Since 1979 the UK has experienced the most decisive break in the providing style and underlying principles of welfare provision since 1944 to 1948, or perhaps ever. This thesis provides an historical overview of the succession of Acts in regards to state education, health and housing. It looks at the effects of, and reasons for, the reforms in these areas, showing how these have changed each sectors' operational style and ethos. A close insight into the reforms is provided by surveys of head teachers of Grant-Maintained schools, chief executives of NHS trusts, directors of local government housing departments and chief executives of housing associations and of Local Government. The questionnaires investigated issues such as, finances, changes in their functions, effects upon staff and external relations and highlights benefits and disadvantages. In general these sectors have experienced the introduction of a quasi-market, via the separation of the provider, purchaser and enabler roles. The aim has been to increase competition and consumer power in the state sector. In reality, competition is expanding, but these welfare markets have been subjected to increased scrutiny and control from Central Government. The market ethos is spreading across the nation, and although many people who are living through it are unaware of the rapid changes, this period may be looked back upon in history as being the most radical and far-reaching alteration of British economic, social and political structures.

This research examines active labour market policy, and in particular, training schemes targeted towards unemployed individuals who are the most disadvantaged in the labour market in Aotearoa/New Zealand. The purpose of this research is to first, highlight the main tensions between the current policy frameworks for the design and the practice of such training. The second purpose is to offer explanations for these tensions by highlighting the competitive free-market and rational individualistic assumptions that underpin the current frameworks and, in particular, how these constrain the 'choices' and possibilities for the most disadvantaged unemployed. The study identifies and examines State Active Neoliberalism, as a specific place-time articulation of neoliberalism, adopted by two successive Labour-led governments in New Zealand from 1999-2005. Thirdly, a community development theoretical framework is proposed to underpin recommendations that could support more enabling and empowering policies for the most disadvantaged unemployed and the organisations that seek to assist them. The thesis draws on case studies of major State-funded training schemes for long-term unemployed individuals to illustrate the 'on-the-ground' consequences of the discursive shifts in policy rhetoric. This research combines an in-depth, qualitative field research approach with a critical analysis of policy frameworks and political representations of unemployment, training and labour market issues in documents, publications and communications. The findings of this research are that a competitive quasi-market for training provision and the increased reliance on narrow outcome measurements, position commercial imperatives ahead of assisting the most disadvantaged unemployed. In order to remain viable, training organisations are increasingly faced with the need to sacrifice social motivations for commercial survival. This situation erodes the scope, at the local level, for services that are relevant to the various needs and circumstances of disadvantaged unemployed people. While the overarching policy discourses maintain that training schemes serve the needs of the most disadvantaged unemployed, policy mechanisms and competitive labour market contexts undermine such objectives. Not only are the most disadvantaged unemployed people frequently unable to access services claiming to be for their benefit, they are by definition less likely to succeed in the context of competitive labour markets and individualised society.

In Sweden, there has been an increased discrepancy between increasing merit ratings and decreasing results in international surveys such as PISA. At the same time, since the 1990s, Sweden has had several reforms that resulted in increased competition, decentralization and trust-based evaluations. Several studies have shown that grade leniency depends on school provider as well as level of competition between schools. This study focuses on how grade inflation in municipality schools for 9th graders is affected when an independent school is established nearby, using a fixed-effects model at the municipality level but with control variables at the individual level. I study all Swedish 9th graders between 2003-2017. An alternative specification with school fixed effects is also presented. I find that grades are set more leniently in competitive municipalities and that grade deviance is highly correlated with socio-economic factors. It is also concluded that the effect size is small in comparison to the average provider difference and individual level characteristics. The study extends the literature by focusing on grade inflation amongst municipality schools, and by focusing on the change in grade inflation rather than the average effect over time in terms of provider differences.

De senaste två decennierna har forskare i Sverige och andra länder riktat allt större intresse mot offentliga marknader. Sådana organisatoriska arrangemang skapas runtom i svenska kommuner. Den här studien är en longitudinell studie av en process där en offentlig marknad för grundskoleutbildning skapas och utvecklas i en svensk kommun. Tidigare forskning har visat att offentliga marknader kan betraktas som marknader i enlighet med exempelvis mikroekonomisk teori, samtidigt som de besitter egenskaper som skiljer dem från ”traditionella” marknader. I studien tillämpas teorier om organisatorisk förändring tillsammans med teorier om marknadsstrukturer. Studien visar hur den marknadsskapande processen kännetecknas av ett samspel mellan voluntarism och determinism där medveten planering och kontroll tydligt kommer till uttryck men där även tilltron till marknaden som ett självreglerande arrangemang är stark. Studiens teoretiska relevans diskuteras tillsammans med praktiska implikationer för offentliga marknadsskapare. / During the last two decades there has been an increasing interest in quasi-markets in Sweden and internationally. Quasi-markets are emerging as new organizational arrangements in many Swedish municipalities. This thesis is a longitudinal study of a process of creation and formation of a quasi-market for compulsory school education in a Swedish municipality. Previous research has suggested that quasimarkets can be regarded as markets according to microeconomic theory but they also possess a number of features that distinguish them from “traditional” markets. In this study, theories of organizational change are combined with theories of market structure. The study shows how the process of quasi-market creation features an interplay of voluntarism of determinism where purposeful planning and control coexist with a strong belief in market self-regulation. The theoretical relevance of the study is discussed along with practical implications for those participating in market creation.

