ABSTRACT
Introduction Across Europe, various procedures and regulations are having a major impact on the management and organisation of service providers. Commissioning, including activities such as contracting and procurement, is one of the most crucial, having obligations to engage in competitive tendering in order to be contracted as providers. Furthermore, once providers secure a contract, various review systems are required to monitor and evaluate the outcomes of the services (Seymour 2010). Since 2000, relations between the state and the voluntary sector have increasingly been managed through market practices (Knapp et al. 2001; Cunningham and James 2009; Alcock 2010). Before this, the voluntary sector was based on principles of solidarity within civil society, often advocating for the rights of marginalised groups (Dufva 2005; Jordan and van Tuijl 2006). Along with commissioning, quasi-markets in social care (with competition amongst independent providers) have replaced monopoly provision by state bureaucracies (Vincent-Jones 2006: 180; Carmel and Harlock 2008; Bode et al. 2011). The basic principle is that the municipal authority will select “the providers who come closest to meeting its needs at the quality and quantity required and at an affordable price” (Wistow et al. 1992: 36). Commissioning requires reformulating and specifying the differing responsibilities between commissioners and service providers (Stace and Cumming 2006; Rubery et al. 2012). This chapter investigates responsibilities of service providers, especially those that relate to their contractual duties within commissioning. We ask how the various responsibilities of non-governmental organisations (NGOs) acting as service providers are constructed, accounted for and resisted in the interview talk of the three parties: the managers of NGOs who provide the services, the commissioners who purchase the services, and the care coordinators who form a link between purchasers, providers and clients. Whereas commissioners and NGO managers have rather straightforward roles, the notion of the care coordinator might require explanation. As noted in Chapter 9, the care coordinator is a case manager, who is responsible for the client’s care plan and managing the contribution of various service providers (Bayard et al. 1997; Onyett 1998). One care coordinator we interviewed explains her role as follows:
“I’m not there to provide that service. We’re [care coordinators] coordinating that service to provide that support”. Similarly, an interviewed manager of a service-providing organisation explains that the task of a care coordinator is to “put together a support plan. And then the project workers [of the service provider] basically deliver the support plans”. However, the care coordinators studied in this chapter do not (as yet) control a budget to purchase services for their clients. Initially, the chapter examines literature on commissioning in social and health services, to illustrate the responsibilities of service providers and the context in which they operate. The expectations towards providers within commissioning processes are then examined in the governmentality literature – more specifically, the ideas of contractual implication and the re-responsibilisation of providers are looked at. Furthermore, recovery as a welfare discourse is linked with the expectations that are set for providers. Empirical analysis draws on interviews with three key stakeholders in commissioning: commissioners, provider managers and care coordinators. Their talk regarding service providers’ responsibilities is analysed by using the analytic concepts of accountability and resistance. Overall, the chapter demonstrates the responsibilities of providers to move their clients forward to more independent support, and the range of subtle ways to resist this responsibility.
