Universal Basic Services: Theory and Practice

Introduction

This report explores the hypothesis that strengthening and extending universal services is an effective way of tackling poverty and improving wellbeing for all. It draws on academic literature including conceptual thinking, political and economic analysis, case studies and evaluations, as well as some ‘grey literature’ and factual reportage. The main focus is on the UK, but there are implications for – and lessons to be learned from - other countries. It builds on earlier work by the Institute of Global Prosperity, summarised in the 2017 report, Social Prosperity for the Future: a proposal for Universal Basic Services[1].

The term ‘universal basic services’ encapsulates three crucial concepts. For the purposes of this review, we define them as follows, in reverse order.

1. Services, meaning collectively generated activities that serve the public interest.

2. Basic, meaning essential and sufficient, rather than minimal, in that these collective activities enable people to meet their needs.

3. Universal, meaning that everyone is entitled to services that meet their needs, regardless of ability to pay.

Our references to ‘public services’ in the rest of this report should be understood in these terms.

Central to the case for UBS is that the idea should be substantially developed in practice, both by improving the quality and reach of existing services such as healthcare and education, and by extending this approach into areas where essential services are not currently available to all, such as care, transport and information.

Our findings are not definitive, as they are based on a rapid, indicative review of relevant literature. We hope to shed more light on the subject and we also expect to reveal uncertainties, questions, knowledge gaps, and areas for further study and debate.

The rationale

The term ‘universal basic services’ (UBS) was originally coined to signpost a policy alternative to ‘universal basic income’ (UBI). The latter is a proposal to give regular, unconditional cash payments to all individuals, regardless of their income or status. The former is a proposal to develop more and better collectively provided services that are free for all who need them, regardless of income or status. Both are put forward as ways of reducing poverty and inequality, and improving wellbeing for all.

It is beyond the scope of this paper to consider the case for UBI in any depth. Arguments for and against are well documented elsewhere[2]. However, the case for UBS rests in part on whether improving and extending public services is likely to be more effective in addressing poverty, inequality and wellbeing than unconditional cash payments to individuals[3].

Shared Needs and Collective Responsibilities

Two principles are fundamental to the rationale for UBS: shared needs and collective responsibilities. We all share certain basic needs that must be satisfied if we are to be able to survive and thrive, think for ourselves and participate in society. Theories of capability and human need converge around this point. Nussbaum (2006) describes three ‘core’ capabilities: of affiliation, bodily integrity and practical reason. Doyal and Gough (1991) identify health and critical autonomy as prerequisites for social participation. This finds an echo in the goals set out by the Social Prosperity Network when it argued the case for UBS to achieve a ‘larger life for the ordinary person’[4] through security, opportunity and participation[5].

Human needs are not context specific, but universal across time and space. While the detail of how needs are met will vary widely, they always require certain generic ‘satisfiers’ (or ‘intermediate needs’) that do not vary. These were originally listed by need theorists as water, nutrition, shelter, secure and non-threatening work, education, healthcare, security in childhood, significant primary relationships, physical and economic security and a safe environment[6]. Some argue that access to motorised transport and to the internet have now become essential for participation in society[7]. However, the latter are perhaps best understood as hybrid satisfiers, between specific and generic, because they have not always been essential but are increasingly felt to be so at a global level.

The social settlement established after the Second World War expressed a shared resolve that everyone’s basic needs should be met. People should be able to buy certain essentials for themselves and – where costs outstripped most household budgets - services should be provided to all who needed them. A national consensus emerged that responsibility for the welfare of the population was a collective function, conducted by pooling resources and sharing risks through the institutions of government. Marshall (1965) summed up the collective approach to social welfare in the concept of ‘social citizenship’ based on economic and social (as well as civil and political) rights[8].

Why Services?

The concepts of shared needs and collective responsibilities beg the question of how responsibility should be exercised to meet needs: through income support or through public services and other forms of collective action? This is not a question of either/or but of the balance between them.

UBS advocates generally agree that adequate and accessible income support is needed, but that this should be augmented by a ‘social wage’ or ‘virtual income’ from collectively provided services that would otherwise have to be paid for out of individual or household budgets.

The notion of a social wage can be traced back many decades. RH Tawney (1964) said of public health and education services that ‘the standard of living of the great mass of the nation depends, not merely on the remuneration which they are paid for their labour, but on the social income which they receive as citizens’[9]. More recently, there have been calls to recognise public services as ‘social infrastructure’, no less essential than highways, the national grid and other aspects of the ‘material infrastructure’ on which we all depend. It is argued that expenditure on both kinds of infrastructure should be treated as investment that will yield social and economic dividends[10].

As this suggests, public services create value that is routinely underestimated and should be taken into account. But we are not talking here about economic value alone. Our analysis suggests that the value of services can be understood across four dimensions:

Equity: services have a strong redistributive effect, as they are worth much more to people on low incomes than to those who are better off.

Efficiency: services deal with market failures and achieve economies of scale.

Solidarity: services are a manifestation of shared interest and purpose; they can help to bring people together and build social cohesion.

Sustainability: services can produce benefits that are continuous and cumulative; they are organised in ways that can facilitate carbon reduction, respond to climate hazards and achieve longer-term environmental sustainability.