Philosophiae Doctor - PhD / This study examines how families judge and choose high schools. The review of literature relating to school choice provides a theoretical framework for the study. The review includes an international perspective including both developed countries such as United States, Canada, Australia, New Zealand, Denmark, England and Wales, the Netherlands, Scotland and Sweden, and developing countries including India, Chile, Uganda, Kenya, Tanzania, Mauritania, Senegal, Cote d'Ivoire and South Africa. The context within which school choice occurs in South Africa is examined. This context includes continued influence of Apartheid policies and current legislation including the South African Schools Act, The Admission Policy for Ordinary Schools Act and the Norms and Standards for Schools Funding. The literature review includes a critical analysis of the research, both Local and International, which addresses questions as to which factors are considered when judging and choosing schools, who makes the choice school, when the choice of school is made and which sources of information inform the choice of school. The empirical study examines the process of high school choice in urban Cape Town. The group areas Act and other Apartheid policies have created a situation where the respondents have a large number of high schools from which to chose. The selected area reflects diversity in Socio-Economic status, including both privately owned homes and council rental flats and houses. The study is limited to English medium or dual medium schools in the area. It includes both co-ed and single gender schools. / South Africa

I denna uppsats undersöks om akutmottagningarnas långa väntetider kan bero på att olämpliga teorier appliceras på vårdmarknaden. Det undersöks med en fallstudie av hälso- och sjukvården i Västra Götaland där vi har genomfört semistrukturerade intervjuer med fem anställda i kanslierna som ansvarar för att ge politikerna information till sjukvårdsbeslut och för att stödja politikerna i styrandet av hälso- och sjukvården. Det är en kvalitativ studie med en abduktiv ansats.Vår empiri indikerar att en stor orsak till akutmottagningarnas långa väntetider är att de har ett inflöde av patienter med relativt milda symptom som kunde ha omhändertagits inom primärvården. Förklaringar till det är att klienterna ofta har bristfällig kunskap om lämpliga vårdenheter och ofta antar att de får bättre vård på akutmottagningar än inom primärvården. Många av de patienter på akutmottagningarna som kommit till olämplig vårdenhet är äldre och kroniskt sjuka.Den här studien indikerar att olämpliga teorier har applicerats på Västra Götalands vårdmarknad. Inspirationen till vårdmarknaden tycks till stor del härstamma från traditionella nationalekonomiska teorier. Vi anser dock att de är olämpliga på Västra Götalands vårdmarknad på grund av bristande utbud, bristande konkurrens, irrationella klienter och risker för missgynnanden. Vi föreslår istället ett större fokus på sociologiska marknadsteorier.Den här studien begränsas av det relativt låga antalet intervjusubjekt. Vi har dock hittat tecken i vår empiri på ett samband mellan missgynnade klienter inom primärvården och det ökade inflödet till akutmottagningarna. Vår förhoppning är att detta kan bidra med uppslag till framtida, mer omfattande undersökningar. / This paper addresses long waiting times in Swedish emergency units by examining if appropriate theories are applied to the healthcare sector. This is examined with a case study of the healthcare sector in Västra Götaland County where we have conducted semi-structured interviews with five members of the staff responsible for providing the county’s politicians with information for healthcare decisions as well as supporting the politicians in managing the healthcare sector. It is a qualitative study with an abductive approach.The findings from our empirical research indicate that one major reason for the emergency units’ long waiting times is that they have an influx of patients with relatively mild illnesses that could have been handled in the primary care. Explanations for that are that clients often are ill-informed and often expect to get better care at emergency units than in the primary care. Many of the emergency units’ misplaced patients are elderly and chronically ill.This study indicates that inappropriate theories have been applied to the healthcare sector in Västra Götaland County. The inspiration for the healthcare sector seems to be from traditional economics to a large extent. We conclude, however, that traditional economics is inappropriate on the healthcare sector in Västra Götaland County because of the lacking supply, lacking competition, irrational clients and risk for disadvantages. Instead, we suggest a higher focus on sociological market theories.This study is limited by the relatively low amount of interview subjects. We have, however, found indications in our empirical material for a connection between disadvantaged clients in the primary care and the increased influx to the emergency units. We hope that this could provide ideas for future and more elaborate studies.This paper is written in Swedish.

