Conventionally, the discussion of the welfare state has focussed on the ‘Five Giants’ – want, idleness, ignorance, squalor and disease – and the services intended to deal with them. However, the focus of this book has been a discussion of the role of the institutions of the welfare state, rather than a focus on poverty and disadvantage, and the discussion of those institutions would not be complete without a discussion of the public services.

The ‘public services’ take into account such broad areas as policing, justice, roads, street lighting, waste disposal, museums, libraries and public transport. Public and social services have important elements in common. Many of these services grew from similar roots – in particular, the structures developed to manage the Poor Law, which led to the establishment of local government in the course of the nineteenth century. Social and public services have a definable institutional structure, they are all seen as part of the remit of government, and in so far as they are actually provided directly by government, they are publicly financed. The public services have not, however, always been seen as part of the ‘welfare state’ – and it is noteworthy that while people who use services such as schools or medical care are being described as ‘dependent’, people who ask the police for help, walk on a pavement or visit a museum are not. Many of us might wish that social services were viewed more like public services – that the service should there for everyone, and taken for granted in the same way as street lighting or drains – but the fact is that they are not seen as equivalent.

Public services have four key features. The first is that they are services to the public – not in the economic sense, which hinges on what they are selling, but in the social sense, that they actually do something directly to benefit people. Roads, sewers, parks, schools and social housing all deliver services to the public. Public functions which serve government, like IT or audit, do not, so they are not ‘public services’ in this sense; nor are areas of government activity, however important, which are focussed on other issues, such as economic management or foreign policy.

Work with ‘equalities’ was not part of the original conception of the welfare state, but a focus on some equalities has since become part of the institutional structure. It is true that major pillars of the welfare state were built in part with the intention of dealing with inequality, mainly understood either in terms of class (as it was in housing and education) or income; and it is also true that other aspects of inequality, notably inequalities in health, have become part of the agenda. ‘Equalities’, for all that there is much about the term that overlaps with inequality of those kinds, address a somewhat different set of issues.

Inequality rests in a relationship of advantage or disadvantage. Saying that people are ‘unequal’ is not the same as saying that they are different; it is a statement than some of them have an advantage over others. A claim for equality between the sexes, for example, does not mean that everyone should be the same sex; it means that women should not be disadvantaged relative to men. And a claim for greater equality for disabled people does not mean that everyone should have the same capacity; it means that people with disabilities should not suffer greater disadvantage because social life is not arranged with them in mind. The pursuit of equality is about the removal of disadvantage.

There are however two key differences between the general concept of ‘equality’ and the specific practice of ‘equalities’. First, ‘equality’ can be, in Rae's terms, ‘individual-regarding’ – looking at the status of each and every person as an individual – or ‘bloc-regarding’, looking at whole groups such as women, minority ethnic groups or LGBT groups. Some of the debates about inequality are mainly concerned with the position of individuals and families – examples are debates about poverty, or living wages, or housing conditions. The main focus of ‘equalities’, by contrast, is bloc-regarding. When we think about such issues as the disadvantage of women, we are comparing one bloc – ‘women’ – to another group – ‘men’. A woman with high income may seek to have disadvantage corrected; a man with lower income may not be able to.

In the course of this book, I have spent some time trying to explain that the issues which have captured attention are often a poor guide to the problems or the performance of the welfare state. Because they misrepresent the issues that services have to deal with, they fail to address the problems with those services that people actually experience, and they distract from the things that need to be done.

That is not to underestimate the power of the narrative. If policy-makers are convinced that the welfare state makes people demanding and dependent, that money spent on welfare is wasted, that welfare is being undermined by false and fraudulent claims, that welfare was only ever supposed to be a safety net, they will take action to deal with those supposed problems. In doing that, they often create further problems in turn. Sometimes the problems that leads to are newly minted. People have been plunged into poverty because of the punitive conditionality introduced after 2008; hundreds of thousands of people have had their only source of income stopped for a month or more. Sometimes the problems that are generated are the very problems that they are supposed to be avoiding. For example, measures to target benefits more precisely are liable to generate wrongful payments. The fraud and error associated with the State Pension is estimated to be 0.1%; but the fraud and error associated with the means-tested Pension Credit appears to be 5%, fifty times greater than the non-means-tested benefit. Pensioners are not generally thought to be fraudulent, and the first figure shows they are not; the second figure shows what goes wrong when the criteria become more detailed. Tighter controls lead to stricter boundaries, and stricter boundaries lead to problems in policing those boundaries.

Some wrong directions

In just about every area of policy I have considered, policies have been diverted, deflected or misplaced because of a set of misconceived beliefs. Four of the false trails stand out as particularly destructive.

Choice and personalisation

‘Personalisation’ has been argued for in a wide range of services – including services to older people, psychiatric patients, learning disability, people with addictions, offenders, school pupils, homeless people, benefit recipients and the unemployed. The central premise is that people should have a choice about the service they receive.

