Health inequalities researchers have long advocated for governments to adopt policy instruments that address structural determinants of health rather than targeting individual behaviours. The assumption behind this position is that such instruments might challenge a core neoliberal principle of individualism embedded in the prevailing health policy paradigm. We critique this assumption by highlighting the discursive construction of policy instruments, and their discursive effects. Using the UK’s Tackling Obesity policy as a case study, we demonstrate how instruments designed to target structural determinants of health (such as food advertisement regulation) can actively sustain – rather than challenge, the dominant policy paradigm. We call this phenomenon ‘upstream individualism’, exploring how it relates to tensions in the research-policy relationship, and its relevance beyond health policy. We argue that instruments can shape policy change and continuity, including at a paradigm level, and that ‘upstream individualism’ provides a useful basis for theorising these power dynamics. This article contributes to the constructivist public policy literature by noting how policy instruments meant to challenge the discursive construction of individualism within public health can ultimately reinforce it.
This concluding chapter reviews the key analytical threads and arguments of the book, returning to the concept of ‘double activation’ and tracing the interconnections (conceptually and at the level of street-level practice) between the quasi-market governance of employment services and workfarist activation. It reviews the key dynamics by which quasi-marketisation intensifies a street-level orientation towards enacting a more demanding, workfare-oriented activation model: through how it reconfigures the profile of organisations and people working at the frontline of service delivery (politics of professionalism), and through applying more intensive performance management accountability regimes that discipline street-level workers’ exercises of administrative discretion. Finally, the book concludes by assessing the evidence-base for a demanding, workfarist model of activation and the reasons why governments continue to favour ‘work-first’ strategies despite limited evidence of their effectiveness.
Since 2010, Ireland has followed a well-trodden path of extending the project of welfare reform beyond the activation of claimants to the ‘double’ activation of the organisations and frontline workers responsible for implementing active labour market policies on the ground. This chapter takes a closer look at ‘double activation’ as an analytical lens, and why the concept holds significance beyond describing the conjunction between the two tracks of welfare reform. What is it about the parallel unfolding of governance reforms of delivery organisations that is of wider interest to the shape of activation reform? The chapter also introduces the Governing Activation in Ireland study underpinning this book: the research design and how the study differed from previous studies of the impacts of marketisation on the frontline delivery of employment services. The chapter concludes with a consideration of the underlying conceptual linkages between workfare and marketisation, drawing attention to the theories of motivation they share and the ways in which they each involve a normative commitment to the commodification of claimants.
This introductory chapter situates the case study of Ireland that follows in the context of wider international welfare reforms. These include the social policy turn away from human capital development approaches towards a more demanding, workfare-oriented activation model, and the creation of quasi-markets in employment services. The chapter reviews these developments internationality while offering an analysis of the distinction between workfare and human capital development approaches to activation, as well as the variety of quasi-market models.
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This book assesses how the practice of contracting-out public employment services via competitive tendering and Payment-by-Results is transforming welfare-to-work in Ireland.
It offers Ireland’s introduction of a welfare-to-work market as a case study that speaks to wider international debates in social and public policy about the role of market governance in intensifying the turn towards more regulatory and conditional welfare models on the ground.
It draws on unprecedented access to, and extensive survey and interview research with, frontline employment services staff, combined with in-depth interviews with policy officials, organisational managers and jobseekers participating in activation.
The experiences of service-users and approaches of frontline staff showed that the model of support delivered under quasi-market conditions was distinctly more workfarist in orientation than the type of support that was provided by not-for-profit organisations in other parts of Ireland’s mixed economy of activation. So why did quasi-marketisation produce these policy effects? How did JobPath’s procurement model – competitive tendering, price-bidding, and performance-based contracting – spill over into organisational practices to adjust the balance between the enabling and demanding elements of activation? This chapter zooms out from the micro-level of caseworker-client interactions to consider issues of organisational dynamics and contracts’ recruitment practices and performance measurement regimes. In so doing, the chapter draws on the Irish case to engage with wider debates about the disciplining effects of managerialism and performance measurement on frontline discretion. It also offers a commentary on the ambiguous ‘professional’ status of activation work and the role of marketisation in contributing to the de-skilling and de-unionisation of employment services staff. The chapter develops the argument that marketisation reshapes agency at the street-level through both a politics of professionalism and politics of discretion
The advent of the COVID-19 pandemic in South Africa and across the globe posed special challenges and implications for low-income families with children. In this study we explored the experiences of primary caregivers of children receiving a South African social assistance programme, the Child Support Grant (CSG), during lockdown in Cape Town, South Africa, and sought to understand whether and to what extent the underlying logic of cash transfers such as the CSG speaks to the pitfalls of the social protection paradigm and the potential for moving closer to a transformative social policy approach.
