Institutional change in UK health and local authorities

Abstract

The programme of market‐oriented reforms to the UK’s welfare state commenced during the 1980s with the implementation of the competitive tendering of certain defined activities in health and local authorities. This paper argues that mainstream economic analysis offers only a very partial analysis of this policy; merely reducing investigation to a comparison of costs across alternative governance arrangements. It is contended that the old institutionalist account of institutional change provides a richer anaytical vein. The paper concisely applies this in a survey of 21 authorities. Results indicate that the policy engendered change in the values correlating behaviour by partially supressing established welfarist values. There was also some deterioration in trust between parties with the formalisation of relationships, although this varied between health and local authorities. The new contracting environment and decline in staff morale may have contributed to increased rigidities.

Citation

McMaster, R. (1999), "Institutional change in UK health and local authorities", International Journal of Social Economics, Vol. 26 No. 12, pp. 1441-1454. https://doi.org/10.1108/03068299910241565