There is a general presumption, not only in Britain, that the best place for a child to grow up is in a family, and the family will be responsible for caring for that child until the child becomes an adult. The UN Convention on the Rights of the Child states that ‘the child, for the full and harmonious development of his or her personality, should grow up in a family environment, in an atmosphere of happiness, love and understanding’. As part of that, there are protections for family life. Raising children is a matter for parents to decide; this is treated as part of the private sphere, rather than the public domain. But there are two reservations to make about this. The first is that parents’ rights are not absolute or inviolate: their rights are only a reflection of the rights of the child. The second is that some families fail, and some fail in particular in their responsibilities to children.

There is no such thing as a British family policy, but there are lots of policies which might be considered to fall into the general area of ‘the family’. It is probably still true to say, though less true than it was fifty years ago, that policy in the UK is based on an idealised model of a normal ‘nuclear’ family, in which two biological parents take responsibility for raising children. At any given time, about a quarter of all children live with lone parents. About one-fifth of children have no contact with non-resident fathers after two years. (The relationship does not seem to be determined by the extent to which fathers have previously been involved with their children.) Because being single is, for many lone parents, a transitional stage, rather more children can be taken to have experienced separation from one of their parents – that may not square with the preconceptions about the norm, but it is relatively commonplace.

The implicit emphasis on the ‘normal’ family is evident in the presumption that children need to be with their birth family; it is also inherent in the idea that some families are doomed to fail because of their deviant behaviour or refusal to conform to social norms.

The employment services sit rather uncomfortably between two opposed understandings about what a welfare state should do about unemployment. One of those is structural: employment and unemployment are determined by the state and structure of the economy. Beveridge identified a range of factors which contributed to unemployment: some was seasonal, some casual, some ‘frictional’ – the delay in moving to new work; but much was cyclical, depending on the general state of the economy. Full employment was presented, in the Beveridge report, as one of its key ‘assumptions’ – a policy that was necessary if the rest of the scheme was to work. At the time, there were grounds for confidence that unemployment could be dealt with. Governments knew, thanks to the ideas of John Maynard Keynes, what they needed to do to secure full employment, and it worked. In a White Paper in 1944, the wartime coalition committed the governments that would come after them to do so. Britain had full employment, more or less, for the best part of twenty-five years after the war. Governments eventually abandoned the policies which had brought that about because they felt that other economic objectives – growth, inflation and the creation of a ‘flexible’ economy – were more important.

The other main approach is individualistic: employment and unemployment depended on the actions and choices of the people affected. That attitude was prevalent in the nineteenth and early twentieth centuries, but it was substantially discredited by the experience of mass unemployment between the wars. It was to resurface despite the resurgence of mass unemployment in the 1980s, and much of the effort to deal with unemployment has been directed at the choices and behaviour of unemployed people. The trend was reinforced by the Labour government, which in 2002 changed the name of the Department of Social Security to Work and Pensions, brought employment services into the same ministry in the form of ‘Jobcentre Plus’, and subsequently introduced ‘welfare reform’ intended to spur people into work.

In the course of the last fifty years, there has been a bewildering range of initiatives and programmes, often short-lived, intended to improve the situation of people who are unemployed.

Social security benefits cover a huge range of different circumstances. The most important are pensions, provision for disability, meeting housing costs and helping people on low incomes, but there are lots of others. In some minds, benefits are there to save people from poverty, but that is only true of some benefits, and not the largest part. Other benefits are there to help people meet personal needs, some to protect people undergoing major changes, and some to support specific activities such as child care and social care. There are many possible objectives: for example, meeting needs, responding to emergencies, economic management, compensation, redistribution and social inclusion.

Most of the services that I will be discussing in this book operate by providing people with something – for example, medical care, housing or schooling. Social security, by contrast, is paid in cash, rather than in kind. That means it is not like other social services. It works by transferring money to people to spend, and the things they buy – such as food, fuel and clothing – are then up to them. It follows that benefit recipients are expected to use the money to buy things from commercial providers. Social security is not a way of making public provision: it is a way of enabling people to pay for private provision. Some political commentators, the radical right or ‘neoliberals’, believe that commercial markets are a much better way of managing resources than public provision of goods and services can ever be. I will be examining some other aspects of those arguments in due course, but for present purposes I want only to note the relationship of that position to social security policy. It is implicit in any call for better social security that the market is expected to provide – and so, that commercial markets work. If people are short of food – many people are – that is usually taken to be an argument for getting them more money, not for bigger food banks.

The right-wing argument for market-based provision is not an argument for services to be cut, though that often overshadows anything else the neoliberals have to say. It is an argument for social security to be paid instead of providing social services.

