Politics, practitioners and people: direct payments for community care, a case study in policy implementation

Abstract

This thesis explores the complex nature of the policy process through the actions and intentions of the multiplicity of national and local actors involved in the development, through implementation, of a particular initiative: direct payments for community care. The methodology combines both 'top down' and 'bottom up' perspectives on policy- action (Sabatier, 1986) in a case study, using documents, personal accounts and observations. The case study follows New Labour's efforts to secure policy effectiveness while delegating the responsibility for implementation to local councils. The research focused primarily on one authority. It took place within the context of that authority's efforts to 'modernise' community care through pragmatism, partnership, participation and centralised performance management. The findings are compared to experiences in another authority, thereby combining the validity of Pawson and Tilley's (1997) assertion that the outcomes of the ideas and opportunities offered by policy initiatives vary with context. This comparison illustrates the influence of contextual features on policy outcomes: local politics, history, culture and the community's expectations and experiences of policy developments. In the 'policy-action' relationship examined, ultimate objectives and the means of achieving them were re-defined and prioritised through negotiation and experience, as parts of New Labour's own discourse were appropriated (Newman, 2001). The relevance of Lindblom's (1959) classic 'muddling through' account of the process is thus revealed, along with the contribution of' street level bureaucrats' in interaction with citizens (Lipsky, 1980), to policy development through implementation. The influences of values and convictions, as well as personal experience and interests, on the agency of policy actors are highlighted. The thesis concludes that central government will only achieve the objective of 'promoting independence', through initiatives intended to extend choice and control to most service users, when and where it engages and empowers people at the level of citizen-practitioner interaction.