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Top down – or bottom up?. Simon Courage. Language Policy levers. Or instruments. What’s available - examples. Taxation Raise money VAT Reward and penalise certain behaviours Zero-rated VAT on food. What’s available - examples. Regulation To permit Civil partnerships In favour of

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what s available examples
What’s available - examples
  • Taxation
    • Raise money
      • VAT
    • Reward and penalise certain behaviours
      • Zero-rated VAT on food
what s available examples1
What’s available - examples
  • Regulation
    • To permit
      • Civil partnerships
    • In favour of
      • Vitamins in bread
    • Against
      • Theft
what s available examples2
What’s available - examples
  • Performance management
    • Targets
      • Hospital A&E admission times
    • Inspection
      • Ofsted in schools
what s available examples3
What’s available - examples
  • Ensure provision of services
    • Direct
      • Police
    • Procured
      • Bulk waste disposal
what s available examples4
What’s available - examples
  • Exhortation
    • Leadership
      • Local authority convening of partnerships
    • Evidence base
      • Research, evaluation, data warehouses
what happens1
What happens

Perverse effects

what happens2
What happens

Professional resistance

slide13
4 Cs

Competition

Contestability

Introduce threat of competition

Reduce barriers to entry

Open up, say, 15% to private or third sector

Keep public sector on toes

NHS elective surgery

  • Providers compete for contracts
  • Price and quality, plus other desired effects
  • Open up to private and third sectors
    • Work Programme for unemployed people
slide14
4 Cs

Choice

Civil society

State rolled back to make way for civil society

Farmers’ markets

Civil society organisations deliver services on behalf of state

Recycling

Civil society creates new services

Pocket parks - dowry

  • Parent, patient – client, user – chooses
  • Expresses preference from range
    • School admissions
    • NHS Choose & Book
    • Choice-based lettings
to make this work
To make this work
  • Requires good information for users
    • League tables
      • Schools
    • Which XX? lists
      • Universities
    • Inspection reports
      • Hospitals
  • Good advice
    • Especially for disadvantaged
      • GP as gateway to hospitals
  • Understand the limits of markets
    • We don’t really understand health, can’t prepare
      • Pathways
where next
Where next?
  • How far could you take this?
    • Choice of police inspector?
  • Where shouldn’t you use this?
    • Judiciary
  • Q&A