There are many reasons why governments provide welfare services. Some are moral. There are principled arguments based on need, common humanity and rights. There are widely held values, such as independence, capacity and dignity, all of which are enhanced when citizens have basic security. We might well consider welfare to be the right thing to do if it is consistent with the teachings of major religions, or principles of humanitarianism, benevolence and altruism. Providing welfare may be treated as fulfilling moral obligations to the people who are being protected, such as older people who have contributed to society. It may be the right thing to do simply because it makes people's lives better.

Some of the arguments for welfare services are about collective action. The provision of welfare is an expression of mutual responsibility, or solidarity; it represents both the moral responsibilities we have to each other, and it reinforces them. It promotes social cohesion and inclusion. Welfare is a tangible expression of citizenship, the status and rights we have as part of a political community. Welfare furthers the common good: the interests that people have in common, the interests they share as members of a community or members of a society, and the things which are needed for the maintenance and reproduction of a society. And cooperation for mutual benefit makes sense, even from the point of view of self-interested individuals. When they can, most people make collective arrangements with others for their mutual benefit, and to further their common and shared interests – that is how insurance works. In many societies, welfare arrangements have begun with voluntary and independent provision, and the state has only become engaged with the activity belatedly.

Then there are economic arguments. The provision of welfare has proved to be a useful tool in the management of the economy. It maintains the workforce; it builds human capital; it is an investment in people for the future. It helps to promote economic development. A casual reader of the British press may well gain the impression that welfare provision is a fetter on the economy. If anything, the opposite is true – richer countries tend, in general, to have better welfare systems.

The foundation of the welfare state took place at the same time as the introduction of universal secondary schooling. Before the 1944 Education Act, secondary education was usually fee-paying: those who were unable to afford it continued in elementary education to age 14. But the principle of universal education had been established long before that. Primary or elementary education had been universal in Scotland since at least the seventeenth century, though the roots of the system go back before that. In England, elementary education was universal after 1870.

Schooling is meant to be inclusive – children are only permitted not to go to school if a satisfactory alternative arrangement has been made. That principle is widely respected: there are difficulties in the inclusion of some groups (such as gypsy travellers and some older pupils) but there are also provisions in place to try to ensure that they do not lose out. There have been arguments to make the provision of education more like a market, notably the idea that public provision of schools could be replaced by a system of vouchers. There are good reasons to doubt whether this would do anything to improve provision, but they need not concern us here: the main thing to note is that vouchers would still be universal, going to everyone. The principle of general inclusion – no child goes without an education – is the guarantee of universality. Universality is not compromised because some children are privately educated, though it is arguable that the quality of state education is – selective education, whether it is selected by cost or academic selection, tends to deprive less valued schools of resources. In primary education, the principle of universalism is unchallenged; the differences emerge in discussions of secondary education, where some argue for selection or different classes of education, such as a divide between vocational and academic education.

Universal education lends itself to the advancement of the general welfare. The education system operates as one of the chief forms of socialisation: education becomes a method of transmission of social norms and values. (This is also sometimes seen as a form of social control.) It may serve as a ‘handmaiden’: the education system serves the industrial process and the economy by producing a trained workforce, and by providing childminding services.

Housing is fundamental to people's welfare. First, it is something that is essential in its own right: people need shelter, warmth and space, as well as somewhere to have and do many of the other things – food preparation, personal hygiene, domestic entertainments – that are basic to well-being. Second, housing is still central to the way that most people relate to other people – making contact, interacting, sharing time, taking part in society. This role may have reduced with modern communications, but location – where the house is – still carries much more weight in valuation than the facilities that the house offers. Third, housing is the foundation for contact with other welfare services – education, health, indeed anything that depends on personal, face-to-face interactions – all organised around the place where people live.

Housing was a central element in the post-war welfare state. It had previously been closely identified with public health and slum clearance. ‘Squalor’ was one of the Five Giants that Beveridge had said needed to be slain. After the Second World War, housing remained a major political priority for both the main parties. What is surprising is not that housing used to be seen as a major source of welfare, but that it stopped being seen in that way. Governments came to think that it was not their business.

Housing tenure

It has been conventional, for many years, to discuss the housing system in terms of tenure: who owns the housing, and how it is paid for.

The growth of owner-occupation has been the biggest change, though it attracts less attention. At its peak, owner-occupation grew to nearly 70% of all housing; that has fallen back in recent years, reflecting the loss of resources many people have suffered through Britain's financial mismanagement and ‘austerity’, but most housing is owned, or is being bought, by the people who live in it.

Social housing – a general term covering both council housing, and the voluntary housing associations – developed mainly after 1919. Two million council houses were built between the wars, another four million in the post-war period. Council housing was initially intended as housing for the ‘working classes’; in the 1930s, it primary role was the replacement of slums, and that meant it has always been associated to some extent with deprivation.