We conducted 26 telephonic qualitative interviews with primary caregivers of recipients of South Africa’s CSG that were part of a longitudinal cohort study assessing the impact of the CSG on child nutritional status and food security.
Even though primary caregivers of the CSG and their children and households were already living in precarity before the pandemic, COVID-19, and particularly the hard lockdown, worsened their social, economic and living conditions, especially as regards hunger and food insecurity.
Low-income women bore the brunt of the pandemic in their roles as mothers, providers and homemakers. The pandemic has highlighted the inadequacies of the social protection paradigm that underlies the design of cash transfers such as the CSG, which has a narrowed focus on chronic poverty and vulnerability. It has also highlighted opportunities to shift to a transformative social policy framework that incorporates production, redistribution, social cohesion, adequacy and protection.
This chapter outlines how Ireland’s welfare system evolved from an ostensibly passive model with minimal conditionality to a sanctions-oriented, work-first model. Under OECD pressure to adopt a more ‘coercive’ model, payment rates were cut, eligibility conditions tightened, and sanctions introduced for non-compliance with new mutual obligations. This was paralleled by major governance reforms of operational services. The state-run employment service was replaced with an integrated benefits and employment service; Local Employment Services delivered by not-for-profit organisations became subject to tighter performance measurement; and a Payment-by-Results quasi-market was introduced to bolster capacity. The design features of JobPath are reviewed, and how it embedded market governance by organising service delivery through competitive tendering and performance-based contracting. This was in sharp contrast to the pre-existing network of Local Employment Services. However, besides these differences, the two otherwise coalesced in policy time and space. Both were targeted towards the same claimant cohorts and operated under the same activation policy setting. Thus, Ireland’s mixed economy of activation was essentially a natural policy experiment in the use of different governance modes to steer frontline delivery that the remainder of the book harnesses to assess whether and how marketisation changes the substance of policy delivery.
The Irish case offers a rare natural policy experiment for exploring the intersection between workfarist activation and welfare-to-work markets. This is due to the co-existence of two similarly targeted employment services programmes commissioned through distinct governance modes. Drawing on survey and interview research with frontline staff delivering JobPath and Local Employment Services, and with service-users participating in the programmes, this chapter explores how the two employment services differed in practice at the coalface of delivery. Formally, both services operated under the same activation policy setting. Yet, as detailed in this chapter, the two services differed in significant ways as to how they implemented this activation case management model. This was especially in relation to how they adjusted the balance between the demanding and enabling elements of activation: whether they prioritised a regulatory approach anchored in job-search conditionality and the enforcement of conduct conditions or focused predominantly on ‘employability building’ through education, training, and work experience. The interview and survey data provide robust evidence that a distinctly more workfarist approach was being enacted by the frontline workers delivering JobPath compared with how activation was being enacted by those delivering Local Employment Services.
The Village Savings and Loan Association (VSLA) model is currently being employed in Uganda for deepening financial inclusion and poverty reduction. Despite its focus on women’s empowerment, concerns have arisen of an under-representation of women on VSLA leadership committees. Human rights-based, economic, and social justice arguments support active participation of women on VSLA leadership committees. The study sought to identify, explicate and characterise the barriers and facilitators to women in VSLA leadership. An exploratory study design using qualitative methods was selected to address the research objectives. Forty-nine focus group discussions were undertaken, featuring both VSLA members and non-members. VSLAs for inclusion in the study were randomly selected from within four regions of Uganda, stratified by: mature (>2 years old) versus new (<2 years old). The study exposed a diverse array of barriers and facilitators to women in VSLA leadership positions, revealing the influence of individual, material, institutional and social factors, in addition to social norms and gender characteristics, on women in VSLA leadership. The findings revealed that the design of interventions to achieve fair representation of women in leadership positions should be informed by an understanding of the different types, relative strengths, support for/against, and intersectionality of the factors impacting women in VSLA leadership.