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The politics of choice: pros & cons of competition & choice in…
The politics of choice: pros & cons of competition & choice in pubic services
Groups
ideological
Social democratic left
conservative right
Functional
Workers of public sectors
Users or potential users
Different interest & concerns
Four models
Trust model
Opposite of trust
Voice model
Choice & competition model
Social democratic left
Negative associations
low-quality goods with high profit margins
Worsen conditions for workers
drive down pay
Implement trust mode
Without interference from government
Opposite of trust
distortions that targets create
implicit in performance management
Middle class can go private
Hostility to choice & competition is misplace
Self-interest
Conservative right
Favour choice & competition
Self-interest should meet the public interest
Why is the market quasi?
Why not full market?
Why empower users?
If people use their own money
Poor be penalized
Poor children will have a bad eduation
Efficient & equitable public services remains
Providers
reforms 2006
Extension of patient choice
New payment system
New trust & independent sector
Targets are dropping
performance management
secondary care
primary care
Changes in both clinical & organisation behaviour
NHS staff, target to market should be improvement
Command & control,
Top-down is demotivating & demoralising
Being told what to do
less opportunity of reemployment
Users
Want choice in public services
The British consumers' opposed to choise
Interests, disadvantaged backgrounds get loss in political debit
public should decide if it is good services
[CVF]
Collaborate = collectivitiy
Create = autonomy
Control = security
Compete = personal utility
Trust & legitimacy