Canada, like all industrialised countries, has become concerned over health care costs. Canada has reason to be concerned, with the most expensive system, on a per capita basis, of any country with national health insurance. This paper briefly reviews Canada's health care system, examines the rhetoric being adopted throughout the country at the current time, and discusses the changes which are now occurring. An assessment of whether change will lead to a more cost efficient and appropriate system for an aging society is then presented. It is concluded that there are profound changes taking place in the health care system in all provinces in Canada. Most of the changes to date reflect a restricting of current medical care by making ineligible previously eligible procedures, introducing user fees where there were none before, and in some instances including means testing where there was none before. In addition, hospital budgets are being cut and beds are being closed. However, a corresponding expansion of community programmes, while evident in the rhetoric, is less evident within current actions.

Considerable debate has taken place as to the nature of social need and ways in which it can best be identified in individual people, but little attention has focussed on the way assessments of need are used in the process of policy formation. The article takes Jonathan Bradshaw's commonly quoted taxonomy of social need and assesses its strengths and weaknesses for use in a practical policy making setting, that of assessment of need for sheltered housing for elderly people by a district housing authority. Some fundamental problems associated with Bradshaw's approach are then discussed, together with those arising from use of a term such as need in the process of policy formation.

Social policy appraisal depends on assumptions that are made about individual motivation and individual behaviour. In recent years greater weight has been given to behavioural characteristics which are typical of homo-economicus. At the same time, a growing body of evidence from experimental economics and from cognitive psychology identifies a ‘richer’ characterisation of individual behaviour. Allowance must be made for ‘individual failure’ and for preference endogeneity when designing and implementing social policy. A ‘broader’ agenda is required when evaluating social policies. When designing social policy greater emphasis must be placed on the ‘demonstration effect’.

In this review of the changing relationship between social policy and social justice I will be concerned with three main areas of debate. Firstly, I wish to attempt a clarification of the moral ideals of social welfare which find expression in those criteria of social justice by which people in similar states of need are treated differently. My second concern is to review and redefine what constitutes the social division of welfare in Britain today. Thirdly, I wish to explore the extent to which these ideals of social welfare complement or conflict with one another.

The priority area approach to problems such as urban deprivation has recently been criticized because of its alleged ineffectiveness and because the majority of the deprived live outside the priority areas. This paper argues that these criticisms do not constitute an adequate appraisal of the area approach, as they ignore some other and equally important considerations, in particular the economic aspects of the approach. One is the possibility of achieving resource cost saving through area action (thus making it possible to help more deprived people from a given level of resources). Another is the possibility of achieving a higher rate of take-up of special assistance. The paper discusses those attributes of utility functions and production functions that are relevant to the appraisal of area policies, and provides a framework that would allow a complete evaluation of the economic aspects of an area policy.

Pension reform is one of the top public policy priorities in advanced industrialized countries due to population ageing and the significant weight of pension spending in governments’ budgets. As a result of these concerns European countries have engaged in varying degrees of pension reforms over the last three decades. The extant literature on pension reform focuses on structural, institutional and blame avoidance theories to explain how pension reform take place. Yet, how do different conditions combine to lead to significant pension reform outcomes? To answer this question we analyze a set of 48 pension reform cases in eight European countries since the late 1980s up until 2014 by using fuzzy set qualitative comparative analysis (fsQCA). Our main finding is that institutional, structural or blame avoidance theories cannot account by themselves for instances of significant pension reform. Rather, we find three pathways that combine structural and institutional conditions to lead to significant pension reform.

The COVID-19 pandemic presents a unique opportunity to study how humans allocate scarce resources in times of hardship. We study public preferences regarding who should get access to government aid for the self-employed, a bed in the intensive care unit, and permission to cross the border using original conjoint survey experiments administered to an incentivised online panel in Switzerland during the first and second waves of the pandemic in 2020. We find that across the three areas, even in extraordinary circumstances such as the COVID-19 pandemic, evaluations of deservingness to aid and support are still based on an underlying logic of conditional solidarity and identity: in all experiments, contributing to the community, be it through past actions and contributions or through current efforts, plays a crucial role in determining an individual’s deservingness, as does their nationality (and legal status) with nationals being perceived as more deserving than non-nationals.

Indigenous Māori in New Zealand have had significant opportunities to influence mainstream politics and policy since 2008 when the Māori Party began negotiating supply and confidence agreements with the conservative National Party in return for progress on Māori Party initiatives. This article assesses whether the Māori Party has made a difference in social policy. It argues that the holistic, whole-family-focused Whānau Ora strategy and initiatives aiming to revitalise the Māori language are significant policy innovations that uniquely embed Māori cultural values and governance into mainstream policy frameworks. A Ministerial Committee on Poverty, established as a result of National-Māori Party negotiations, put Māori politicians at the decision-making table and led to some important housing and health initiatives but fewer gains are evident regarding income/employment policies that address the disproportionate material disadvantage of Māori. Ultimately, the Māori Party has provoked policy innovation and there is some evidence of improving Māori outcomes. But political constraints inhibit opportunities for significant and lasting recognition of indigenous rights and radically improved socio-economic outcomes in the social policy arena.

