bluuebunny/crossref_metadata_2025 huggingface dataset:
Personhood, Identity and Care in Advanced Old Age
Authors: Higgs Paul , Gilleard Chris
Published: May 2017

How do we sustain agency and identity amidst the frailty of advanced old age? What role does care play in this process? Pushing forward new sociological theory, this book explores the theoretical and practical issues raised by age and infirmity. It begins with a theoretical examination of the fourth age, interrogating notions of agency, identity and personhood, as well as the impact of frailty, abjection and ‘othering’. It then applies this analysis to issues of care. Exploring our collective hopes and fears concerning old age and the ends of people’s lives, this is essential reading on one of the biggest social issues of our time.
Agency, identity and personhood in the social sciences
Authors: Higgs Paul , Gilleard Chris
Published: May 2017

This chapter explores how terms like agency and personhood have been understood within the social sciences. It argues that there has long been a tradition of scepticism to the use of such terms and their status as ‘social realities’ rather than ‘social representations’. More recently, there has been renewed interest in concepts of ‘individualisation’ and ‘reflexivity’ as part of the cultural framework in late or ‘second’ modernity. This cultural turn toward demanding increased autonomy, choice and the necessary reflexivity to choose wisely, the chapter argues, has given the problem of dementia a more critical place in society. Addressing dementia as a particularly powerful threat to the lifelong realisation of individual life projects is a useful framework through which to explore care.
Care without limits
Authors: Higgs Paul , Gilleard Chris
Published: May 2017

While previous chapters considered care within the context of choice and options, of caring more or less, in a better or a worse way – care as a potential protection against as well as an inducer of the fourth age’s social imaginary, this chapter examines care at the extremities of dependency, particularly in relation to advanced dementia. Caring at these limits, it may be thought, is in many ways easier, since it involves less negotiation, less need to co-construct the care relationship as it becomes almost entirely a ‘relationship of one’. At the same time, such advanced care is carried out in circumstances of evident suffering when the goals of care are less about protecting the person from the fourth age and more to do with enabling the person’s ending. This is an ending delivered and managed by others whose goal at such times is to bring peace rather than restore personhood, where the fourth age may be a kind of haven, and an end to trying not to not be.
Class, inequality and community development: editorial introduction
Authors: Shaw Mae , Mayo Marjorie
Published: May 2017

In contexts across the world, community development is being rediscovered as a cost-effective intervention for dealing with the social consequences of global economic restructuring that has taken place over the last half century. This chapter introduces the term ‘community development’ and its plurality of meanings, as well as introducing the ways in which community development can be used to address inequality. The authors pose that class should be central to an analysis of inequality and the ways in which it is framed by community development strategies. The chapter then goes on to give a more detailed explanation of the terms ‘class’ ‘inequality’ and ‘community development’ and how they interplay with one another. The chapter concludes by giving a description of the layout of the remainder of the book.
Community development in the UK: whatever happened to class? A historical analysis
Authors: Craig Gary
Published: May 2017

Prior to the 1950s, differing strands of what might be seen as community development can be perceived in work by extension officers in colonial settings, as an extension of trades union activism, or ‘community-building’ with a social focus, usually in social housing areas. Yet, despite a common emphasis on poverty and disadvantage, attempts to locate community development within a class-based understanding of, for example, the unequal distribution of income, wealth and power within most societies have been limited. This chapter will trace ways in which the issue of class has or has not been addressed within community development theory and practice, drawing on key texts and experiences from across the world. It will seek to identify the extent to which the mainstream practice of community development, as it has developed, has been able to locate itself solidly within and build alliances with more explicitly class-based forms of political struggle.
Community development practice in India: Interrogating caste and common sense
Authors: Shahid Mohd. , Jha Manish K.
Published: May 2017

This chapter aims to explore the subtle relationship between social class and caste and its implications for community development practice in the Indian context. The chapter locates the ways in which ‘common sense’ conceals the subordination and oppression of the marginalised, and normalises it as a ‘natural’ process. The chapter focuses on the Balmiki community, a substantial majority of whose constituents are still engaged in the inhuman practice of manual scavenging. This practice of the manual sweeping of household dry toilets and carrying of human excreta, though banned by law, still exists in many parts of India. It has been enforced as a traditional hereditary caste-based occupation. Based on field experiences of working with the Balmiki community, the chapter explores the dynamics of social class, caste and common sense, and accordingly argues for an anti-hegemonic community development practice.
The impact of gender, race and class on women’s political participation in post-apartheid South Africa: challenges for community development
Authors: Hicks Janine , Myeni Sithembiso
Published: May 2017

