The Social Policy Digest went online in the summer of 2003. This means that the Digest, which used to be printed as part of the Journal of Social Policy, is now only available via the web.

Extending choice in health care is currently popular among English, and other, politicians. Those promoting choice make an appeal to a simple economic argument. Competitive pressure helps make private firms more efficient and consumer choice acts as a major driver for efficiency. Giving service users the ability to choose applies competitive pressure to health care providers and, analogously with private markets, they will raise their game to attract business. The article subjects this assumption to the scrutiny provided by a review of the theoretical and empirical economic evidence on choice in health care. The review considers several interlocking aspects of the current English choice policy: competition between hospitals, the responsiveness of patients to greater choice, the provision of information, and the use of fixed prices. The article concludes that there is neither strong theoretical nor empirical support for competition, but that there are cases where competition has improved outcomes. The article ends with a discussion of the implications of this literature for policies to promote competition in the English NHS.

Poverty research has a long history in both Australia and Britain, but its influence on policy remains subject to political priorities and ideology. This can partly be explained by the limitations of defining poverty as low income and measuring it using an income poverty line. This article examines two national data sets that allow the income poverty profile to be compared with, and enriched by, the incidence of deprivation and social exclusion, measured using data that directly reflect experience. Although a degree of care must be applied when interpreting these new indicators within and between countries, a validated poverty measure is developed that reflects both low income and the experience of deprivation and exclusion. When results for the two countries are compared, they reveal stark differences between the alternative indicators. Britain has the higher income poverty rate and, although the incidence of both deprivation and exclusion are higher in Australia, Britain still has more validated poverty. The distributional profiles of deprivation and exclusion are shown to be very different in the two countries. These differences are explained by the very low incomes of low-income households in Britain, relative to other British households and relative to their Australian counterparts. Despite these differences, the results indicate that the same three groups face the greatest risk in both countries: lone parents, single working-age people and large (couple) families.

This paper takes issue with arguments emanating from the global social policy literature that neoliberal policy agendas have been largely a consequence of the interplay of international agencies with indigenous reform interests. While relevant, such arguments grasp only part of the story of social policy change. By means of a case study of Hungary between 1990 and 2002, this article emphasises the role played by the bureaucratic reconstitution of the state and changing forms of national economic governance in the explanation of social policy change. We show how the bureaucratic redesign of the Hungarian state generated a ‘finance-driven’ form of economic governance with the state bureaucracy reconfigured around the fiscal control of the Finance Ministry. These changes had significant implications, not simply for social expenditure, but for the intellectual nature and bureaucratic space for social policy-making. Whereas critiques of neoliberal social policy reform tend to focus on the ideological nature of the projects, this analysis highlights the need to develop visions of, and arguments for, an alternative to the finance-driven forms of economic governance that have become the de facto bureaucratic archetype for re-designing welfare states.

We explore the dimensionality of attitudes towards the welfare state among university students in eight countries representing four worlds of welfare: liberal, radical, conservative and social democratic. We use new data from cross-nationally comparable 25-item questionnaires to derive a two-level bi-factorial hierarchical model that specifies six different attitude facets. These facets are clustered into two distinct sets of attitudes: the ‘market-based frame’, which entails (a) individualism, (b) work ethic and (c) internal attribution of inequality and the ‘welfare-statist frame’, which entails (d) egalitarian redistribution, (e) broad scope of welfare and (f) external attribution of social inequality. In line with our expectations, respondents across different regime types structured their welfare state attitudes according to the six a priori defined types of attitudes and two sets of opposing attitudes. The study also found that the six facets are differently affected by regime type, which further corroborates our argument that the construct of welfare attitudes is complex and inherently multidimensional.

This article reviews the policy process behind recent welfare reforms and considers the policy styles used in a broad range of social policy areas on the basis of interviews with leading policy actors. It argues that a mix of policy-making methods is currently being used, ranging from the classic top-down approach, through the use of external commissions to a more bottom-up approach, where policy is to a large degree designed by external groups. The type of policy and the power relations between key actors and the government determine the approach. Indeed, this shows a different perception of British policy-making, as the inclusive approach contrasts sharply with the traditional directive Westminster model.

Fifteen per cent of British babies are now born to parents who are neither cohabiting nor married. Little is known about non-residential fatherhood that commences with the birth of a child. Here, we use the Millennium Cohort Study to examine a number of aspects of this form of fatherhood. Firstly, we consider the extent to which these fathers were involved with or acknowledged their child at the time of the birth. Secondly, we identify characteristics that differentiate parents who continue to live apart from those who move in together. Thirdly, for the fathers who moved in with the mother and their child, we enquire whether they differ in the extent of their engagement in family life compared with fathers who have been living with the mother since birth. Finally, for fathers who were living apart from their child when the child was nine months old, we assess the extent to which they were in contact, contributed to their maintenance and were involved in their child's life at this time.

In response to population ageing, the UK intends to increase female labour supply. To this end, the Chancellor has announced a ten-year strategy designed to allow parents to combine work with family responsibilities more easily. The policies proposed centre on extending parental leave and childcare provision, while promoting greater flexibility in employment. While these policies may improve labour supply in the short term, this article looks at their implications for fertility, which if negative may reduce the labour supply in the longer term. Recent demographic studies suggest that measures which allow women more readily to combine childbearing with paid employment may also stabilise or improve fertility rates, so mitigating the trend to population ageing. However, the evidence is not conclusive, for relationships between female employment and fertility are complex and context dependent. The article suggests several factors that might therefore merit further consideration. These include gender inequities in the domestic division of labour, long working hours and a re-evaluation of unpaid work in the home. Enthusiasm for the work ethic may have to be balanced by a more explicit acknowledgement of a care ethic.

Using detailed extracts from two life histories, this article examines the nature of the personal identifications that often underpin the commitment of welfare workers to their jobs. We explore the paradox that it is those identifications such as class and gender, mediated through individual biography, that fix the ‘self as object’ and that also provide us with the resources for self-transformation. In this respect, the article not only throws light upon the psychical and emotional roots of commitment to the other, but also upon some of the impasses ‘identity theory’ currently finds itself in.