A great deal depends on how services are designed, funded and delivered, and on their scope and quality. We explore the potential benefits of services in Chapter Three. First we turn to what is known about public services in the UK today.

Potential benefits of UBS

Here we consider potential benefits of strengthening and extending public services, drawing on studies of existing services, across four dimensions: equity, efficiency, solidarity and sustainability.

Equity

Public services are found to reduce income inequalities by providing a ‘social wage’ that is worth much more to people in the lowest income groups. In the absence of public provision, for people on low incomes meeting basic needs is likely to consume the majority of their income. If not, basic needs go unmet with negative impacts on individuals and society.[11] A study of OECD countries found that poor people would have to spend three quarters of their income on essential services if they had to purchase them directly. Services reduced income inequality by an average of 20%.[12]

Modelling by the Institute for Global Policy found similarly that extending public services to new areas such as information and transport would have far greater value, proportionately, to low-income households than to rich ones.[13]

Services bring intrinsic benefits without which individuals and families are less likely to be able to meet their needs and flourish. Getting an education makes it easier to find work and earn money; access to healthcare means there is less risk of becoming disabled by illness and dependent on care; access to transport makes it possible to get to work and gain access to other services, and so on.

The effects are not just individual: reducing inequalities will benefit society as a whole. As Wilkinson and Pickett have demonstrated, outcomes for a range of health and social problems (physical and mental health, drug abuse, education, imprisonment, obesity, social mobility, trust and community live, violence, teen pregnancies and child wellbeing) are significantly worse in more unequal rich countries.[14]

Some studies have shown that public services are more likely to benefit those who are better off than the poorest.[15] Yet overall, there is strong evidence that public services benefit lower-income households disproportionately. A detailed analysis of the distributional effects of the social wage in the UK confirmed a consistent pro-poor bias in most services (higher education being an exception), which is borne out by more recent data from the ONS.[16],[17] The ways in which universal services are designed and delivered – and how they interact with each other - are likely to influence the extent to which they benefit the poorest, as well as other income groups.

Efficiency

Efficiency is usually measured in terms of the ratio between output and inputs: the greater the amount of useful output per unit of input, the more efficient the process is deemed to be.i Outcomes refer to the broader and longer-term impacts on individuals (such as poverty and mortality) or on social distributions (e.g. levels of inequality).[18] They will be influenced by how services interact with each other, as well as by a wide range of social, cultural and economic conditions. Given these complexities, measures of efficiency in the public sector are usually complex and contested.

Public services have often been accused of inefficiencies, which market theorists have linked to the vested interests of bureaucrats and professions. These shortcomings were used to justify introducing market rules into public services from the 1980s onwards. But competition between multiple providers, customer choice for service users and conventional cost-efficiency criteria for measuring success have largely failed to improve outputs let alone outcomes. These failings have been greatly exacerbated by public spending cuts, with decisions often predicated on the notion that simply reducing inputs is equivalent to increasing efficiency. Getting ‘more for less’ by cutting staff or increasing workload to compete in a quasi-marketplace has generally proved to be self-defeating.[19]

Market processes deliver inefficiencies in public services. Transaction costs are often higher for both consumers and providers. Public sector organisations can keep costs down in ways that cannot be achieved by competing commercial organisations – for example, through sharing administrative, purchasing and research functions, by avoiding duplication and by working together to achieve shared goals.[20] Moral hazards are encountered when profit incentives combine with unequal knowledge in markets. For example, private medical providers have incentives to behave in ways that put others at risk by undertaking unnecessary medical interventions, while patients know too little to judge whether they are right or wrong.[21],[22] In addition – and crucially - a non-profit system does not need to extract funds to pay dividends to shareholders.

Turning to outcomes efficiency, there are further advantages to a public – rather than market-based - system of service provision. Where a range of collective activities are intended to serve the public interest, receive funding from public sources and share a democratic framework, they are, in theory at least, better able to interact in mutually beneficial ways – and they can be orchestrated to interact effectively by public authorities. An example is where schools encourage healthy eating and active pursuits, making people healthier and better able to benefit from clinical interventions; another is where high quality childcare helps children to get more out of primary education.

Definitive studies of the efficiency of public services are rare, and most that do exist focus on healthcare and cost-efficiency. A 2016 study for the Office for National Statistics compared spending on health care and average life expectancy in OECD countries. It found the USA, which is a mainly market-based system, outspent the UK by the equivalent of £6,311 per person, compared with £2,777, yet had an average life expectancy at birth of 78.8 years, compared with 81.4 in the UK.[23]

Other studies have found that, while the UK spends a smaller proportion of GDP on healthcare than other European countries, the NHS is regarded as the most efficient and cost-effective healthcare systems in the world.[24] This is regarded as a ‘vindication for the UK model of predominately publicly funded health (‘free at the point of use’ but funded mainly through taxation).[25]

Where efficiency is assessed in narrow output terms, calculations overlook the multiple dimensions of value, the many ways in which value is experienced and how it accrues. The concept of ‘social return on investment’ (SROI) has been developed over the last decade and adopted by government in the 2012 Social Value Act, which instructs public service commissioners to consider how to ‘improve the social, economic and environmental well-being of the relevant area.’[26],[i]