The inclusion of women, and women’s participation in politics has been identified as key prerequisites for the development of an inclusive democracy and the promotion of good governance in post-apartheid South Africa. Yet women still face a series of barriers to their active participation in development policy-making and political processes, barriers that have been compounded by structural inequalities of race and social class. This chapter draws upon a recent study, implemented by the Commission for Gender Equality (CGE), to investigate institutional and structural barriers to women’s full political participation and representation, impacting both on experiences of women in political parties, and on ordinary women’s shaping of development priorities and decision-making at the local level.
What happens when community organisers move into government? Recent experience in Bolivia
Authors: Geddes Mike
Published: May 2017

Since 2005, the Bolivian government has been in the hands of the MAS (Movimiento al Socialismo), a party which defines itself as the ‘political instrument’ of Bolivia’s strong social movements which brought Evo Morales and the MAS to power. The chapter explores how conceptions of class and race are reflected in the policies of a government in which many leading figures come from a community organising and social movement background. The MAS claims that ‘state power circuits (now) pass through the debates and decisions of indigenous, worker and neighbourhood assemblies’, rather than elite channels. However, as the MAS nears its first decade in power, tensions are beginning to show. In exploring these tensions, the chapter helps to illuminate both the potential and the pitfalls of an attempt to embed radical conceptions of class and race in the state, and to foreground community organising and community development principles in government policy.
Community organising for social change: the scope for class politics
Authors: Taylor Marilyn , Wilson Mandy
Published: May 2017

Launched in England in 2010, the government-funded Community Organisers Programme was one of a number of initiatives claiming to put power back in the hands of people. However, it was introduced at the same time as the government was introducing a range of austerity policies, and the divide between the rich and the poor was growing ever greater. This chapter explores the Community Organisers Programme’s approach and the extent to which issues of class have featured in its approach and practice.
Narcissistic Parenting in an Insecure World
Authors: Hendrick Harry
Published: May 2017

This book analyses the social, political and economic reasons behind parenting trends. It shows how broader social changes, including neoliberalism, feminism, the collapse of the social democratic ideal, and the 'new behaviourism', have led to the rise of the narcissistic parent. The book charts the shift from the liberal and progressive parenting styles of the 1940-1970s, to the more 'behavioural', punitive and managerial methods of child rearing today, made popular by 'tough love' experts, and by New Labour's parent education programmes. The book argues that this trend is symptomatic of the sour, mean-spirited and vindictive social norms found throughout society today, which undermine the better instincts of parents and damage parent-child relations. The book urges parents to focus on helping and understanding their children as they work at growing up.
Introduction
Authors: Hendrick Harry
Published: May 2017

The chapter introduces the reader to the book's argument, themes, broader context, and methodological considerations. It discusses the central thesis, which is in two parts. First, between the 1920s and the late 1960s the culture of parenting progressed away from being characterized mainly by disciplinary attitudes towards one that was increasingly psychoanalytically informed and, particularly from the 1940s through to the early 1970s, also began to emphasize liberal social democratic ideals. Second, from the 1970s to the present, under the influence of neoliberalism, feminism, social liberation (permissiveness and identity politics), and structural economic/political reconfigurations, the social democratic ideal declined and popular child-rearing came to be represented by 'authoritative' ('tough love') parenting styles reflecting neoliberal and narcissistic values expressed through a form of adult-child relations governed by childism - 'a prejudice against children.’
The ‘long sixties’: 1958–1974
Authors: Hendrick Harry
Published: May 2017

The theme of this chapter is the emergence by the late 1960s of an environment that gradually became more hostile to the social democratic family and to liberal progressive child rearing. The key themes of the chapter focus on the concerted political attempts to undermine 'Bowlbyism' (including the influence of Winnicott), particularly by feminists and Bowlby's enemies in the psychological/psychoanalytic community. In order to contextualize the 'dethroning' of Bowlbyism, the chapter considers the emergence of new social problems in relation to the changing perception of children (through the re-discovery of poverty and the spectre of juvenile delinquency), the failure of the Children's Rights movement, the ending of progressive primary education, and the hostility of the New Left to many of the values of old style social democracy.
The New Labour era, and beyond: narcissism comes of age
Authors: Hendrick Harry
Published: May 2017

After describing New Labour's use of 'the child' as a form of human capital in social investment, and its penal ASBO programme as a breeding ground for childism, the chapter focuses on the government's innovatory ideal of disciplinary governance, encoded in neoliberal practice, to explain how, with reference to parent education, the behavioural approach to child-rearing grew to be regarded as normal and natural. The chapter discusses Supernanny, the reality television show, as an example of how, through the principles of narcissism, behaviourism and childism were popularised. The chapter argues that the effect of the neoliberal parenting industry on parent-child relations has been to negate the 'unconditional' in parental love in preference to a managerial and contractual approach that epitomises the general principles of neoliberalism and the specifics of the narcissistic temperament.
Sickness in slavery and freedom
Authors: Hill Shirley A.
Published: May 2017

