Management and administration of welfare: Health, Medicine, Nursing Essay

MANAGEMENT AND ADMINISTRATION OF WELFARE
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Introduction
Though before the publication of the Beveridge Report the UK was relatively a welfare state. The report became the blueprint for the legislation that cemented the country as a welfare state. It was published in 1942, and it sought to provide a roadmap for the government to eliminate want, disease, ignorance, squalor and idleness. Immediately after the war, the Labour Party passed many legislations that created the welfare state, and most of them remained largely unchanged until Margaret Thatcher came along. Though she did not completely destroy the social services, she largely reduced it by eliminating many programs such as milk for school children and embarking on the privatization of many public organizations. She also sought to create separation between individual and state as social services had largely allowed government interference in the economy. During Thatcher’s reign, many social welfare programs came to their knees. Eventually, when she was ousted, the incoming government sought to strike a balance between state interference and the market. When David Cameron assumed power, he sought to reduce the State's reach over the third sector. His approach to social welfare is theorized to lead to better pay while also pushing welfare dependents to find work. The UK government has also created a framework to measure the efficacy of social services performance. Measuring social services performance has been a reference point for forming the legislation. For service users, the expectation derived from performance management is that service delivery will be enhanced. UK welfare system has undergone several iterations of development and has changed though it remains largely pinned on Beveridge report. Newer ways of improving the system have been suggested, including performance measurement, and it seems it is at least likely to remain at least in the foreseeable future.
Development of the UK Welfare State
In the years following the Great Depression, the standards of living of most people in the UK were poor. Millions were unemployed, and the Conservative Party, which had the reins of power, seems incapable of solving the problems. The economy was adversely affected by the depression and recovery was taking time; hence finding work was hard. Many factories had been shut down, and while unemployment remained very high, many people were languishing in poverty. The war exacerbated things as more resources were channelled to win the war. The bombing also destroyed homes and other European facilities costing many lives, fear and increased homelessness. The government had to come up with new innovative ways to set safety nets for the people as it fought the war. As the war started, things had not significantly improved, and talks for government intervention to improve the lives of its citizens prompted the commissioning of the Beveridge Report.
The main aim of the Beveridge Report was to come up with a blueprint to tidy the existing welfare system. Beveridge’s report was centered on how to fight five ‘giant evils’: want, disease, ignorance, squalor and idleness. Alongside these financial security provisions for all, there would be universal access to education and health services.
Opinion polls showed that the public wanted the implementation of the Beveridge report. The people seemed to have shifted to the left during the war. It was partly the reason why Churchill was ousted in the post-war elections. The Labour Party, which ran on a manifesto of implementing the Beveridge report took office and, in the years that followed, passed many ‘pro-welfare state’ legislations. Despite the rising cost of funding the schemes rooted in the Beveridge Report, the domestic political consensus on welfare state remained for early 30 years until Margaret Thatcher came along. Tom Marshall captured the attitude of the people when he pointed out that it was generally agreed that the overall responsibility for the welfare of the citizens should remain with the state (Deakin, Finer, & Matthews, 2004).
The report sought to find ways to generate jobs for people, use systems of family allowances, set up social insurance extending from ‘cradle to grave’, and a flat rate contribution to fund social insurance expenditures. Essentially the Beveridge report advocated for a state-run insurance system where every worker would contribute. The scheme would be used to pay out benefits of those sick, unemployed or injured, and the worker would get a pension at the end of working life. For those who were unable to contribute to the scheme, there was a second-tier welfare system of national assistance. Those seeking national assistance were subjected to a test to evaluate their eligibility. The report also advocated for universal education and healthcare system to be funded using taxpayer’s money. A state-run insurance system was key for the program as the majority of the people opposed funding the scheme using taxpayer’s money. The state's role was to establish the national insurance to fund the schemes advocated for in the Beveridge report. The state was the collecting agent and redistributed the resources to those in need. Secondly, the state was to foot the education and health bill using taxpayer’s money.
Margaret Thatcher and Neoliberalism (1979 onwards)
By the 1970s, the government bill to fund social services had ballooned. Thatcher sought to reduce expenditure on social services such as education, health care and housing. He paved the way for privatization of public housing and advocated for greater independence of the individual from the state. Earlier in the 70s, she had banned the milk for school children and compulsory charges for schooling. It was also noted that she was pushing for compulsory charges to the NHS, which would effectively mean its end. Though in the public thatcher claimed that the NHS was safe with her, behind closed doors she was strategizing on how to end it. Thatcherism was very similar to Reaganomics in the United States as the executive sought to cutting funding to social services. Newly released documents show that Thatcher proposed introducing education vouchers, ending the state funding of higher education, freezing welfare benefits and insurance-based health service (Travis, 2012). The only exceptions might be the long-term institutional care of the "mentally handicapped, elderly" who "clearly could not afford to pay" (Travis, 2012). The documents show the strategy and plan the conservative government under Margaret Thatcher had for the welfare state.
When the Labour party won the elections in 1945, the people wanted an end to wartime austerity and economic growth. The people had soaked in the Labour Party manifesto which was hinged on Beveridge report. According to the Beveridge Report, the Labor Party embarked on nationalization and in the spirit of fighting unemployment, and ought to impose regulations that could alleviate unemployment. One such policy was to increase import tax. The British government issued taxes on imported goods (66% of the price of a foreign car, for example) to encourage the consumption of local products; foodstuffs, clothing and furniture were also rationed. This was to protect the local industries and ensure they were competitive enough and could employ more citizens. The nationalization efforts were soon smothered by doubts as they fell in private shareholders' hands, notably the British Railways and coal mines. Manufacturing industries were heavily subsidized to create more jobs, and the public became increasingly affected by the government’s policies on the economy. Ministers would use their levers, such as cutting taxes and boosting state spending, to increase the level of economic activity (Kavanaugh, 2011).
Thatcher inherited a weak economy. She sought to eliminate governmental regulations and subsidies to businesses. Her economic policies sought to separate the state from the business and ensure very little if any interference. Because many of the businesses, especially in manufacturing, were hinged on different economic philosophy, the manufacturing industry was shaken and led to the loss of many jobs. Inflation also doubled in the early years of her administration. She pulled the plug on many social services. She also embarked on the privatization of state-owned industries and public services.
Voluntary Sector
Before the New Labour government’s ascension, the Deakin Commission of 1996 had released a report that called for “closer, and better managed, relations between the third sector and the state” (Alcock, 2015). It had been established that enhancing or building on the relationship between the State and the third sector would benefit society. The New Labour Party government’s approach was a continuation or a build-up of what had already been developed by the earlier governments with the 1978 Wolfenden Report’s recommendations. After getting into power, the New Labour government thus adopted policies that saw the partnership with the third sector flourish. As Alcock (2010) indicates, the government’s move was welcomed by the third sector and even led to what he calls strategic unity. The main goal of the above was to ensure that there will be collective engagement with the New Labour government. The partnership’s formalization was known as the ‘Concordat’ or the ‘Compact,’ With this, the third sector’s position was elevated (Hogg, Kendall, & Breeze, 2016).
The move to partner with the third sector was seen as desirable at the time because of the concept of a third way. The notion of the third way meant the use of the third sector as an effective proxy for public service users (Mazzei et al., 2019). Alcock (2015) confirms the above, noting that the third-way notion was built on the foundation of “what matters is what works.” The focus was to be shifted from who the service providers were to simply the effective provisio...