Legislative changes and a recent court ruling allow private schools in England and Wales to determine how to provide the public benefits required to justify their charitable status. We investigate how private school headteachers and other informed stakeholders perceive their public benefit objectives and obligations. We find that schools interpret public beneficiaries widely to include one or more of state school pupils, local communities, other charities, and general society through raising socially responsible adults. Private schools pursue their own goals through public benefit provision, and balance the advantages of public benefit activities against the costs. The schools are not constrained by the ‘more than tokenistic’ minimum set by the regulator. The findings highlight the difficulties faced by governments who seek to pursue redistributive educational policies through charitable law.

It may be that when the history of social administration as an academic discipline during the 1960s comes to be looked back upon, one of the most significant developments will be seen to have been the growing influence upon it of sociology. As social services have developed in extent and complexity, a descriptive approach to the study of them has appeared ever more inadequate; and with the rapid development of sociology, both new empirical material, new perspectives, and new methods of analysis have become increasingly accessible. Social administration now uses sociological research methods, and draws heavily upon sociological theory. At the same time, both the active interest of ‘committed’ sociologists in the field of social welfare and, specifically, the emergence of the ‘sociology of welfare’ to join other sociological specializations indicate that the tendency for the two disciplines to impinge increasingly upon each other is not one-sided.

Welfare policy may promote social integration and reduce social conflicts in communities. However, this study finds that the Indonesian unconditional cash transfer program stimulated multifaceted conflicts, which were accompanied by harmful social unrest. The government failed to lessen such conflicts, but community leaders successfully minimized the conflicts through informal redistribution. This redistribution reflects problematic informal-formal layering and nesting, which lead to a complicated policy failure. Employing social conflict and institutional change theoretical frameworks, this article aims at using the Indonesian cash transfer as a lens to understand how and why welfare policy causes social conflicts in communities and how the conflicts stimulate policy distortion and modification, resulting in policy failure. This policy failure reveals important theoretical implications on the nexus of conflict and institutional change.

Migration is an important social determinant of health for immigrants in the United States. Increased attention on Latino immigrants in recent years has sparked interest in policies that affect this population. While prior research has assessed the potential health impact of specific immigration policies, there is limited understanding of how the overall sociopolitical context shapes the health of Latino immigrants. This study examines the potential mechanisms that link the sociopolitical context and health among Latino immigrants. Specifically, we explore how perceptions of the sociopolitical context are implicated in this relationship. Qualitative interviews with community gatekeepers (n=13) and Latino immigrants (n=34) in New York City revealed general perceptions about the overall sociopolitical context, which were characterized by discrimination towards immigrants, unpredictable and mercurial circumstances, and confusion and lack of information. These perceptions influenced participants’ psycho-emotional health and health-related behaviors. Findings suggest the importance of integrating immigrants’ perceptions of the sociopolitical context into health promotion efforts. Furthermore, findings demonstrate the need for paradigm shifts in developing policy-related actions to integrate immigrants’ perspectives. We propose an integrated, multi-level framework to guide future research and practice regarding social determinants of immigrant health.

This article reports on the effects of the Social Support Act (Wmo) in the Netherlands, implemented in 2007. The Dutch Act resembles the current European political interpretation of citizenship: stressing self-responsibility in one's personal life, fighting against elements of the welfare state that are believed to be invasive and implying a shared responsibility of government and civil society for the care of socially vulnerable groups. Data were collected on the basis of two surveys evaluating the effects of the Wmo for voluntary organisations and professional non-profit institutions in social care and welfare (2007: N = 383 and 2009–10: N = 389). In addition, in-depth interviews with stakeholders and qualitative case studies were carried out. The study yields several paradoxical policy outcomes. Contrary to the objectives of the Social Support Act, a ‘revitalisation’ of the Dutch civil society – in terms of a greater contribution to social goals and policies – remains problematic, whilst professional entities thrive under the new governmental élan. Other paradoxical outcomes stem from a too-dogmatic approach to the social participation of people with severe mental disabilities. Instigating the socialisation of these groups through mandatory measures can in practice increase their isolation. To reduce unintended effects, the Social Support Act should take into account the divergent capacities of vulnerable groups and prioritise the psychological safety of clients over political and administrative policy objectives.