The health deficit of African Americans is explored in a historical context, starting with the abuse, poor treatment, and sub-standard medical care Blacks received during and after slavery. Segregation was the law of the land until the 1960s, and African Americans not only received marginal health care but faced significant barriers in access to medical schools. This chapter looks at the battle to end segregated medicine and the gradual acceptance of black people in medical schools and as members of the American Medical Association.
Introduction
Authors: Seal Mike , Harris Pete
Published: May 2017

In this chapter, the authors introduce the ‘problem’ of youth violence, as well as introducing the youth workers who attempt to redress this problem through youth work. The authors state that they will use case studies in the remainder of the book to investigate, through practical examples, how processes of intervention, prevention and desistance work. In doing this, they will provide an accessible vision for what constitutes a more meaningful youth work response to youth violence. They then go on to outline the structure of the book.
Rethinking some youth worker ‘tales’
Authors: Seal Mike , Harris Pete
Published: May 2017

This chapter begins by challenging workers to critically interrogate what the authors see as archetypal youth work ‘tales’. The authors highlight how some youth workers can over-privilege and idealise their own relationships with young people and need to be wary of over-identifying with them to such an extent that challenging their violent behaviour falls off the agenda. They also argue that youth workers need to develop greater conceptual clarity, especially around notions of respect and trust. With the former, for example, workers may need to make distinctions between earned, intrinsic respect, and respect that is based around fear. The chapter explores how workers might encourage young people to reflect on self-respect and how status is constructed in their community and culture, working on alternative attainable and sustainable ways to develop it. The authors then cast a critical eye over the relationships between youth workers and professionals from other agencies, arguing that youth workers should not develop a crab mentality towards these agencies but rather seek to present the distinctive, but not unique, contribution they can make.
Order and disorder
Authors: Millie Andrew
Published: May 2017

Criminology is intrinsically concerned with questions of order and disorder. Philosophy can help understand people’s conceptions of order and the mechanisms which take place that make order more likely to occur. The importance of social order in criminology and how it can be maintained is considered. As well as ideas about how we can live together at a time where this increasing emphasis on the importance of individualism and always putting yourself before others. How can social existence be encouraged within a society of individuals? This chapter also looks at disorder, drawing from Emile Durkheim and Robert Merton’s perspectives on anomie and chaos theory. Furthermore, this chapter continues the discussion about aesthetics and crime by placing order as a central aspect of aesthetics.
Extending the ‘desistance and recovery debates’: thoughts on identity
Authors: Hamilton Paula
Published: May 2017

This chapter introduces ideas of identity and identity transformation in processes of personal change. The author starts by exploring what is meant by identity, and analyses the two theoretical frameworks most commonly employed by the writers in this collection – narrative theory and social identity theory. She then draws on concepts such as Goffman’s (1963) ‘spoiled identity’ and Braithwaite’s (1989) ‘master status’ to consider ways in which involvement in offending, substance misuse and other ‘problematic’ behaviours and lifestyles can be implicated in an individual’s sense of self and, of course, the views that others take of such individuals. She highlights key implications in terms of stigma, discrimination and cumulative disadvantage and how these processes can represent obstacles to change.
Growing out of crime? Problems, pitfalls and possibilities
Authors: Robinson Anne
Published: May 2017

This chapter considers questions of identity during adolescence and in the transition to adulthood, noting that the latter often involves a parallel transition out of youthful delinquency. The focus is on narrative identities and developing sense of biography as revealed across a range of empirical studies. The author also begins to explore how young people exercise agency in their construction of life stories and narratives of self, particularly where they have few resources to enable them to present themselves ‘well’, and may also be designated by others as in some way ‘troubled or troublesome’. Difficult or fractured transitions may have knock on effects for developing positive adult identities and practices, and may trap some young people in a position where their ‘offenderhood’ is both internalised and externally reinforced in their social relations. The challenge is then how to offer meaningful opportunities for growth and early forms of generativity.
Street harassment activism in the twenty-first century
Authors: Keyhan Rochelle
Published: May 2017

