ‘Designing risk communications and correcting mental models of hazardous processes’, Risk Analysis, 14: 5, 779–87.

R. Axelrod (1981), ‘The evolution of cooperation’, Science, 211: 4489, 1390–6.

R. Baggott (2007), Understanding Health Care, Bristol: Policy Press.

G. Bevan and C. Hood (2006a), ‘Have targets improved performance in the English NHS?’, British Medical Journal, 332: 419–22.

G. Bevan and C. Hood (2006b), ‘What's measured is what matters’, Public Administration, 84: 3, 517–38.

K. Cook and M. Levi (1990), The Limits of Rationality, Chicago: University of Chicago Press.

A. Dixit (2002), ‘Incentives and organisations in the public sector’, Journal of Human Resources, 37: 696727.

E. Fehr and S. Gächter (2000), ‘Fairness and retaliation: the economics of reciprocity’, Journal of Economic Perspectives, 14: 3, 159–81.

P. Hoggett , M. Mayo and C. Miller (2006), ‘Private passions, the public good and public service reform’, Social Policy and Administration, 40: 7, 758–73.

E. Huber and J. Stephens (2001), Development and Crisis of the Welfare State, Chicago: Chicago University Press.

J. Le Grand (2003), Motivation, Choice and Public Policy, Oxford: Oxford University Press.

P. Norris (ed.) (1999), Critical Citizens, Oxford: Oxford University Press.

P. Pierson (2001), The New Politics of the Welfare State, Oxford: Oxford University Press.

P. Todd and G. Gigerenzer (2003), ‘Bounding rationality to the world’, Journal of Economic Psychology, 24: 143–65.

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Journal of Social Policy
  • ISSN: 0047-2794
  • EISSN: 1469-7823
  • URL: /core/journals/journal-of-social-policy
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