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New Labour and the enabling state.

Ian Taylor1

  • 1Public Services Management Group, Aston Business School, Aston Triangle, Birmingham, UK.

Health & Social Care in the Community
|September 19, 2001
PubMed
Summary

The enabling state model shifted UK public services towards provider autonomy, particularly in health and social care. This analysis evaluates the impact of New Labour

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Area of Science:

  • Public Administration
  • Health Policy
  • Social Care Policy

Background:

  • The 'enabling state' concept emerged in the UK in the 1990s, contrasting with the traditional 'welfare state'.
  • This shift was influenced by policies like contracting out in the National Health Service (NHS) and compulsory competitive tendering (CCT) in local government during the 1980s.
  • Key developments in health, social care, and education during the 1990s further shaped this model, including the NHS internal market and purchaser-provider splits.

Purpose of the Study:

  • To examine the extent to which service providers were genuinely enabled under the 'enabling state' framework.
  • To assess whether New Labour's policies reinforced or moved away from the 'enabling state' model.
  • To evaluate the shift towards more direct provision versus continued enablement in public services.

Main Methods:

  • Analysis of policy shifts and their impact on service providers.
  • Examination of the 'enabling state' concept in relation to health, social care, and education sectors.
  • Assessment of New Labour's specific policy interventions and their alignment with or divergence from the enabling state model.

Main Results:

  • The creation of internal markets and purchaser-provider splits in the NHS led to a perceived transfer of service ownership to providers.
  • The 1990 NHS and Community Care Act facilitated a mixed economy of care, enabling non-state providers in community services.
  • Service charters aimed to empower users by increasing their influence over service provision, a component of the enablement process.

Conclusions:

  • The 'enabling state' model represented a significant shift in public service delivery, emphasizing provider autonomy and a mixed economy of care.
  • The effectiveness and extent of provider enablement varied across sectors and policy implementations.
  • New Labour's policies introduced complexities, potentially balancing enablement with tendencies towards more direct state provision.

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