In public policy, inputs can refer to expenditure of resources, such as money or labour, as well as government regulation. Outputs refer to the implementation of legislation and the delivery of specific transfers and services, such as social care or health procedures. Applying social value analysis to an assessment of service efficiency means taking account of indirect as well as direct effects. For example, if staff delivering meals on wheels to people who are housebound take time to sit and chat with them, this may reduce their sense of social isolation and generally improve their wellbeing, but it will increase costs by demanding additional staff time. If a school opens up as a community centre at weekends, it may improve opportunities for local residents to get together and help each other in various ways with positive long-term effects, but it will also eat into the school budget. Some forms of social value take years to accumulate, with no immediate tangible benefits; often, they accrue in ways that do not return dividends of any kind to the organisation that made the investment in the first place.

SROI has become a formula used to encourage private as well as public and third sector organisations to think about the ‘bottom line’ in public interest terms, and to seek innovative ways of achieving success. But market incentives tend to pull in the opposite direction for commercial organisations, except where achieving positive social outcomes directly boosts profits. When services influence and largely depend on the quality of human relationships, it is especially hard to square the circle.

Solidarity

The concepts of shared needs and collective responsibilities embody the idea of solidarity, and the practice of UBS (as we have defined it) arguably has potential to develop and strengthen solidarity. For this review, we take solidarity to mean feelings of sympathy and responsibility between people that promote mutual support. It is an inclusive process, not just within well-acquainted groups but also, crucially, between people who are ‘strangers’ to each other. It involves collective action towards shared objectives.[27]

As a policy goal, UBS calls for collective policy and practice: sharing resources and acting together to deal with risks and problems that people cannot cope with alone. It is not something that can be achieved by individuals or groups simply fending for themselves and pursuing their own interests. Society is not constructed simply through atomised choices spontaneously generating co-operation, but by mutual regard and consideration: people ‘cannot live together without agreeing and consequently without making mutual sacrifices, joining themselves to one another in a strong and enduring fashion’.[28] These things are not nice-to-haves, but the ‘fundamental basis’ of social life.[29]

Pursuing the goal of more and better public services not only requires solidarity but also contributes to it – in three main ways. First, it develops experience of shared needs and collective responsibility, which can build understanding of how people depend on each other and a commitment to retaining these interconnections. Secondly, where services bring people together from different social groups, they can provide opportunities for developing mutual sympathy and responsibility. Thirdly, the combined effects of more and better services, as we have noted, bring benefits to society as a whole and have a redistributive effect, reducing inequalities which otherwise create barriers to solidarity.

Some have argued that welfare states – and thereby public services - ‘crowd out’ social capital by inhibiting informal caring networks, mutual trust and social norms that favour civil commitment and trustworthiness. However, evidence contradicts this hypothesis, finding instead that Nordic-style welfare regimes, where there are more universal services, tend to have higher rather than lower levels of bonding and bridging social capital.[30],[31],[32]

Much evidence and commentary relating to solidarity and public services focus how market-based systems undermine a shared sense of interest and purpose, and how ‘calculations of individual self-interest diminish collective understanding and recognition of mutual need.’[33] Richard Titmuss famously demonstrated that a market-based blood donation service is likely to be less effective than a collective one based on voluntary donations.[34] When nursery staff decided to fine parents who collected their children late, to encourage good time-keeping, parents interpreted the fine as payment for services and felt able to ‘buy themselves out of their social contract’.[35],[36]There is a rich literature on the ways in which neoliberal capitalism, based on individualism, choice and competition, weakens the values of social citizenship and undermines solidarity.[37]

Sustainability

Sustainability involves, at its simplest, an inherent ‘capacity for continuance’.[38] That suggests a system that can function in ways that continue to achieve its desired goals over time. UBS could have positive impacts on sustainability through prevention of harm, through economic stabilisation and through helping to mitigate climate change and the depletion of natural resources.

Depending on how they are designed and delivered, and how they interact with each other, public services can prevent harm. They are arguably better able to do this than market-based systems, because their aim is not simply to sell specific commodities, but to serve the public interest. When people are healthy and able to think for themselves and function well in society, they are less likely to have problems that require costly interventions. Good education and decent housing can help to avoid illness, for example.[39] Preventative services not only help people to stay well and flourish; they also preempt spending in the medium and longer term. They generally cost less than downstream interventions that try to cope with the consequences of harm.[40] And they can reduce demand for a range of services, not just healthcare. Unemployment, anti-social behaviour and many forms of crime, for example, have roots in poverty and deprivation.[41]

Public services can help to stabilise economic fluctuations by generating relatively secure employment. And, while they are vulnerable to government austerity policies, they are not directly linked to downturns in the market. By acting as a counter cyclical buffer, helping to offset the effects of market cycles and recession, they contribute to the economy’s ‘capacity for continuance’.