The experience of gender-based violence, and the internalised shame and self-blame that so often accompanies it, hinders the full emancipation of women and lesbian, gay, bisexual or transgendered (LGBT) members of society. This chapter examines CSOs currently working toward ending street harassment. Technological advances have created innovative options for today’s CSOs to unite in unprecedented ways. Modern activism will be highlighted through a case study of Hollaback!, an international network of unified activists who simultaneously work locally and globally to fight street harassment. Research and academic discussion about street harassment and the culture that sustains it have lagged far behind global anti-street harassment activism. Street harassment activists emphasize shifting cultural perspective to a perpetrator-focused, survivor-centred approach that supports survivors. The chapter concludes with an analysis of how the internet has provided organizations and activists the capacity to embrace intersectional and cross-cultural ideals.
How a feminist activist group builds its repertoire of actions: a case study
Authors: Hildwein Fabien
Published: May 2017

This chapter analyses the tactical repertoire of a French feminist group focusing on the absence of women in high positions in organisations and in positions of power. The article presents an example of a CSO actively promoting the emancipation of women and introducing new theoretical perspectives, by questioning French feminism. Theoretical and ideological resources can provide a good starting point for the struggle for women’s emancipation, enabling women to create new tactical repertoires to voice their claims and reveal patterns of domination. The analysis presented here describes the strategy of an activist group attempting to trigger change in organisations and in management practices and demonstrates how a social movement is influenced by its theoretical inspirations. The chapter concludes that research into the tactical repertoires of social movements should pay more attention to the theoretical inspirations that motivate activist groups and to the innovations conducted by activists in renewing their repertoire.
From feminist extravagance to citizen demand: the movement for abortion legalisation in Uruguay
Authors: Pousadela Inés M
Published: May 2017

This chapter illustrates the crucial, decades-long contribution of Uruguayan women’s organisations to the emancipation of women. It does so by analysing the political process leading to the recent legalisation of abortion in Uruguay, as well as the multiple strategies resorted to by the women’s movement to create a social consensus around women’s rights – and sexual and reproductive rights in specific – as integral to human rights. The story of the struggle for the legalisation of abortion in Uruguay also demonstrates the fragility of rights; as Uruguayan women’s organisations have learned the hard way, rights should never be taken for granted. Steps backwards are always possible and emancipation is never complete; further action will always be required to secure rights, as well as to advance new generations of rights.
Working within associations: recognition in the public space for women?
Authors: Dussuet Annie , Flahault Érika
Published: May 2017

Today, working in paid employment is the norm for women in France, and many of them are working in associations, which the authors regard as a specific type of civil society organisations. In this chapter, the authors enquire whether working in associations can lead to women’s emancipation. Firstly, they show that associations play an important economic role for women and create a particularly distinctive relationship to work, but they also emphasise the poor quality of the jobs in which women are disproportionately represented. The authors then discuss the effects of women’s employment in associations in terms of emancipation: they suggest that associations tend to maintain gendered norms rather than challenging them even when the organisations are feminist oriented. The risk is then that women may not achieve real recognition for their contribution unless the associations engage in a clear policy in favour of equality between men and women.
Flexible working practices in charities: supporting or hindering women’s emancipation in the workplace
Authors: East Sally A , Morgan Gareth G
Published: May 2017

This chapter explores the debates and practices regarding flexible working in the context of the charity workplace, and examines the consequences of these practices for women in their dual role of adult/child-carer and employee. The arguments presented here are drawn from an original study involving 30 interviews in four medium-sized service-providing charities registered in England and Wales (East, 2013), and offer a snap-shot to help us determine whether flexible-working practices assist or impede women’s emancipation. The authors further explore why flexible-working arrangements are primarily utilised by women rather than men, asks whether women are coerced by organisational, personal or societal pressures to take the lead as primary carer, and if so, how this affects their roles in the charity workplace. The discussion touches upon the debates surrounding diversity, equity and the significance of nature versus nurture in shaping identity.
Examining and contextualising Kenya’s Maendeleo ya Wanawake Organisation (MYWO) through an African feminist lens
Authors: Lutomia Anne Namatsi , Sanya Brenda Nyandiko , Rombo Dorothy Owino
Published: May 2017

In this chapter, the authors apply African feminist lenses to evaluate the activities of the Maendeleo ya Wanawake Organisation to determine its role in the emancipation of Kenyan women. Maendeleo has gone through difficult periods based on social, cultural, and identity politics within the organisation as well as in response to the shifting national political landscape. However, despite these challenges and contradictions, Maendeleo has been a conduit for elite women to attain political leadership positions, has provided economic assistance to women in some regions, developed a programme for eradicating female genital cutting while sustaining the rite of passage in the eastern province, participated in international conferences and played social and political roles in changing the status of Kenyan women’s rights. Still, the extent to which Maendeleo has achieved emancipation for women is negligible.
Private landlords: ‘Rachmans’ or ‘residential property-owners’?
Authors: Lund Brian
Published: May 2017