Welfare spending in the UK is too low to provide services at the level to which most citizens aspire. The problem is that, although most people state in surveys that they would like to pay higher taxes for better services, politicians from all the main parties generally do not believe that they would put their vote where their mouth is. Advocates of higher spending increasingly retreat to a position of promoting ear-marked taxes for specific, highly favoured services, as in the 2002 Budget plan to finance the cost of improvements in the highly valued NHS through increased National Insurance Contributions. Recent theoretical work further undermines arguments for higher state spending: an important strand in political science argues that trust in state institutions is in decline, and work in sociology claims that citizens are becoming more independent, reflexive and keen to take responsibility for meeting their own needs. This paper uses data from a recent ESRC-financed national survey to examine these arguments. It shows real support for hypothecated taxes for the NHS, and more generalised support for higher taxes for welfare provision. Such support is not undermined by a decline in citizen trust in the welfare state or by a rejection of collective solutions. However, there is little endorsement of hypothecated taxation in other areas, and the use of such measures may encourage citizens in a pick-and-mix approach to welfare services.

A system of devolved welfare governance, it is argued, increases participation in welfare services. However, limited empirical evidence has been reported on how it influences welfare reform. This paper draws upon evidence from the mental health system in Spain, where health care is devolved to the regional states (autonomous communities), to examine whether policy reform of neglected policy areas may be triggered through heightened policy awareness and better participation of interested stakeholders. We find that regional devolution has helped to scale up mental health in some of Spain's autonomous regions relative to support for other services. Evidence suggests that whilst fragmentation and certain historical legacies remain path dependent, regional devolution has indeed enhanced experimentation, reform and policy innovation in mental health care. However, the expansion of mental health care coverage has been constrained by the lack of a clear definition of public coverage, as well as the need to meet the demands of evidence-based policy in an era of cost-containment. Inequalities in access to mental health care remain; they are compounded by the stigma and discrimination experienced by people with mental health problems, which is a common challenge for all health systems in Europe.

This paper is concerned with the work of child care and with the division of work between mothers and others. Drawing on research data, it explores the idea that this work takes place in a domain located between the public and the private. The perspectives of mothers and health visitors on child care and health care are considered, with particular reference to their perspectives on their own and others' knowledge and responsibility.

In response to the economic vulnerability of single mothers and in keeping with a neoliberal ideology, many Western countries have encouraged increased labour-market participation, often through welfare-to-work (WTW) programmes. One practice adopted in these programmes is deepening knowledge of pension savings and increasing financial savviness. Feminist research points to women's lower economic status than men at retirement, especially divorcees and widows. Based on perceptions of single mothers participating in a WTW programme in Israel and their trainers, this study examines how such mothers, in a framework of vulnerability, experience policy imperatives regarding paid labour and examines their attitudes to pension savings. Findings reveal that, in reaction to the imperative of pension savings, some single mothers believed their present employment provided them with a more secure economic future, while others rejected this belief. The trainers also had divided opinions, despite their role in encouraging mothers to follow the imperative.

The referendum vote for Remain in Scotland and Northern Ireland and the small majority for Leave in Wales immediately attracted much attention to the position of the devolved governments on Brexit negotiations and to the impact of Brexit on their jurisdictions. As the core of devolved powers relate to social policy, identifying the impact of leaving the EU on aspects of social policy is highly significant. This article examines the impact of EU programmes, funding, directives and regulations as delivered in recent years, noting the nature of the participation of the devolved administrations in EU decision making. The post-referendum concerns of the devolved governments and their approaches to Brexit and Brexit negotiations are explained. Also discussed are the likely major changes as well as possible changes that will take place in the operation of devolution after Brexit.

This article explores the impact of poverty on working men in light of the great diversity of the working poor population. Grounded upon a social constructivist theoretical framework and a comparative qualitative study of the working poor in Israel, this article examines the construction of ‘waged work’ among low income, Israeli working men. To illuminate the complex intersection of masculinity, poverty and waged work with ethnic and cultural categories, this unique study examines four different groups of Israeli citizens, corresponding to the main sub-groups of the Israeli population: secular, ultra-Orthodox, and immigrant Jews and Arab Israeli citizens.

The article has five sections. The literature review briefly introduces the intersection of masculinity, poverty and waged work, presents some background about the social construction of masculinity in the local context and concludes with a short review of the definition of ‘working poor’. The context section explains concisely the background of this study, including the uniqueness of the Israeli labour market and some short references to the different sub-groups in the study. The methodology section specifies the theoretical framework, and the data gathering and analysis methods. The findings section presents an analysis of emerging themes. Finally, the discussion elaborates on the interrelation between masculinity, poverty and waged work in light of the great diversity among the working poor and the uniqueness of the Israeli labour market.

Past comparisons of the extent of poverty in Britain have been based on widely differing poverty levels. A constant relative poverty level is defined and new estimates of the extent of poverty from 1899 to 1983, based on this consistent standard, are presented. Factors that have contributed to the past changes are analysed.