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The Strategy of Equality Revisited*

Published online by Cambridge University Press:  12 June 2009

Martin Powell
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Abstract

In 1982 Julian Le Grand in his text, The Strategy of Equality delivered the message that ‘almost all public expenditure on the social services in Britain benefits the better off to a greater extent than the poor’. This has been developed into the conventional wisdom, that the welfare state has failed to achieve equality. However, this pessimistic verdict may be challenged on a number of grounds. First, it is debatable to what extent the welfare state was intended to achieve the types of equality defined by Le Grand. Second, it is possible to arrive at a less pessimistic conclusion both by re-examining Le Grand's original evidence and by examining subsequent evidence on the extent of equality achieved by the welfare state. This article examines the pessimistic thesis on both conceptual and empirical grounds, with a specific focus on the National Health Service. It is concluded that reports of the failure of the welfare state may be premature.

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Journal of Social Policy , Volume 24 , Issue 2 , April 1995 , pp. 163 - 185
Copyright
Copyright © Cambridge University Press 1995

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References

REFERENCES

Abel-Smith, B. (1984), ‘Social welfare’ in Pimlott, B. (ed.) Fabian Essays in Socialist Thought. Heinemann, London.Google Scholar
Abel-Smith, B. and Titmuss, K. (1987), The Philosophy of Welfare, George Allen and Unwin, London.Google Scholar
Barbalet, J. (1988), Citizenship, Open University Press, Buckingham.Google Scholar
Barr, N. (1987), The Economics of the Welfare State. Weidenfeld and Nicolson, London.Google Scholar
Baugh, W. E. (1983), Introduction to the Social Services, Macmillan, Basingstoke.Google Scholar
Bevan, A. (1978 [1952]), In Place of Fear. Quartet Books, London.Google Scholar
Bean, P., Ferris, J. and Whynes, D. (1985) (ed.). In Defence of Welfare. Tavistock. London.Google Scholar
Bosanquet, N. (1980), ‘Labour and public expenditure: an overall view’ in Bosanquet, N. and Townsend, P. (eds.) Labour and Equality, Heinemann, London.Google Scholar
Bosanquet, N. and Townsend, P. (1980) (eds.), labour and Equality, Heinemann, London.Google Scholar
Boulton, M., Tuckett, D., Olson, C. and Williams, A. (1986), ‘Social class and the general practice consultation’. Sociology of Health and Illness. 8, 325–50.CrossRefGoogle Scholar
Bradshaw, J. and Deacon, A. (1986), ‘Social security’ in Wilding, P. (ed.) In Defence of the Welfare State, Manchester University Press, Manchester.Google Scholar
Bramley, G., Le Grand, J. and Low, W. (1989). ‘How far is the poll tax a “community charge”?’. Policy and Politics, 17, 187–205.CrossRefGoogle Scholar
Bryson, L. (1992) Welfare and the State, Macmillan, Basingstoke.CrossRefGoogle Scholar
Butler, J., Bevan, J. and Taylor, R. (1973), Family Doctors and Public Policy, Routledge and Kegan Paul, London.Google Scholar
Butts, M., Irving, D. and Whitt, C. (1981), From Principles to Practice, Nuffield Provincial Hospitals Trust London.Google Scholar
Cartter, A. M. (1955), The Redistribution of Income in Post-War Britain: A Study of the Effects of the Central Government Fiscal Program in 1948–49, Yale University Press, New Haven.Google Scholar
Collins, E. and Klein, R. (1980), ‘Equity and the NHS: self-reported morbidity, access and primary health care’, British Medical Journal, 281, 1111–15.CrossRefGoogle Scholar
Collins, E. and Klein, R. (1985), Self-reported Morbidity, Socio-economic Factors and General Practice Consultation, Bath Social Policy Papers. No. 5. University of Bath. Bath.Google Scholar
Crosland, C. A. R. (1964 [1956]), The Future of Socialism, Jonathan Cape, London.Google Scholar
Crossman, R. (1970 [1952]), New Fabian Essays, Dent and Sons, London.Google Scholar
Crossman, R. (1976), ‘The role of the volunteer in the modern social services’ in Halsey, A. H. (ed.) Traditions of Social Policy, Blackwell, Oxford.Google Scholar
Culyer, A. J. (1976), Need and the National Health Service, Martin Robertson, London.Google Scholar
Culyer, A. J. (1988), ‘Inequality of health services is. In general, desirable’ in Green, D. (ed.) Acceptable Inequalities?, Institute of Economic Affairs, London.Google Scholar
Curtis, S. (1989), The Geography of Public Welfare Provision, Routledge, London.Google Scholar