A move towards more and better public services is likely to prove more environmentally sustainable than a market based system. There is some comparative evidence that publicly funded health care has a lower carbon footprint than privately funded alternatives. For example, the US healthcare system directly accounts for 8 per cent of emissions in the US, compared with 3 per cent of UK emissions directly stemming from the NHS. This is due both to the greater macro-efficiency and lower expenditure shares of health in the UK, and to lower emissions per pound or dollar spent, presumably as a result of better allocation of resources and procurement practices.[42]

Public services perform important precautionary environmental and climate functions in their own right. The impact of Hurricane Katrina on the poor and black populations of New Orleans, in contrast to the population of Cuba, affected by the same hurricane, demonstrated the importance of collective services in dealing with climate-related risks. They are also better able to pioneer and support environmentally sustainable practices, for example energy and resource efficiency in social housing and other buildings, and supporting sustainable travel for staff, and are more likely to spread these out among a wider range of institutions. They are more ready to follow guidance and directives from government to reduce emissions, because they share public interest values. Finally, there is some evidence that welfare states are generally better suited to adopting and implementing pro-environmental policies, especially where they embody ideas about shared needs and collective responsibilities.[43]

Complexities and Challenges

UBS is a complex, multi-faceted idea, as we have noted. The term refers to collectively generated activities, funded or otherwise supported by the state, that enable people to meet their needs and are available to all according to need, not ability to pay. Since the goal of UBS is to strengthen and extend the range of services, much depends on how it is done in order to maximise equity, efficiency, solidarity and sustainability. In this chapter, we explore complexities inherent in the idea that point to options for meeting the challenge, and then engage with critiques of UBS that have been raised in the short space of time since the idea was first published.

Meeting Different Needs

The most obvious complexity is the wide range of services that express collective responsibility for meeting shared needs. Education, healthcare and policing are obvious examples of existing services that are free to all. Childcare and adult social care can be seen as partly – and inadequately – included. Housing, libraries, legal aid and youth clubs were once included but are now residual or non-existent. Public transport services vary widely between areas and are sometimes free. Household utilities (water, sewage, energy, telephony) are regulated but not publicly funded. Other essential services such as roads and railways, street lighting and management of parks and leisure facilities are part of the picture. It is beyond the scope of this review to provide a full taxonomy.[44]

Here, we focus mainly on social - or what have been described as ‘providential’ -services, as distinct from ‘material’ services. These comprise ‘(mainly) public-sector welfare activity providing the universal services available to all citizens’, rather than ‘the pipes, cables, networks and branches which continuously connect households to daily essentials’[45] We are also interested in transport and information, which in our view span both categories.

Responsibilities and Power

There are multiple ways in which responsibility is exercised to ensure that services are accessible to all according to need, not ability to pay. The post-war settlement located responsibility with the state, so that services were provided directly by national or local government. Many services are now commissioned by government from private or third sector organisations. NGOs have sometimes stepped in to provide services abandoned by government. Responsibilities are thus spread out in various combinations, with government, commercial businesses, non-profit, charitable and voluntary organisations playing different roles in different settings. Meanwhile, members of the public who use or may need services are cast variously as clients, customers, consumers, partners or participants, signalling different functions and degrees of responsibility.[46]

The traditional top-down model of public provision has been criticised for disempowering people who use services, discouraging civic and familial mutual aid, and encouraging dependence on the state. Advocates of market values, as well as some groups of services users, have claimed that people are empowered by exercising choice. However, experience has shown that, unless everyone has adequate information, skills and confidence, choice will only empower the better off and better educated. It has also shown that choice is often illusory because there is little or nothing to choose between. Meanwhile, some commercial organisations have amassed power by growing their share of contracted-out services, where regulation is too light or ineffective; some have come to enjoy monopolistic power.[47]

There is substantial support for devolving power to local areas. This ambition is shared by widely differing political tendencies. For those on the right, the aim is to shift responsibility away from the state to locally based charities, businesses and other non-government organisations, and to reduce state funding or withdraw it altogether.[48] Around the political centre, ‘localism’ means shifting power from national to local government and boosting the capacity of councils to raise funds so that they can ensure that their residents’ needs are met – either directly or in partnership with other local organisations and residents.[49]

Communitarians and supporters of the ‘commoning’ movement want to encourage independent, local groups to take control of services, which they define and manage for themselves. Within these groups, there is a strong anti-state strand of politics, which sees government as part of the problem not the solution, and favours local self-determination and self-organisation as an alternative, rather than a market-based system.[50] Others favour devolution of power to local areas and want much more control in the hands of residents than some protagonists of localism, but they seek to achieve this within a social democratic framework where the state retains three key responsibilities: to collect and distribute funds, to set and enforce quality standards, and to ensure equity of access.[51]

Models of Ownership and Funding

Beyond direct state ownership, there is a wide range of models for organisations providing services. These include multi-national corporations, small and medium-sized businesses, social enterprises, cooperatives and mutuals, user-led organisations, registered charities and community groups organised around neighbourhoods or shared needs and interest. Partnerships are often formed between public bodies and NGOs for the purpose of delivering services.[52]

Arrangements for resourcing services vary across the range of ownership models. Major public services are fully funded through taxation, with levels of funding varying according to government policy. In some cases, those who need the service must make a financial contribution and the level may be means-tested. Sometimes public funds are distributed to individuals as fixed payments or vouchers, which can be used to buy services they need or want (and can afford).[53]

