PUBLIC EXPENDITURE AND POLICY IMPLEMENTATION: THE CASE OF COMMUNITY CARE
| DOI | http://doi.org/10.1111/j.1467-9299.1983.tb00499.x |
| Published date | 01 March 1983 |
| Date | 01 March 1983 |
| Author | GERALD WISTOW,ADRIAN WEBB |
PUBLIC EXPENDITURE AND POLICY
IMPLEMENTATION: THE CASE
OF
COMMUNITY
CARE
ADRIAN WEBB AND GERALD WISTOW
This article explores the contention that the conventions
of
public expenditure accounting
conceal, rather than reveal, the real nature and implications of resource trends.
A
benchmark
-
a constant level of service output
-
is established as a basis for examining
the relationship between trends in expenditure inputs and service outputs. Changes in unit
costs are identified as the major source of deviation between expenditure and output
trends. The impact of resource constraint on policy and policy-implementation
is
then
examined in relation to one, essentially stable, area of policy in the personal social services:
community care.
The meaning of the term ’policy’
is
far from straightforward and community care is best
understood as the interaction
of
relatively independent streams
of
policy, towards service
outputs and resource inputs, extant in both central and local government. Mechanisms by
which policy streams could be reconciled are
of
particular interest and an innovative
example
-
joint finance
-
is examined in some detail.
Since the mid-seventies the language of ’cuts’ has rarely been far from the lips of
local government practitioners and observers. The controversy surrounding
recent central government attempts to restrict local government expenditure has
in turn generated heated debate about the implications of these expenditure
policies for local services and for the very survival‘of local democratic
government. It is therefore appropriate
to
question how, in practice, local
government has responded to this worsening resource environment and what
impact that environment has had on policy and policy implementation. We will
pursue these queries by considering the fate of the dominant policy in the personal
social services: community care. This is a useful case example because the
commitment to community care is long-standing and we can therefore examine
the impact of expenditure trends on an apparently stable area
of
policy.
The real significance of this case study, however,
is
that it forces
us
to face two
questions which are all too easily by-passed on the assumption that the answers
are self-evident. The first is simply: how can we define ’cuts’ and how difficult, in
reality, has the resource environment been since the mid-seventies? The second
is: what do we really mean by ‘policy’ and therefore the impact
of
expenditure
Adrian Webb is Professor of Social Administration and Gerald Wistow Research Fellow in Social
Administration, Department
of
Social Sciences, University
of
Loughborough. This paper has been
developed from evidence submitted by the authors to the Social Services Committee of the House of
Commons in May 1982 (Webb and Wistow 1982b).
Public Administration Vol. 61 Spring 1983 (21-44)
0
1983 Royal Institute of Public Administration.
22
ADRIAN
WEBB
AND
GERALD WISTOW
trends on policy implementation?
To
explore these questions is to move beyond
the particular case of community care and to highlight areas of conceptual and
analytical weakness which need to be strengthened.
Our approach to the first problem
-
that of defining precisely what we mean by
'cuts' and 'growth'
-
is partly conditioned by the nature of the personal social
services
(PSS),
but
the question and problem have a wider import. In the particular
case
of
the
PSS,
expenditure grew very rapidly in the sixties and early seventies,
but from a very low base. These services, therefore, faced an especially large task
of re-adjustment to limited growth or actual cuts. This process of adjustment was
eased somewhat by comparatively favourable treatment in expenditure plans up
to 1979. The incoming Conservative Government reversed this stance and
suggested that the
1%
should suffer the largest cuts of all in 198011 (a 6.7%
reduction in real terms). On the whole, however, local authorities have continued
to try to protect the services,' though their declining capacity for independent
action may be expected ultimately to reduce the degree to which such protection
can be continued. Nevertheless, the
PSS
should illustrate the comparatively muted
effect
of
expenditure policies on a favoured service area.
This general picture
of
a changing resource environment is readily stated, but
beyond the generalized picture there is only uncertainty. This uncertainty has
been well illustrated by a series of claims and counter-claims that the
PSS
have
experienced: the benefits of profligate overspending; cuts in planned growth; cuts
in unproductive bureaucracy but not in direct services; and harsh cuts leading to
closures of facilities and reductions in service provision. The confused character of
these arguments underlines our primary contention: that the language of public
expenditure accounting and debate has obscured, rather than revealed, the nature
and implications of expenditure trends.
Once we have analysed changes in the
PSS
resource environment as precisely as
we are able at present, we will proceed to explore their impact on community care.
To
do this, however, it will be necessary to recognize that far from being a coherent
policy, community care is best seen as a set of different, competing, and often
conflicting, policies which tend to be well institutionalized and therefore to exist
independently of one another. One way of describing this complexity is by
distinguishing, as we have done elsewhere (Webb and Wistow 1982a, 14-15)
between a stream of resource (input) policies and another of service (output)
policies.2
As
a resource policy, community care is about achieving
cost-effectiveness throughout a service system; as a service policy it
is
about
achieving the best mix of services with which to meet needs. The point of making
this distinction is to question whether these policy streams are effectively
reconciled, rather than to assume that they are, and to look for ways in which the
1
Spending in the
PSS
was estimated to be
16.4%
above the indicative figure for the
PSS
included in the
RSG-settlement for
1981/2
compared to
7.9%
over the settlement provis;on for local authority current
expenditure
as
a
whole.
2
We have also argued that there is a strong governance policy at work in this field. The Government
has increasingly moved from an emphasis on care in the community through the provision of local
services to care by the community. This neatly reflects its predisposition to minimize the role of the
state.
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