Deconstructing The Welfare State

7 When organizations disappear: deconstructing management at a primary care trust -- 8 Managing the impossible: the challenges of organizational change in the NHS -- Afterword -- References -- Index

Who are NHS middle managers? What do they do, and why and how do they do it’? This book explores the daily realities of working life for middle managers in the UK’s National Health Service during a time of radical change and disruption to the entire edifice of publicly-funded healthcare. It is an empirical critique of the movement towards a healthcare model based around HMO-type providers such as Kaiser Permanente and United Health. Although this model is well-known internationally, many believe it to be financially and ethically questionable, and often far from 'best practice' when it comes to patient care. Drawing on immersive ethnographic research based on four case studies – an Acute Hospital Trust, an Ambulance Trust, a Mental Health Trust, and a Primary Care Trust – this book provides an in-depth critical appraisal of the everyday experiences of a range of managers working in the NHS. It describes exactly what NHS managers do and explains how their roles are changing and the types of challenges they face. The analysis explains how many NHS junior and middle managers are themselves clinicians to some extent, with hybrid roles as simultaneously nurse and manager, midwife and manager, or paramedic and manager. While commonly working in ‘back office’ functions, NHS middle managers are also just as likely to be working very close to or actually on the front lines of patient care. Despite the problems they regularly face from organizational restructuring, cost control and demands for accountability, the authors demonstrate that NHS managers – in their various guises – play critical, yet undervalued, institutional roles. Depicting the darker sides of organizational change, this text is a sociological exploration of the daily struggle for work dignity of a complex, widely denigrated, and largely misunderstood group of public servants trying to do their best under extremely trying circumstances. It is essential reading for academics, students, and practitioners interested in health management and policy, organisational change, public sector management, and the NHS more broadly.

This book presents an alternative theoretical approach to the study of the transformation of the modern welfare state. It draws upon the undogmatic Marxism of Gramsci in order to deconstruct the Marxist tradition and develop a general theory of capitalist regulation which emphasizes the primacy of the political. In so doing, it seeks to integrate French regulation theory and British state theory within the broader framework of discourse analysis. This theoretical framework is applied in an empirical analysis of the Danish variant of the Scandinavian welfare state model. The book is written for advanced undergraduates, postgraduates and professionals within the field of political theory, institutional economics and sociology.

Social Policy, Welfare State, and Civil Society in Sweden I-II gives a comprehensive account of the global invention of the welfare state, from the far north of the West to the global East and Southeast, and from its social policy origins to the most recent challenges from civil society. This second volume aims at the civil society challenge to the welfare state since 1988, or "the lost world of social democracy." It opens with an overview of the three generations of comparative welfare state research, from Harold Wilensky to Gosta Esping-Andersen, Theda Skocpol and onwards. Inspired by the work of Norbert Elias, Karl Polanyi, and Stein Rokkan as well as by Benedict Anderson, Tom Nairn and Elinor Ostrom, the civilizing process and embeddedness of the welfare-industrial complex are scrutinized. The author's key concepts are imagined welfare communities, and common pool resources in (civil) society and state. Privatization trends in Sweden - from take-off to bonanza - and domestic resistance to the powers of the day are then lucidly assessed, and the simultaneous deconstruction and reconstruction of a once famous welfare state is elaborated with force and vigour. Finally, the cross-national Scandinavian differences are outlined. The five essays of volume II emphasize the historical relativity of social welfare institutions and argue against all developmental metaphysics. This work is an updated and enlarged edition in two volumes of Sven Hort's well-known and wide-ranging dissertation Social Policy and Welfare State in Sweden, published under the author's birth name Sven E. Olsson in 1990. The first volume contains the original four essays and covers the formation and evolution of the Swedish welfare state 1884-1988. In praise of the new edition: "The publication of this book in 1990 marked a turning point in understanding of how the Swedish welfare state should be conceptualized both from a historical and comparative perspective. Its combination of sophisticated theoretical perspectives and in-depth empirical analysis became a model for many later studies of welfare state regimes. Added to the timely new edition is a 'volume II' sequel that updates and deepens the analysis of how the Swedish welfare state has fared during the era of globalization. This new edition is a 'must read' for everyone interested in the history and future of welfare state regimes." - Bo Rothstein, August Rohss Chair in Political Science, University of Gothenburg In praise of the first edition: ..". takes us beyond simple analyses, emphasizing the deep historical roots of social democracy in Sweden and considering the role of ideas, the organization of politics, and the activities of social classes other than labor in building and securing Swedish social policy. Olsson's book presents a comprehensive overview of the development of the Swedish welfare state and a detailed consideration of several key episodes of welfarestate development." - American Journal of Sociology "This is a very scholarly and broad ranging analysis of the postwar Swedish welfare state ... which is invaluable for comparative policy analysis." - Critical Social Policy ..". essential reading for sociologists and political scientists." - Contemporary Sociology Sven E. O. Hort is Professor in Social Welfare at the College of Social Sciences, Seoul National University, Korea. He is an alumnus of Lund University. In Sweden he taught sociology at Linneaus and Sodertorn universities. Currently he is the chief editor of the Swedish journal Arkiv. Tidskrift for samhallsanalys and a deputy editor of European Societies. With Stein Kuhnle he is the author of "The Coming of East and South-East Asian Welfare States," Journal of European Social Policy (2000)."

The welfare state in all its many forms has had a profound role in many countries around the world since at least the Second World War. The Routledge Handbook of the Welfare State explores the classical issues around the welfare state, but also investigates its key concepts, along with how these can be used and analysed. This book provides expert analysis of the core issues related to the welfare state, including regional depictions of welfare states around the globe. The book combines essays on methodologies, core concepts and central policy areas to produce a comprehensive picture of what 'the welfare state' means around the world. In the midst of the credit crunch, this book addresses some of the many questions about the welfare state. This book is suitable for students and scholars throughout the social sciences, particularly in sociology, social policy, public policy, international relations, politics, and gender studies.

This book surveys the creation and existence of the welfare state in the developed economies, analyzes ways in which problems have emerged, and suggests possibilities for reform.

The book is important reading for second- and third-year undergraduate and postgraduate students of politics, social policy and sociology.

This book introduces a unique, new dataset on welfare state reforms in the UK, Denmark, Finland, France and Germany from 1974 to 2014. Using a variety of welfare state types in Europe, the authors have systematically investigated core questions that have preoccupied the welfare state literature at least since the 1990s. These include the extent of path dependency in mature welfare states, the usage of so-called invisible policy instruments for hiding cutbacks, and the role of partisanship - on whether the ideological color of the incumbent affects policy - which have been analysed in depth by examining the new dataset presented in this book. This text will be of key interest to scholars, students and practitioners studying, and working in, welfare and the welfare state, and more broadly to political science, sociology and social policy.