In many cases, government bodies fully fund contracted-out services; they also give grants to third-sector organisations to enable them to undertake various activities and encourage them to raise further funds elsewhere. Businesses sometimes invest but only where they anticipate future dividends. Philanthropic giving is an increasingly important source of funds as austerity kicks in. Voluntary activity (unpaid labour) also provides substantial – and routinely undervalued - resources.[54]

Degrees of Participation

Most providers these days have policies on user participation or personalisation, but the extent to which people actually participate in decisions about services varies widely. This ranges from receiving information and being consulted, to being actively engaged and co-producing services at the planning, design and delivery stages. Co-production involves users and providers of services forming an equal partnership and combining experiential and codified knowledge to develop ways of meeting needs. Advocates of ‘commoning’ envisage people taking control of identifying needs and the best way to meet them, as well as design and delivery. Coproduction and commoning challenge the very idea of a ‘service’, because they focus on people being part of the action to meet their own needs, rather than simply having services delivered to them - hence our reference to ‘activities’ rather than just services in our definition of UBS.[55]

Potential benefits of UBS and the Role of the State

The quality and scope of collective activities – and how far they promote equity, efficiency, solidarity and sustainability - depend on how all these variables are combined and how they interact. Perhaps the most crucial factors are the ways in which people are engaged in designing and delivering activities to meet their needs, and the role of the state in distributing funds and ensuring standards and equal access.

Funding and participation are often interdependent. As Beresford observes, austerity has been a ‘poor bedfellow’ of participation, as policy makers pay lip service while implementing spending cuts. ‘Retreat from meaningful involvement impoverishes public provision, undermines accountability and creates a vicious circle of ever-diminishing engagement and support.’[56]

A positive relationship between locally generated activities and state institutions is all-important if the ‘vicious circle’ is to be turned into a virtuous one. This points to a new dynamic between ‘bottom-up’ and ‘top-down’ politics, and the need for significant changes to the culture and practice of public authorities. In a nutshell, public service professionals would need to encourage inclusive participation and local control, welcome innovation, facilitate diverse activities, actively support local organisations to meet quality standards, rather than simply police them, and distribute adequate resources equitably between different localities.[57]

Conditionality and Entitlement

Inherent in the idea of a universal service (as distinct from a universal cash payment) is that access is conditional in that it depends on need. Who decides who needs what will vary from one service to another: eligibility may depend on professional judgement, locality or age, or on a claim by the individual – or a combination of these.

Assuming universality is country specific rather than global, who within the UK is eligible for access to services to meet their needs? Would eligibility derive from citizenship or from residence, or something else? Atkinson put forward the idea of entitlement based on resident participation,[ii], [58] which could be seen as ‘a move towards a reimagined social citizenship, based on plural identities and rights conferred on residents rather than on passport-holders’.[59]

The concept of UBS implies that eligible individuals have rights to activities that meet their needs. These are positive social rights to gain access to services, as distinct from negative civil and political rights, which usually involve freedom from various kinds of intrusion or harm. Social rights are strongly linked with the vision of social citizenship that underpins the post-war settlement, but unlike civil and political rights, they are not well established in UK law and would need further development. Equally important are ‘procedural rights’: systems and protocols that enable people to know and claim what they are entitled to by means that are fair, accessible, timely and affordable.[60]

Common Features

Taking all these factors into consideration and looking across the range of possibilities suggested here for strengthening and extending UBS (education, healthcare, childcare and adult social care, transport, information and housing) we can see that mechanisms for design and delivery would be customised to suit the character and history of each service area. Transport services, for example, would be varied according to local geography and are less individually tailored than adult social care (at its best) – and so forth.

Yet there are certain features that should arguably be shared across all of them:

• collective responsibility for meeting shared needs, exercised through democratically elected governments;
• accessibility and affordability for all, according to need not ability to pay;
• devolution of power to the lowest appropriate level (according to the principle of subsidiarity);
• diverse models of ownership and control, with collaboration and partnerships within and between service areas;
• meaningful participation by people who use or may need to use services, alongside professionals and other front-line workers, in decisions about design and delivery;
• key role for the state in distributing funds and ensuring standards and equal access;
• clear rules and procedures for eligibility and entitlement.

Challenge to UBS

Because UBS has only recently been articulated as an option for public policy, there is so far very little direct challenge in the literature. Where it has begun to emerge, the challenges can be roughly summarised as follows. UBS would lead to big government, centralised power, paternalism and social engineering. The state is not competent to realise the vision. There is lack of clarity about how decisions would be made. It would lead to further accumulation by big business. It would be too costly to win support from the electorate and would run into strong resistance from those with an interest in the status quo. It is incompatible with capitalism and calls for radical transformation, not piecemeal reform.[61] These are all valid points. As the authors of Foundational Economy rightly note, ‘the devil is in the detail’.

The extent to which any UBS system enhanced the power of central government would be influenced by how far it adopted diverse models of ownership and by degrees of public participation. The state would be more or less competent to realise the vision depending on how far the development of UBS was accompanied by institutional learning and systemic change. A democratic framework for making decisions would be essential: one approach that may merit further exploration is ‘a dialogue that combines lay people along with professionals (in service delivery, for example) and other experts, and with democratically elected representatives.’[62]The challenge about maximising profits for big corporations could be met through tighter regulation and stronger commissioning criteria, as well as by making it easier for public bodies and other non-profit organisations to provide services. How far costs would meet voter opposition and resistance from current stakeholders would depend partly on whether changes were introduced incrementally, partly on voters’ attitudes to paying more taxes for public services (which as we have noted are more favourable now than they have been for some time), and partly on the political and economic environment in which changes were introduced. The question of whether UBS is incompatible with capitalism is worth asking but beyond the scope of this review.

