Evidencing and evaluating the uptake and impact of outsourcing social care services in England and Denmark
Name of applicant
Anders Bach-Mortensen
Title
Postdoctoral Fellow
Institution
University of Oxford
Amount
DKK 1,253,392
Year
2022
Type of grant
Reintegration Fellowships
What?
With an aging population and a record high number of children in need of care, it has never been more important to provide effective, equitable, and well-regulated social care. To meet the growing demand of social care, England has adopted a commissioning structure that promotes and facilitates the outsourcing of social care provision to private providers. Proponents of this development argue that private sector outsourcing counteracts the inefficiency of state monopolies by allowing open competition among service providers. Several countries, including Denmark, have begun to imitate this development in the expectation that doing so will improve service quality and reduce costs.
Why?
Empirically, the shift towards outsourcing social care to private (most of which are for-profit) providers has been associated with mixed evidence in terms of service outcomes. For example, research on England tend to find substantial ownership differences in performance (often favouring non-profit and public providers), whereas studies conducted in Scandinavia demonstrate more modest variation between for-profit, non-profit, and public social care providers. Yet, the influence of country and regulatory context on outsourcing uptake and success is poorly understood and under researched. In fact, little is known about the ability of municipalities and national regulators to oversee the outsourcing of social care services and to regulate poor market outcomes.
How?
Debates about the appropriateness and consequences of outsourcing, or how to best regulate care provision, are often based on imperfect or missing information regarding the factors influencing the performance and needs of social care providers and commissioners. This lack of evidence is a central barrier to regulation. This project aims to directly address this research gap and information barrier to meaningful regulation by documenting the implications of outsourcing in terms of service outcomes in both Denmark and England. As such, the key objectives of this project are to document and evaluate the uptake of adult and children’s social care (e.g., nursing and children’s homes) outsourcing in Denmark and England, and to compare the impact this development has had on service outcomes in each country.