This chapter charts the politics involved in the decline and post 1997 growth in the private landlord sector of the housing market. Slum landlord politics in the 19th and early 20th centuries are examined with particular reference to landlord involvement in local politics and labour movement attitudes to private landlords, culminating in the Glasgow rent strike. The electoral politics of rent control from 1915 are explored with the 1957 Rent Act given detailed consideration. The political reasons for the growth in private landlordism post 1997 are investigated with the role of Buy to Let highlighted. The contemporary politics of private landlordism are considered in relationship to the growth of generation rent, Housing Benefit expenditure, rent regulation and institutional investment in private landlordism.
Eclipsing council housing
Authors: Lund Brian
Published: May 2017

This chapter examines the politics involved in local authority housing supply. It records hostility to the idea, especially to subsidised council housing, at the end of the 19th century and Lloyd-George’s crucial role in securing its acceptance in 1918. It charts Conservative attempts to direct state help towards needs arising from slum clearance and its implications for housing form. The politics involved in the growth of council housing in the post Second World War period are examined in relationship to the Conservative revival of the sanitary approach, the protection of rural Britain, high- rise construction and the role of the architectural profession. The political implications of the residualisation of council housing are explored with reference to the image of council housing and attitudes towards its tenants.
Homelessness politics
Authors: Lund Brian
Published: May 2017

This chapter focuses on the salience of homelessness constructions reviewing how the various meanings attached to homelessness ― masterless men, vagrancy, destitution’, houseless poor’, rootless’, statutory homeless and rough sleepers ― have had lasting political importance with their structural/agency dimensions framing wider debates on the housing issue. It examines the political processes involved in homelessness designations reflected in the Poor Law, vagrancy legislation, the 1977 Housing (Homeless Persons) Act, rough sleeper initiatives and the prevention strategy adopted by New Labour and the Coalition government. It explores the application of the perverse incentives notion to homelessness and the political importance of the headline figures generated by the operations of homelessness legislation. The politics of Housing First are examined.
Probation and criminal justice, 1997–2015: from New Labour to the Coalition government
Authors: Whitehead Philip
Published: May 2017

This chapter excavates substantive developments in probation, criminal justice, and penal policy, from the election of new labour in 1997 to the end of coalition government in 2015. New labour modernised and the coalition government transformed the criminal justice system, an essential component of public service reform. The latter constituted a series of political incursions that culminated in a rehabilitation revolution. By October 2014 a large proportion of probation work had been privatised through the creation of 21 Community Rehabilitation Companies. Payment by Results is an important signifier of substantive ideological and material changes throughout the system of justice in England and Wales.
Crafting public policy: choosing the right social science method
Authors: Stoker Gerry , Evans Mark
Published: May 2017

This chapter aims to give a realistic account of how to select a method and so provide the reader with a guiding introduction to the methods that follow. It argues that the choice of method to aid policymaking will reflect a range of factors. For example, the breadth and range of evidence that is already available, or the need to gain insights from hard to reach citizens.
Systematic reviews for policy
Authors: Gough David , Tripney Janice
Published: May 2017

The authors argue that learning from existing evidence is a key skill both for researchers and policy makers. However, how do you go about accomplishing this? What are the key approaches, and how do you make the right choices? Additionally, what are the common pitfalls? This chapter gives the reader a guide to best practice in systematic reviews.
Narrative and storytelling
Authors: Lowndes Vivien
Published: May 2017

This chapter discusses how policymakers tell stories. Each piece of legislation and policy advice is a narrative in its own right, proposing specific links between ideas, actions, and institutions. However, what stories do they listen to in formulating policy, and can social scientists influence this process? This chapter argues that by constructing stories that ‘resonate’ with policymakers’ everyday experience (based on case studies, action research, appreciative enquiry or ethnography), social scientists are able to facilitate processes of critical reflection and creative thinking.
Microsimulation modelling and the use of evidence
Authors: Tanton Robert , Phillips Ben
Published: May 2017

This chapter provides an overview of microsimulation modelling and how it is used to evaluate policy with an emphasis on tax and government cash benefits. The chapter will provide a brief history and introduction to microsimulation modelling.
Restructuring care: concepts and classifications
Authors: Adamson Elizabeth
Published: May 2017

This Chapter discusses the complexities of defining ‘in-home child care’, which are linked to broader conceptualisations of care and the welfare state that cut across the informal/formal and public/private domains. Key terms that are central to the analysis of care analysis are discussed, including informalisation/formalisation, privatisation, marketisation, familisation and commodification/decommodification. The chapter also outlines and explains the emergence of the term ‘social investment’, an idea that has driven Western (and some developing) countries’ recent investment in ECEC. Governments tend to rationalise involvement in the funding and delivery of ECEC in relation to perceived needs and policy problems. This part of Chapter 2 presents key social investment narratives, specifically as they relate to rationales for public spending on ECEC. The concepts of ‘care ideals’ and ‘care culture’ are also introduced.
Policy structures in Australia, the UK and Canada
Authors: Adamson Elizabeth
Published: May 2017