There is clearly a great deal more work to be done to flesh out aspirations for UBS, its philosophical bases, costs and benefits, and the nuts and bolts of implementation

[i] In public policy, inputs can refer to expenditure of resources, such as money or labour, as well as government regulation. Outputs refer to the implementation of legislation and the delivery of specific transfers and services, such as social care or health procedures.

[ii] Atkinson was considering eligibility for income support, but the concept can equally apply to services.

References

[1] Social Prosperity Network. (2017). Social prosperity for the future: A proposal for Universal Basic Services. UCL: IGP. https://www.ucl.ac.uk/bartlett/igp/sites/bartlett/files/universal_basic_services_-_the_institute_for_
global_prosperity_.pdf

[2] Standing, G. (2017). Basic Income: And How Can We Make It Happen. London: Pelican; Van Parijs, P. and Vanderborght, Y. (2017). Basic income. A radical proposal for a free society and a sane economy. Cambridge: Harvard University Press; Downes, A., & Lansley, S.(2018). It’s Basic Income: the global debate. Bristol: Bristol Policy Press; Zamora, D. (2017). The Case against a Basic Income. Retrieved from https://www.jacobinmag.com/2017/12/universal-basic-income-inequality-work. Accessed 9 January 2018; Mestrum, F. (2018) .Why basic income can never be a progressive solution. In Downes, A. & Lansley, S. (eds.), It’s Basic Income: The Global Debate. Bristol: Bristol Policy Press.

[3] Coote, A. and Yazici, E. (2019, forthcoming) Universal Basic Income, A Literature Review, Public Services International.

[4] Roberto Unger, (2014) https://www.ippr.org/juncture/juncture-interview-roberto-unger-onthe-means-and-ends-of-the-political-left

[5] Social Prosperity Network (2017) op cit, p.10-11

[6] Doyal, L. & Gough, I. (1991). A Theory of Human Need. Basingstoke: Palgrave Macmillan

[7] Rao, N. and Min, J. 2018. Decent living standards: material prerequisites for human wellbeing. Social Indicators Research, Volume 138, Issue 1, pp 225

[8] Marshall, T. (1965). The Right to Welfare. The Sociological Review, 13(3), pp.261-272.

[9] Tawney, R. (1964). Equality. 5th ed. London: Allen and Unwin.

[10] Slocock, C. (2018) Why social infrastructure is key to prevention. Retrieved from https://www.
civilsociety.co.uk/voices/caroline-slocock-whysocial-infrastructure-in-key-to-prevention.html Accessed 30 January 2019

[11] Gough, I. (2017) Heat, Greed and Human Needs, Edward Elgar, ch.7.

[12] G. Verbist, M. F. Förster & M. Vaalavuo. (2012). The Impact of Publicly Provided Services on the Distribution of Resources: Review of New Results and Methods. OECD, OECD Social, Employment and Migration Working Papers, No. 130, p. 35.

[13] Ibid, p. 25-26.

[14] Wilkinson, R. G., & Pickett, K. (2010). The spirit level: Why greater equality makes societies stronger. New York: Bloomsbury Press.

[15] Evandrou, M, Falkingham, J., Hills, J. & Le Grand, J., (1993). Welfare Benefits in Kind and Income Distribution. Fiscal Studies. 14(1). pp. 57 – 76.

[16] Sefton, T. (2002). Recent Changes in the Distribution of the Social Wage. CASE Paper 62, London: LSE. p. 46.

[17] Office of National Statistics (2018) Effects of taxes and benefits on UK household income: financial year ending 2017. Section 4, Fig. 5. https://www.ons.gov. uk/peoplepopulationandcommunity/ personalandhouseholdfinances/ incomeandwealth/bulletins/theeffectsoftaxes andbenefitsonhouseholdincome/ financialyearending2017#how-much-do-taxesand- benefits-affect-the-distribution-of-income Accessed 28th February 2019.

[18] Gough, I. (2008) European welfare states: Explanations and lessons for developing countries. In Dani, A., and Haan, AD. (eds.), Inclusive States: Social policy and structural inequalities, Washington DC: World Bank. p. 42.

[19] Wahl, A. (2011). The Rise and fall of the welfare state. London: Pluto Press, p. 122-123.

[20] Local Government Association. (2012). Services shared: costs spared?. Retrieved from https://www.local.gov.uk/sites/default/ files/documents/services-shared-costs-spa- 61b.pdf Accessed 18 January 2019; OECD (2015), Building on Basics, Value for Money in Government, OECD Publishing, Paris, https:// doi.org/10.1787/9789264235052-en. Accessed 28th February 2019. p. 145-163.

[21] Modi, N., Clarke, J. and McKee, M. (2018) ‘Health systems should be publicly funded and publicly provided’, BMJ. 362. https://www.bmj. com/content/362/bmj.k3580 Accessed 20the February 2019.

