Social care services have led the way in relation to the transfer of budgets down to the individuals and families who need support. Thus this sector provides an opportunity to theorise about the emerging role of the local state in a context in which it no longer purchases services directly – linking it directly to the core themes of this panel.
This paper will make a distinctive contribution by applying the grid-group theory derived from the work of Mary Douglas (e.g. Douglas, 2004) to a theorisation of market shaping in relation to social care service. The theory considers how far people’s lives are governed by external rules (the grid dimension) and how far people feel part of a loose or tightly bounded social group (the group dimension). Both dimensions of the grid-group analysis appear to have a prima facie relevance for exploring the role of the local state in a context of personalised care. Entwistle (2016) describes a low-grid approach as 'government having to rely on the soft instruments of diplomacy, partnership and trust’ with high grid being about ‘the use of hard regulatory instruments and the maintenance of hierarchy’ (Entwistle et al., 2016, p.899.). Both of these types of approaches seem likely to be found in local state practices as they shift from being the main purchaser of care to being a shaper or steward of the market. The group element relates to how far there is an in-group of providers who work closely with the local authority, or how far it is a fairly open market with weak coordinating factors. Some local authorities, for example, seek to develop relationships with a small number of large providers, whereas others encourage large numbers of providers to operate on their patch.
This paper draws on a three year Department of Health funded study to identify different forms of market shaping in English care services, a majority of which are delivered through personal budgets. It derives data from a national survey of all English local authorities and 30 interviews with national stakeholders to explore the extent to which local authority practices in relation to care are developing in ways which fit the grid-group model.
Douglas, M. (2004) Natural symbols: Explorations in cosmology. Routledge.
Entwistle, T. et al. (2016) Reframing Governance: Competition, Fatalism and Autonomy in Central-Local Relations, Public Administration, 94: (4): 897-914.