This chapter provides a comprehensive account of the policy details that shape the supply and demand of in-home childcare in each country. Based on a structural approach to analysis, the different funding mechanisms, eligibility criteria, regulatory requirements and migration rules are detailed to compare and contrast how in-home childcare is supported by governments in each country. It focuses on how nannies and other forms of in-home childcare are situated within ECEC structures, but also considers broader policy influences, namely immigration policy and regulation. The second part focuses on the intersection of these policy mechanisms to highlight some tensions and inconsistencies in governments’ approaches to supporting in-home childcare. This chapter provides a foundation for Part 2 of the book, which turns to the rationales and implications of in-home childcare policies.
Orders of change in the ordered changes in the NHS
Authors: Powell Martin
Published: May 2017

The author introduces the difficulty in conceptualising or measuring change in health systems. The author states that in this chapter draws on the account of Hall which differentiates between first, second and third order change. It views policymaking as a process that usually involves three central variables: the overarching goals that guide policy in a particular field, the techniques or policy instruments used to attain those goals, and the precise settings of those instruments. Hall regards change in settings as first order change; changes in instruments and settings as second order change; and changes in all three components – instrument settings, the instruments themselves and the goals – as third order or paradigm change. Implementing some aspects of this approach, this chapter tracks the main policy measures introduced by the Coalition’s Health and Social Care Act of 2012 backwards to the Conservative government of 1979.
NHS finances under the Coalition
Authors: Charlesworth Anita , Roberts Adam , Lafond Sarah
Published: May 2017

This chapter introduces some of the challenges the NHS faced over the five years of Coalition government. ‘The Nicholson Challenge’ arose following the 2008 global economic crisis. The NHS was faced with making £20 billion of efficiency savings over the next 4 years from 2011/12 to 2014/15. The Quality, Innovation, Productivity and Prevention (QIPP) programme was created to deliver these efficiency savings. The chapter discusses the various challenges faced by the NHS during these the years of this ‘Nicholson Challenge.’ The authors point out that there were various problems with the approach to measuring savings under the QIPP programme. They also evaluate the Payment by Results tariff. The chapter concludes by making some international comparisons, looking at ways in which OECD health care spending was effected during this period.
The central management of the English NHS
Authors: Greer Scott L , Rowland David , Jarman Holly
Published: May 2017

The English NHS, serving over fifty million people, is one of the largest health care systems in the rich world. Because of this, the NHS’s political directors have long been preoccupied with making the NHS respond to its political direction. Since its creation in 1948, there have been constant attempts by Ministers to keep the NHS under central political control in ways which are commensurate with the political salience of the service, and the high levels of taxpayer funds which pay for it. This chapter discusses the central management of the NHS and reviews the central management of the NHS in 2010, then focusing on the architecture proposed for it by the Coalition reforms and its subsequent evolution.
Clinically led commissioning: past, present and future?
Authors: Checkland Kath , Coleman Anna , McDermott Imelda , Peckham Stephen
Published: May 2017

One of the key elements of the Health and Social Care Act 2010 (HSCA 2012) was the transfer of responsibility for commissioning healthcare services from managerially led Primary Care Trusts (PCTs) to newly established Clinical Commissioning Groups (CCGs), led by General Practitioners. In this chapter, the authors explore what can be learned from previous attempts to involve GPs in commissioning care. They then apply that learning to the provisions of the HSCA 2012, highlighting the correspondences and discontinuities between what is known from history and what was proposed. They then present evidence from their research on CCGs, exploring what happened in practice when CCGs were established. Finally, the authors discuss the continuing evolution of health policy in the UK in the light of both historical evidence and their current findings.
‘Much ado about nothing’? Pursuing the ‘holy grail’ of health and social care integration under the Coalition
Authors: Miller Robin , Glasby Jon
Published: May 2017

Seeking greater integration in the delivery of health and social care has been a longstanding aim of different governments over time, yet deep-seated and seemingly intractable barriers remain. While the Coalition has stressed the importance of integrated care and introduced a number of new initiatives, it remains open to question as to whether health and social care are more or less joined up than they were in 2010. Against this background, this chapter begins by summarising the state of play at the end of the New Labour governments of 1997 – 2010 and the main reforms introduced under the Coalition government of 2010-15. The chapter considers the emerging evidence about the impact of the Coalition’s policies, and offers some thoughts on how such developments might be interrupted. The chapter draws on both formal and informal sources of knowledge and seeks to combine a review of the published data with some more personal reflections. In the process, a ‘three stream multidimensional policy implementation framework’ is used to critique the implementation of integration policy by the Coalition.
Public health: unchained or shackled?
Authors: Hunter David J
Published: May 2017