[22] Brownlee, S. (2007). Overtreated: Why too much medicine is making us sicker and poorer. New York: Bloomsbury USA, p. 99-109; 206.

[23] ONS. (2016). How does UK healthcare spending compare internationally?. Retrieved from https://www.ons.gov.uk/ peoplepopulationandcommunity/healthand socialcare/healthcaresystem/articles/ howdoesukhealthcarespendingcompare internationally/2016-11-01. Accessed 10 January 2019.

[24]Mladovsky, P., McKee, M., Ingleby, D., and Rechel, B. (2016). Greater public investment is needed to fund the NHS at a level considered normal in other high income countries. Retrieved from http://blogs.lse.ac.uk/ healthandsocialcare/2016/01/11/greater-publicinvestment- is-needed-to-fund-the-nhs-at-alevel-considered-normal-in-other-high-incomecountries/. Accessed 17 January 2019.

[25] Harding, AJE., and Pritchard, C. (2016). UK and Twenty Comparable Countries GDPExpenditure- on-Health 1980-2013: The Historic and Continued Low Priority of UK Health- Related Expenditure. International Journal of Health Policy and Management. 5(9). pp. 519- 523.

[26] DCMS. (2018). The Public Services (Social Value) Act 2012: introductory guide. Retrieved from https://assets.publishing.service.gov. uk/government/uploads/system/uploads/ attachment_data/file/690780/Commissioner_ Guidance_V3.8.pdf. Accessed 17 January 2019. p. 2.

[27] Coote, A., and Angel, J. (2014). Solidarity: Why it Matters for a New Social Settlement. NEF Working Paper. Retrieved from https://b.3cdn. net/nefoundation/207c255d8a0c04cba0_ sum6b1yy7.pdf. Accessed 17 January 2019.

[28] Durkheim, E. (1984). The Division of Labour in Society. London: Palgrave Macmillan, pp. 154-9.

[29] ibid.

[30] Kääriäinen, J. and Lehtonen, H. (2006). The Variety of Social Capital in Welfare State Regimes – A Comparative Study of 21 Countries. European Societies, 8(1), pp.27-57.

[31] Oorschot, WV., and Arts, W. (2005). The social capital of European welfare states: the crowding out hypothesis revisited’. Journal of European Social Policy, 15(1), pp. 5-26.

[32] Rothstein, B., and Stolle, D. (2003). Social Capital in Scandinavia. Scandiavian Political Studies. 26(1), pp. 1-25.

[33] Sennett, R. (2012). How Markets Crowd Out Morals. The Boston Review. Retrieved from http://bostonreview.net/forum-sandel-sennettmarkets- morals. Accessed 17 January 2019.

[34] Titmuss, R., Oakley, A. and Ashton, J. (1997). The gift relationship. New York: The New Press.

[35] Sandel, M. (2013) What Money Can’t Buy: The Moral Limits of Markets. London: Penguin. 64-5.

[36] Dean, J. (2015). Volunteering, the market, and neoliberalism. People, Place and Policy, 9(2), pp. 139-148.

[37] Lynch K. and Kalaitzake, M. (2018). Affective and calculative solidarity: the impact of individualism and neoliberal capitalism. European Journal of Social theory. pp 1-20; Brodie, J.M. (2007). Reforming social justice in neoliberal times. Studies in Social Science: 1, no.2.; Jayasuriya, K. (2006). Statecraft, welfare and the politics of inclusion. Basingstoke: Palgrave Macmillan, p.15.

[38] Ekins, P. (2014). Strong sustainability and critical natural capital. In G. Atkinson, S. Dietz, E. Neumayer and M. Agarwala (eds), Handbook of Sustainable Development, UK: Edward Elgar Publishing, p 56.

[39] Marmot, M., Allen, J., Goldblatt, P., Boyce, T., McNeish, D., Grady, M., & Geddes, I. (2010). Fair Society Healthy Lives: The Marmot Review. London: Department of Health, p.16- 18. Retrieved from https://www.parliament.uk/ documents/fair-society-healthy-lives-full-report. pdf Accessed 10 January 2019.

[40] Early Action Task Force. (2011). The Triple Dividend. Retrieved from https://s27436.pcdn. co/wp-content/uploads/Triple_Dividend.pdf. Accessed 17 January 2019.

[41] Coote, A. (2015). People, Planet Power: towards a new social settlement. London: NEF, p.19.

[42]. Gough, I. (2017) Heat, Greed and Human Need, p.163.

[43]Gough, I., Meadowcroft, J., Dryzek, J., Gerhards, J., Lengfeld, H., Markandya, A. & Ortiz, R. (2008). Climate change and social policy: A symposium. Journal of European Social Policy, 18(4), pp. 325–344.

[44] Dwyer, P., and Shaw, S, eds. (2013). An Introduction to Social Policy. London: SAGE Publications, p.20.

[45] Foundational Economy Collective. (2018). Foundational Economy: The Infrastructure of Everyday Life. Manchester: Manchester University Press. pp.40-41.

[46] Barnes, M., and Prior, D., eds. (2009). Subversive citizens: Power, agency and resistance in public services. Bristol: Policy Press, p.5.

