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project findings | PROJECT OUTLINE |

Modes of Consumption and Citizenship and the Welfare State in the UK

Issues of choice and consumerism have been central in recent policy making and discourse. The overall aim of the project was to examine how policy makers have viewed users of the welfare state in three services (health care, education, and housing) since 1945 in terms of ‘ideal types’ of citizen, consumer and client. We compared the existing conceptual and empirical literature with evidence from policy documents, files from the National Archive and oral testimony from a Witness Seminar. Our findings challenge the conventional understanding of the development of public services in the post-war period. Instead of viewing users largely as citizens, our research suggests their predominant conception has been that of clients, and more recently as consumers.   

This project ran from October 2004 to December 2006

image illustrating findings

click to view the findings summary sheet for this project>>

Project team
Martin Powell award holder
Ian Greener
Nick Mills
Shane Doheny

Prof. Martin Powell
Health Services Management Centre
University of Birmingham
Park House
40 Edgbaston Park Road
Edgbaston, Birmingham, B15 2TT

0121 414 4462

Publications include

Greener I., Powell M., Mills N. and Doheny S. ‘How Did Consumerism Get Into the NHS?’ Cultures of Consumption Working Paper No.29,(2006) download as word document >>

Greener I., Powell M., Mills N. and Doheny S. ‘The Governance of Health Policy in the United Kingdom’, in Bevir M. and Trentmann, F.(eds.), Governance, Consumers and Citizens: Agency and Resistance in Contemporary Politics (Basingstoke: Palgrave Macmillan, forthcoming, 2007).

Greener I., ‘Markets in the Public Sector: When Do They Work, and What Do We Do When They Don’t?’, Policy and Politics (forthcoming, 2007).


Project outline

The following is the text of the project's original proposal


Issues of consumption, consumerism and choice are at the centre of the New Labour’s public sector reform agendas across the public services. However we still have only a limited knowledge of consumption in relation to the welfare state. This project analyses consumption in the welfare state using ideal types based on consumerism, citizenship and clientism. It then examines how policies in three UK public services – health care, education and housing - have utilised discourses based on these ideal types since 1945

The project utilises computer software (‘T-lab’) to present statistical characteristics of. key theoretical texts on consumption in the welfare state and policy statements and other key welfare documents which will be supplemented by iterative close readings of the same documents. The two elements will be mapped onto one another, looking to see how theoretical debates on consumption and citizenship have affected policy in the areas examined.

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In today’s welfare state in the UK issues around consumption have become central to programmes of policy reform and reorganisation. In education we have seen the rise of parent choice in all levels of provision, in healthcare an attempt at an ‘internal market’ for health in the 1990s and a revitalisation of patient choice under the present government, and the balance between public and private housing provision has been a central concern throughout the post-war period.

The government claims that the welfare state has to move from a 'command and control', ‘one size fits all’ model towards greater choice, flexibility and diversity. However, consumption in the welfare state was (and remains) more complex than this simple claim allows. For example, the 'classic welfare state' of 1945 was never simply a 'command and control' model, but better described as 'bureau-professional', with a mix of citizenship and clientism. Moreover, there is a body of work, largely uncited today, that recognised, at the beginning of the welfare state, the problems of going from the 'Austerity Society' to the 'Affluent Society'.

New Labour’s reforms appear to suggest that consumption can be made to work in tandem with citizenship, but, again, it is not entirely clear that this is the case. An important question for policy is whether different elements can be combined: can we achieve the best of both worlds, or do the elements not mix (like oil and water), or - worse- do they drive each out others (eg contract drives out trust).

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  • Are users or recipients of welfare largely conceptualised in terms of being consumers, citizens or clients (or hybrid types)?
  • Do these conceptions vary over time? (eg do we see moves from citizen to consumer?)
  • Do these conceptions vary between services? (eg at an given point in time, do we see consumers in health care but citizens in education? )
  • Do these conceptions vary within services? (eg do we find consumers in primary health care but clients in secondary health care; or citizens in primary education, but consumers in higher education?)
  • To what extent are these models compatible? Are terms consistent (eg are wants associated with consumers, while needs associated with citizens?) Is a consumer-citizen possible, or do the elements of citizenship drive out those of consumerism?

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The project has two stages. The first stage involves identifying key terms in the welfare state and consumption literature associated with the three ideal types of consumer, citizen and client. This draws on wider conceptual sociology, politics and welfare state literature, with a particular emphasis on retrieving and refining forgotten theoretical approaches. Key sources from both literatures will be entered into the T-Lab software, which may be used in confirmatory and exploratory senses. It can count the occurrences of specified terms, but it can also examine the over-use or under-use of (unspecified) terms, both in respect of each other, but also in relation to a general corpus of the English language. For example, it can easily and quickly report how often terms such as 'rights' appear, and whether they are associated more with 'citizen's' or 'consumer's' in a particular text. It can also draw attention to concerns of consistency in a text; for example, whether 'needs' are associated with 'citizens' while 'wants' are associated with 'consumers'. Not only will this yield quantitative information, but will also allow attention to be focused easily on vital areas of text. As such, it goes some way to dealing with a central problem of critical discourse analysis: the entry point or means of beginning a coherent textual analysis. Stage one will produce conceptual maps of keywords from the texts, providing statistical triangulation of our findings, which will be checked against existing typologies and accounts.

The second stage involves detailed textual analysis of key policy documents (White and Green Papers) in three services of education, health and housing over the period from 1945. It is intended that all White and Green Papers will be consulted and any found relevant will be scanned into T-lab. These documents will be analysed in two ways. First, they will be read using the historian's skills of documentary analysis. Second, textual analysis, as in stage one of the project, will be carried out to supplement these readings through the use of T-lab software.

The documents, however, will not be in isolation, and will be set within wider social, economic and political context. This will be achieved by a focused analysis of The National Archives (TNA) sources and Parliamentary (Hansard) Debates associated with the documents. The TNA material (open until 1974) will give the background to the documents, while Hansard will highlight any differences in terminology between Government and Opposition. In addition, the 'Times' will be searched for comments about the White and Green Papers. The final contextual material will be derived from 'witness seminars' and interviews with policy-makers (politicians, civil servants, and think tanks).

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We aim to produce a multidisciplinary project that presents retrieved and refined theoretical approaches to consumption, and new empirical evidence about the role of consumption in the welfare state. It will link welfare state with consumption literature, within a framework of consumers, citizens and clients, but with broader linkages to other frameworks of analysis whilst at the same time providing a detailed empirical study of the evolution of the welfare state. The ‘witness seminars’ will also present our findings with policymakers and civil servants from all three welfare areas we are examining to validate our findings further.



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