As in the case of other parts of the UK wider health system, it has been a turbulent time for public health since 2010. Not only has the function undergone major structural and cultural change following its return to local government from the NHS, where it had been located since 1974, but it has had to confront new challenges in public health arising from lifestyle behaviours and a widening health gap between social groups. All of this has occurred during a period of unprecedented financial austerity affecting public services in general but local government in particular. This chapter reviews the state of public health in the lead up to the changes announced by the Coalition government in 2010. It then summarises the reforms before offering an interim assessment of their impact. Finally, it discusses the evidence to date concerning the reforms and speculates on likely prospects in the years ahead.
Setting the workers free? Managers in the (once again) reformed NHS
Authors: Hyde Paula , Exworthy Mark
Published: May 2017

Despite repeated reorganisations, the NHS continues to be under severe pressure as it faces profound challenges in terms of growing patient demand, shrinking resources and a rise in external competition. Managing the healthcare workforce was a central focus for Coalition government reforms and it continues to present several challenges; not least that demand for workers often exceeds supply and workforce is often the single most expensive budget item. This chapter identifies recent trends in staffing across the NHS and specifically builds on a growing body of research on NHS managers and NPM. The authors take a broad sweep from the 1980s but focus mainly on the 2010 – 2015 period of the Coalition government. They frame their argument in terms of the shift towards entrepreneurialism. The chapter is divided in to two sections. The first examines the context of and background to recent reforms of NHS staffing. The second examines the state of NHS management and identifies the challenges that remain.
Health and Wellbeing Boards: The new system stewards?
Authors: Coleman Anna , Dhesi Surindar , Peckham Stephen
Published: May 2017

Health and Wellbeing Boards (HWBs) emerged from debates about the Health and Social Care Bill (2011) as a key coordinating mechanism or steward for local health and social care systems. For many this is yet a further attempt to improve coordination between health and social care services which historically has been a mixed experience. The rationale for HWBs, however, includes a broader coordinating function across local authority services with a role in addressing the wider social determinants of health such as housing, education and planning, as well as social care. This chapter examines the development of HWBs and draws on the findings of studies conducted by the authors and considers whether or not HWBs are emerging as system stewards. By this the authors mean HWBs acting at a strategic level to coordinate and set the direction of health and social care developments at the local level, as well as encouraging integrated working.
Blowin’ in the wind: The involvement of people who use services, carers and the public in health and social care
Authors: Newbigging Karen
Published: May 2017

Patient and public involvement (PPI) is often framed in terms of addressing the democratic deficit in the NHS but in England, since 2000, it has become increasingly aligned with the reform of the NHS to become patient centred by enabling people to exercise choice as a right and responsibility across all aspects of healthcare. Since then, there has been a rapid diversification of approaches to and methods for PPI, which experienced organisational turbulence under the Labour administration. This chapter discusses the evolution of PPI in England before 2010, and it examines the Coalition’s reforms of PPI, and the implications of these reforms.
‘Groundhog Day’: the Coalition government’s quality and safety reforms
Authors: Powell Martin , Mannion Russell
Published: May 2017

Quality and safety are defined and measured in different ways by academics, commentators and agencies, while the relationships between them are viewed in different ways. Raleigh and Foot write that while the definitions of quality vary in different settings, some themes – safety, effectiveness and patient experience – are common to most quality frameworks and are regarded as the three pillars of quality in healthcare. This chapter examines these three pillars, and, after a brief review of earlier periods, it focuses on reforms in England under the Coalition government. It then explores the impact of reforms on quality and safety, providing a wider comparative perspective.
Mediated Representations and Understandings of Co-Offending Women
Authors: Barlow Charlotte
Published: May 2017

This chapter begins by introducing readers to the significance of the social construction of crime and criminal justice issues. It outlines the existing literature which explores the dominant ways in which female offenders and co-offenders are represented in media and legal discourse, particularly drawing upon dichotomies such as bad/ mad. It also considers the ways in which gendered constructions, such as ‘bad mother’ (Barnett, 2006), evil manipulator (Jewkes, 2015) and mythical monster (Heidensohn, 1996; Jewkes, 2015) permeate media representations of female offenders.
Coalition health policy: a game of two halves or the final whistle for the NHS?
Authors: Powell Martin
Published: May 2017