The National Health Service is held in some high regard, and with considerable affection. People love it for the high principles it embodies, the protection and security it offers and (for the most part) their experience of its service – there are few families where no one has experienced a serious illness. The NHS is, a former Conservative chancellor famously observed, ‘the closest thing the English people have to a religion’. The rationale for the NHS is both moral – it represents a moral commitment and a right to welfare for everyone in the community – and practical. The service has been, for most, the very model of the welfare state – a universal service, free to all at the point of delivery.

Despite that, it has also been the subject of continual criticism. The criticism has abated during the coronavirus crisis, but there is no reason to expect that it will be quelled for the next few years. Some part of the criticism has been based in a loss of respect for the expertise of the medical profession, evidenced partly in press reports about failures, and partly by the increasing numbers of cases taken against doctors and health trusts for negligence or malpractice. Some part, too, has been political. Since the 1960s, there has been a steady stream of commentators ready to say that it could all be done better if only more was done through the private sector. And part, perhaps, is intrinsic to the nature of the NHS. The NHS, the Prime Minister has said, is ‘powered by love’. That, the Economist comments, is genuinely true, some of the time: ‘but it can also run on anger’. Enoch Powell, a former Minister of Health, wrote nearly sixty years ago that everyone in the NHS had an interest in saying that it wasn't good enough, because that was the way to get better funding. A private firm tends to attract business by claiming that the service it provides is wonderful, even if it is on the brink of collapse. The NHS, by contrast, rewards ‘shroud waving’ – showing how awful the consequences of underfunding can be.

Most of my career has been concerned with social policy and administration, whether that was done through study, practice, teaching or writing. I began with housing, serving as a voluntary advisor when I was a student and then taking a job as lettings officer in a local authority housing department. My interest in social security came about because it was such a large part of work in housing rights; I became a voluntary representative while studying law, and later I moved on to teach, write and research in the area. Teaching social workers led me to work on health and social care, including research on mental health and dementia. As a carer, I have encountered more recently many of the same problems in mental health services that I first became aware of as a researcher. And then, as a jobbing policy analyst, I would be asked to find out about a range of topics from the point of view of service professionals and users, including work on poverty, homelessness and disability. Much of this book has been built on a flow of insights, experiences and conversations with practitioners and service users. Those exchanges have fed into and reinforced a generally critical (and occasionally jaded) view of how social services work.

This will not be my last book, but it might have been. In May 2020, a few weeks into lockdown, I was diagnosed with a variant of blood cancer that would, only a few years before, have been considered terminal. Despite the crisis that was gripping the NHS, I received urgent attention from the GP, rapid admission to hospital (less than two hours after blood tests), the work of a suite of specialist consultants, a dedicated nursing team, and the laboratories in England and Scotland who analysed the condition. I was lucky in other ways. The illness was rare but appeared to be treatable, by a drug initially approved for another purpose. There were not enough case examples to justify a formal validation of the treatment, but the lead consultant asked the Scottish Medicines Consortium for permission to prescribe it, and the approval came through within twenty minutes. The performance of the NHS was, then, outstanding, and my appraisal of the service is possibly coloured by the fact that it has just saved my life.

By contrast with the health service, social care has a much more residual focus, coupled with an individualist emphasis on independence, personal choice and commercialised services. The idea of ‘social care’, as we now understand the term, was hardly thought of at the time when the NHS was founded; ‘community care’ emerged as an issue in the 1960s, and social care has emerged as a major theme largely because of changes in other services. At the time of the welfare state's foundation, the main provision for frail older people or people with severe disabilities would have implied either long-stay hospital provision or residential care under Part III of the National Assistance Act, mainly provided by local authority Welfare Departments. The ‘personal social services’ – provision by Welfare, Health and Children's Departments – had only limited involvement with care in people's own homes, and in the case of Health and Welfare, that involvement was mainly linked to hospitals or day care. In the early 1960s there was an extension of two main types of domiciliary support, meals on wheels and home helps; depending on the area, there may also have been some day care provision. Home helps were provided through the Health Departments; meals on wheels and residential care were the responsibility of the Welfare Department. Occupational therapists worked in either service.

The new Social Services Departments (or Social Work Departments, in Scotland), formed from the three existing departments, were supposed to deliver adult social care, but this consistently received less attention and a lower priority than children's services. During the 1980s, central government opted to develop in particular the residential care sector, with a strong emphasis on private provision; the costs were paid as part of Supplementary Benefit. The result was a rapid expansion of private residential and nursing care, which went in about ten years from being on the margins of provision to equal the local authority sector in size.

The Griffiths report of 1988 proposed a rationalisation of a sort: that local authorities should be in charge of the service, that the money being provided by the social security system should go through local authorities instead, and that services should be provided by multiple providers and paid for by multiple purchasers.