Macro‐, Meso‐ and Microeconomic considerations in the delivery of social services

Abstract

PurposeIn the wake of public service liberalisation in many OECD countries, economic interventions into the purpose and implementation of social policies have gained a lot of interest in recent years. The prime aim of this paper is to describe the nature of these interventions. The paper examines the reasons for pursuing elusive efficiency objectives in the conduct of public policy, rationales for purchaser‐provider splits, evaluation of cost‐quality relationships, service costing and pricing, and the influence of “external” economic variables.Design/methodology/approachThe paper breaks the analysis of public policy down to three layers of economic interventions: macroeconomics (allocative efficiency, intervention rationales and macroeconomic environment), mesoeconomics (economics of delivery in “social industries”) and microeconomics (agent behaviour, contracting, pricing and evaluation). Each level of economic intervention is illustrated with examples, mainly taken from Australian public policy and mainstream social economic research.FindingsSome of the most critical questions in policy implementation (outsourcing, pricing, contracting and agency problems) can be traced back to economic reforms. Experiments with new modes of service delivery are driven by a changing economic context, yet the efficiency gains from these innovative approaches may come at the expense of service quality.Practical implicationsChanging macro‐, meso‐ and microeconomic variables profoundly alter the parameters of service delivery. Designers and managers of service delivery systems need to be aware of – and skilled in – the practical application of economic principles, concepts and methods.Originality/valueExcept for the health sector, there is a lack of consistent research on the interrelationships between the standard economics toolkit and the delivery of public services. Yet the two are profoundly intertwined. The paper helps distinguish these relationships by putting together elements of conceptual analysis and fieldwork.

Ethics of psychotherapy rationing: A review of ethical and regulatory documents in Canadian professional psychology.

“…Overall, regarding psychotherapy, we should consider a factor important to rationing if it impacts who we treat (e.g., urban-living, wealthy, high-risk, motivated, likeable), the timing of treatment (e.g., how soon, at what frequency, short- or long-term), and the treatment type or means (e.g., telepsychology, brief Cognitive Behaviour Therapy). Of course, these rationing decisions are impacted by clients, clinicians, clinics, managers, policy, government, and social trends (Freyens, 2008; Gevaert et al, 2018; Scott, 2017). In other words, rationing decisions are partly determined by practical factors in specific settings (e.g., a program’s policy on number of sessions per client), but ethics remain at play throughout, explicit or not.…”

Competition and Collaboration in the Contracting of Family Relationship Centres1

“…Even where government follows a ‘leveraged funding model’ (through which NFPOs are provided top‐up funding to do more of what they do already) the terms of such funding is contractually‐based and incorporates stringent – often onerous – compliance reporting (Flack and Ryan 2005). More often than not, compliance reporting is heavily skewed towards counting inputs and outputs as opposed to being focused on the achievement of outcomes for end users (Freyens 2008; Wanna, Butcher and Freyens 2010). This represents a form of path dependency in which the character of the transaction between government and non‐government providers simultaneously reflects the institutional origins of the public sector (predisposing it to rigidity and control) and the received values of New Public Management (NPM) with its emphasis on market solutions.…”