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Modernisation at the end of the 20th century
The latter half of the 20th century witnessed a reshaping of government and public services across the western world (Organisation for Economic Co-operation and Development (OECD) 2003). By the early 1980s, the post-1945 monopoly of central provision was being called into question, with concerns raised over quality and choice within public services and the increasing financial burden they placed on governments. A number of administrations of the 1980s and 1990s (as in the United Kingdom (UK), New Zealand and Australia) adopted management theories from the private sector and applied them in a raft of public-sector reforms (Hood 1991), but these did not take into account the complexity of public services when applying management processes and 'created a greater need for co-ordination while reducing governmental ability to co-ordinate' (Rhodes 2000).
In the UK, the self-styled modernisation reforms of the incoming Labour administration of 1997 drew heavily upon the neo-liberal reforms of the preceding Conservative administrations whilst attempting to overcome their failings. The modernisation reforms in health and social care exemplified this approach to public policy. For example, The New NHS: Modern - Dependable White Paper stated, 'There will be no return to the old centralised command and control systems of the 1970s ... but nor will there be a continuation of the divisive internal market system of the 1990s. ... Instead there will be a "third way" of running the NHS (National Health Service) - a system based on partnership and driven by performance' (Cm 3807 1997: para 2.1-2.2).1 In the social care White Paper, Modernising Social Services, published the following year, the emphasis was very much on empowering the service user: 'Our third way for social care moves the focus away from who provides the care, and places it firmly on the quality of services experienced by, and outcomes achieved for, individuals and their carers and families' (Cm 4169 1998: para 1.7).
Thus the consumerist approach underpinning the Conservative reforms (Cm 1599 1991), which promoted the direct accountability of public services to the service user and the idea that service quality could ultimately be enhanced through consumer choice, was still clearly evident in the modernisation reforms of the Labour...