Andelen konkurrensutsatt offentlig verksamhet har ökat i jämn takt sedan början av 1990-talet, och utvecklingen har både sina förespråkare och kritiker. När det gäller de stora partierna inom de olika politiska blocken, är konsensus numera att konkurrensutsättning är här för att stanna, skiljelinjen ligger mer på hur stor andel av den offentliga verksamheten som skall konkurrensutsättas. Även bristen på en genomlysning och uppföljning av konkurrensutsatta verksamheter har väckt kritik. Kostnadseffektivitet är det som förespråkas vid konkurrensutsättning och används som syfte till att anlita privata eller korporativa aktörer etc., för att bedriva en tidigare offentlig verksamhet på ett mer företagsekonomiskt effektivt sätt. Syftet med uppsatsen var att undersöka hur Region Gotland använder sig av konkurrensutsättning och upphandling för att nå en företagsekonomisk effektivitet i sin verksamhet, och jämföra det empiriska underlaget mot tillgängliga teoretiska källor. För uppsatsen har följande två frågeställningar valts som uppsatsens problemformulering: (1) På vilket sätt genomförs konkurrensutsättning för att uppnå företagsekonomisk effektivitet i offentlig verksamhet? (2) I vilken omfattning sker uppföljning av verksamheter för att kontrollera att tilldelade resurser används på bästa sätt? Uppsatsen visade inte på något otvetydigt klargörande när det gäller ekonomisk vinst vid konkurrensutsättning, eftersom uppföljning och utvärdering av upphandlade verksamheter inte sker i den utsträckning som vore önskvärd. Detta skapar problem med att dra några konkreta slutsatser om det råder någon ekonomisk skillnad, ifall verksamheten bedrivs i offentlig eller privat regi, det blir mer ett antagande än bevisad kunskap. Det framkom även att den byråkratisering som medföljer vid konkurrensutsättning innebär ökad kostnad för det offentliga, och det är inte alltid som effektiviseringarna motsvarar omkostnaderna. Ingen av respondenterna ansåg att konkurrensutsättning är ett felaktigt förfarande utan det behövs mer tid för att bygga upp kunskapen, och att därmed fullt ut utnyttja upphandlingen som ett ekonomiskt instrument. Skiljepunkten mellan respondenterna är snarare hur användandet av konkurrensutsättning bör användas för att gynna Region Gotland och det lokala näringslivet. Flertalet av de anbudsförfaranden som har utfallit med bra resultat, är inom områden där konkurrensutsättning har använts under längre tid, och ”trial and error” är en av förklaringarna som uppsatsen har kommit fram till. Storleken på förfrågningsunderlagen är betydelsefullt, för att öka antalet anbud och därmed konkurrensen. Vilket i sin tur minskar risken för oligopol - eller monopol - ställning för något enstaka storföretag.  Antalet anbud ger också en prispress vilket för det offentliga kan betyda större ”effektivitetsvinster”. / The proportion of Swedish public sector exposed to competitive tendering has increased steadily since the early 1990s. This development or progress has its proponents as well as critics. As for the major parties in the two political blocs, there is now a consensus that competitive tendering is here to stay. The dividing line is more on what proportion of the public sector to be opened to competition. The purpose of this thesis was to examine how The Region of Gotland uses the competitive tendering and procurement to achieve business efficiency in their activities, and compare the empirical basis in relation to the available theoretical sources. For our thesis the following questions are chosen: In what way are implementations of competitive tendering used in order to achieve business efficiency within the public sector? To what extent is monitoring of public sector to ensure that allocated resources are used as intended in the best way? The empirical data shows that there is no straight line in terms of financial results of competitive tendering, as the monitoring and evaluation of procurement activities does not occur to the extent needed. For the same reason a comparison with financial outcome of public operation would become more an assumption than proved knowledge. Areas where a tender procedure has turned out with good results are mostly, in areas where competition has been used for a long time. Our conclusion is that time is needed to develop knowledge of good practice and examples. The size of the tender specifications is important, to increase the number of tender and thus competition. This in turn reduces the risk of monopoly. The number of tenders also provides a downward pressure in prices which can mean greater “efficiency gains”.