This chapter contains an analysis of the development of the NHS under the Coalition Government. While some argue that under the Coalition Government the UK approaches the end of the NHS, the analysis shows that the reforms initiated by the Coalition Government have diverging directions and diverging ideological foundations. Whereas in the first part of the Coalition Government’s rule merely competition, privatization and marketization dominated the debate, the second part stills carries the heritages of the neo-liberal paradigm but also introduces other measures to improve the performance of the NHS and guarantee its financial sustainability: prevention, integration and localisation. But the question is if these initiatives are strong enough to guarantee a bright future for the NHS.
Citizenship, conduct and conditionality: sanction and support in the 21st-century UK welfare state
Authors: Dwyer Peter
Published: May 2017

This chapter shows how the evil giant of ‘idleness’ has returned in the political debate, but with new features. In the current age, the welfare state is no longer considered as a solution for idleness, it is also assumed to cause idleness. This chapter shows how T.H. Marshall’s notion of social citizenship in which largely unconditional, de-commodified social rights have been replaced by a system of behavioural conditions and sanctions in different domains of the welfare state. The main focus of this paper is on conditionality in social security benefits, housing and homelessness. The chapter shows an intriguing picture of how the twenty-first century welfare state is concerned with regulating individual behaviour.
Right time, right place? The experiences of rough sleepers and practitioners in the receipt and delivery of personalised budgets
Authors: Brown Philip
Published: May 2017

This chapter outlines one way in which personalisation has been implemented within the field of homelessness within the United Kingdom. The chapter draws on research findings from a longitudinal study in Wales, which evaluated the delivery of an approach to allocate ‘individual budgets’ to people experiencing homelessness. The chapter outlines the effectiveness of the approach both in terms of outcomes for those who participated as recipients and its operationalisation by workers. The chapter makes a number of central points. First, individual budgets can be a particularly effective tool in reducing the length of time homelessness is experienced. Second, how such budgets are delivered is as important as the budgets themselves. The skill of workers to work in innovative and creative ways is crucial to their success. Finally, there are inspiring findings arising which point to the pragmatic yet frugal approach by rough sleepers towards the use of individual budgets.
Personalised care funding in Norway: a case of gradual co-production
Authors: Christensen Karen
Published: May 2017

In this chapter, using a case analysis of personal assistance in Norway, the author argues that it is fruitful to combine the concepts of personalisation and co-production. Co-production represents a stronger version of personalisation, but there are also different strengths of coproduction, implying gradual manifestations of user involvement and participation. Through exploring the history of the Norwegian personal assistance model, BPA, the chapter considers different interplays between personalisation and co-production. It concludes that there is the highest level of personalisation where the professionals are no longer directly involved because the users are self-organised. While this obviously is the future policy aim of some users, this will not be an option for others. The right to BPA will provide a future dividing line between those who possibly will be viewed as able to reach this self-organising level, and those for whom the welfare state will still be very important.
Islamophobia
Authors: Zempi Irene , Awan Imran
Published: May 2017

This book examines British Islamophobia both in the cyber and physical world. Drawing from qualitative data elicited through a national UK-based study, this text considers the online and offline experiences of ‘visible’ Muslim men and women as victims of Islamophobia and the impacts of these attacks upon victims, their families and wider communities. Key themes that emerge from the research findings include ‘trigger’ events of local, national and international significance. Accordingly, terrorist attacks carried out by individuals who identify themselves as being Muslim or acting in the name of Islam – such as the Woolwich attack, the atrocities committed by ISIS and attacks around the world such as Sydney, the Charlie Hebdo and Bataclan attacks in Paris, as well as attacks in Copenhagen and Tunisia – increase Muslims’ vulnerability to Islamophobic attacks, both online and offline. The book highlights the multidimensional nature of Islamophobia, and recognises the fact that there is a relationship between online and offline Islamophobic attacks, especially in the globalised world. The Short concludes with recommendations for preventing and responding to Islamophobia, both online and offline.
Triggers of Islamophobic violence
Authors: Zempi Irene , Awan Imran
Published: May 2017

This chapter examines the factors that determine the prevalence and severity of Islamophobia, namely ‘trigger’ events of local, national and international significance. Correspondingly, participants in this study reported that the prevalence of both online and offline Islamophobia increased following recent high-profile terrorist attacks around the world such as Sydney, the attacks in Paris, Copenhagen and Tunisia. In addition, national scandals such as the grooming of young girls in Rotherham by groups of Pakistani men and the alleged ‘Trojan Horse’ scandal in Birmingham framed as a ‘jihadist plot’ to take over schools, were also highlighted as ‘trigger’ events. The visibility and intersectionality of victims’ identities is also discussed.