[47] Jones, R. (2015). The end game: The marketisation and privatisation of children’s social work and child protection. Critical Social Policy, 35(4), p. 447; Liberty. (2016). G4S a History of Discrimination, Human Rights Violations Malpractice and Mismanagement in the UK. London: Liberty. https://www. libertyhumanrights.org.uk/sites/default/files/ G4S%20dossier.pdf Accessed 22nd January 2019.; NHS Support Federation. (2016). Contract Alert: Outsourcing in the NHS. http://www. nhsforsale.info/uploads/images/contract_alert_ feb_2016.pdf Accessed 22nd January 2019.

[48] Coote, A. (2010). Ten Big Questions about the Big Society. London: New Economics Foundation, https://neweconomics.org/2010/06/ ten-big-questions-big-society. Accessed 22nd January 2019.; Findlay-King, L., Nichols, G., Forbes, D. and, Macfadyen, G. (2018). Localism and the Big Society: the asset transfer of leisure centres and libraries – fighting closures or empowering communities?, Leisure Studies, 37:2, p. 158.

[49] Turner, E. (2019). Empowering local government or just passing the austerity buck? The changing balance of central and local government in welfare provision in England 2008–2015, Regional & Federal Studies, 29:1, p. 45.

[50] McCarthy, J. (2005). Commons as counterhegemonic projects, Capitalism Nature Socialism, 16:1, p.17.

[51] Mestrum, F. (2018) .Why basic income can never be a progressive solution. In Downes, A. & Lansley, S. (eds.), It’s Basic Income: The Global Debate. Bristol: Bristol Policy Press, p.97-8.

[52] . Angel, J. (2014) Moving Beyond the Market: a new agenda for public services, London: NEF, 35-41. https://b.3cdn.net/nefoundation/ d2675fe54cb1ce0203_ldm6bkjoz.pdf Retrieved Jan 2019. See also Cumbers, A. (2012). Reclaiming Public Ownership. London: Zed Books; Wainwright, H. (2009). Reclaim the State: Experiments in Popular Democracy. London: Seagull Books.

[53] Konings, J. (2010). Childcare Vouchers: Who Benefits?. London: Social Market Foundation, p. 7. http://www.smf.co.uk/wp-content/ uploads/2010/01/Publication-Childcare- Vouchers-Who-Benefits-An-Assessment-of- Evidence-from-the-Family-Resources-Survey. pdf. Accessed 23rd January 2019.; Wood, C., and Slater, J. (2013). The Power of Prepaid. London: Demos, p. 9-15. https://demosuk. wpengine.com/files/Power_of_prepaid_-_web. pdf?1359476379 Accessed 23rd January 2019.

[54] Goodwin, N. (2018). There is more than one economy. The real-world economics review, 84, p. 24. http://www.paecon.net/PAEReview/ issue84/Goodwin84.pdf. Accessed 22nd January 2019.; Hill, M. (2014). It’s the economic value, stupid but is volunteering really worth £100bn to the UK?”. https://blogs.ncvo.org. uk/2014/06/26/its-the-economic-valuestupidbut- is-volunteering-really-worth-100bn-tothe- uk/. Accessed 22nd January 2019.

[55] Coote, A. (2017). Building a New Social Commons: The People, the commons and the public realm. London: New Economics Foundation, p. 5. https://neweconomics.org/ uploads/files/Building-a-New-Social-Commons- WEB-version.pdf. Accessed 23rd January 2019.; Stephens, L. (2008). Co-Production: A manifesto for growing the core economy. London: New Economics Foundation, p. 9-12.

[56] Beresford, P. (2019). Austerity is denying patients and care service users a voice. The Guardian. Retrieved from: https://www. theguardian.com/society/2019/jan/14/austeritydenying- patients-care-service-users-voice. Accessed 17 January 2019.

[57] Boyle, D., Coote, A., Sherwood, C., and Slay, J. (2010). Right here, right now: Taking coproduction into the mainstream. London: Nesta, p.16. https://media.nesta.org.uk/documents/ right_here_right_now.pdf. Accessed 23rd January 2019.

[58] Atkinson, AB. (2015). Inequality: What Can Be Done? Cambridge, Mass.: Harvard University Press, p.219.

[59] Coote, A. (2017). Building a New Social Commons. London: NEF, p.16. https:// neweconomics.org/uploads/files/Buildinga- New-Social-Commons-WEB-version.pdf Accessed January 2019.

[60] . ibid, 12-13. See also: Galligan, D. “Procedural Rights in Social Welfare” in Coote, A. (ed). (1992). The Welfare of Citizens: Developing New Social Rights. London: IPPR, p.56.

[61] See for example, Foundational Economy op cit, p. 123-130; Simon Duffy (2018) https:// www.centreforwelfarereform.org/library/ by-az/basic-income-or-basic-services.html; Frankel B., (2018) Fictions of Sustainability, 262-266 https://static1.squarespace.com/ static/5a31d12464b05f599b827478/t/5b8e 7ed170a6adae1d474b39/1536065238265/ FictionsOfSustainability_REVIEW.pdf.

[62] https://neweconomics.org/uploads/files/ Building-a-New-Social-Commons-WEB-version. pdf p.14-15.

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