Davies, G. and Piachaud, D. (1983), ‘Social policy and the economy’ in Glennerster, H. (ed.) The Future of the Welfare State, Heinemann, London.Google Scholar
Deacon, A. (1993), ‘Richard Titmuss: 20 years on’, Journal of Social Policy, 22: 2, 235–42.CrossRefGoogle Scholar
DHSS (1976), Sharing Resources for Health in England (Report of the Resource Allocation Working Party), HMSO, London.Google Scholar
Durbin, E. F. M. (1940), The Politics of Democratic Socialism, Routledge and Sons, London.Google Scholar
Evandrou, M., Falkingham, J., Le Grand, J. and Winter, D. (1992), ‘Equity in health and social care’. Journal of Social Policy, 21: 4, 489–523.CrossRefGoogle Scholar
Foster, P. (1983), Access to Welfare, Macmillan, Basingstoke.CrossRefGoogle Scholar
Fraser, D. (1984), The Evolution of the British Welfare State, Macmillan, London.CrossRefGoogle Scholar
Freidman, M. and Freidman, R. (1981), Free To Choose, Avon, New York.Google Scholar
George, V. and Wilding, P. (1984), The Impact of Social Policy, Routledge and Kegan Paul, London.Google Scholar
Glennerster, H. (1983), The Future of the Welfare State, Heinemann, London.Google Scholar
Glennerster, H. (1990), ‘Social policy since the second world war’ in Hills, J. (ed.) The State of Welfare, Clarendon Press, Oxford.Google Scholar
Graham, D. and Clarke, P. (1986), The New Enlightenment, Macmillan, Basingstoke.Google Scholar
Gutmann, A. (1980), Liberal Equality. Cambridge University Press, Cambridge.Google Scholar
Ham, C. (1985), Health Policy in Britain, Macmillan. Basingstoke.Google Scholar
Harris, D. (1987), Justifying State Welfare, Blackwell, Oxford.Google Scholar
Hart, N. (1985), The Sociology of Health and Medicine, Causeway, Ormskirk.Google Scholar
Heald, D. (1983), Public Expenditure, Martin Robertson, Oxford.Google Scholar
Hill, M. and Bramley, G. (1986), Analysing Social Policy, Blackwell, Oxford.Google Scholar
Hindess, B. (1987), Freedom. Equality and the Market, Tavistock, London.Google Scholar
Jones, K. and Moon, G. (1987), Health, Disease and Society, Routledge and Kegan Paul, London.Google Scholar
Klein, R. (1988), ‘Acceptable Inequalities?’ in Green, D. (ed.) Acceptable Inequalities, Institute of Economic Affairs. London.Google Scholar
Le Grand, J. (1978), ‘The distribution of public expenditure: the case of health care’, Economica, 54, 125–42.CrossRefGoogle Scholar
Le Grand, J. (1982), The Strategy of Equality, George Allen and Unwin, London.Google Scholar
Le Grand, J. (1983), ‘Making redistribution work’ in Glennerster, H. (ed.) The Future of the Welfare State, Heinemann, London.Google Scholar
Le Grand, J. (1985), ‘Comment on inequality, redistribution and recession’. Journal of Social Policy, 14: 3, 309–12.CrossRefGoogle Scholar
Le Grand, J. (1991), ‘The distribution of health care revisited’. Journal of Health Economics, 10, 239–45.CrossRefGoogle ScholarPubMed
Le Grand, J. (1992), The Distribution of Public Expenditure on Health Care Revisited, STICERD WP 64, London.Google Scholar
Le Grand, J. and Robinson, R. (1984), The Economics of Social Problems, Macmillan, Basingstoke.CrossRefGoogle Scholar
Le Grand, J., Winter, D. and Woolley, F. (1990), ‘The NHS: safe in whose hands?’ in Hills, J. (ed.) The State of Welfare, Clarendon, Oxford.Google Scholar
Marquand, D. (1988), The Unprincipled Society, Fontana. London.Google Scholar
Marshall, T. H. (1963), Sociology at the Crossroads, Heinemann, London.Google Scholar
Marshall, T. H. (1970), Social Policy. Hutchinson. London.Google Scholar
Marsland, D. (1992), ‘The roots and consequences of paternalist collectivism’. Social Policy and Administration, 26: 2, 144–50.CrossRefGoogle Scholar
Maynard, A. (1985), ‘Welfare: who pays?’ in Bean, P., Ferris, J. and Whynes, D. (eds.) In Defence of Welfare, Tavistock, London.Google Scholar
Maynard, A. and Ludbrook, A. (1982), ‘Inequality, the NHS and health policy’. Journal of Public Policy, 2: 2, 97–116.CrossRefGoogle Scholar
Mays, N. and Bevan, G. (1987), Resource Allocation in the Health Service, Bedford Square Press, London.Google Scholar
Miller, S. (1987), ‘Introduction’ in Abel-Smith, B. and Titmuss, K. (eds.) The Philosophy of Welfare. George Allen and Unwin, London.Google Scholar
Minford, P. (1992), Daily Telegraph. 13 04, p. 21.Google Scholar
Ministry of Health (1944), A National Health Service (Cmnd 6502), HMSO, London.Google Scholar
Mooney, G. (1986), Economics, Medicine and Health Care, Wheatsheaf. Brighton.Google Scholar
Mooney, G. et al. (1991), ‘Utilisation as a measure of equity: weighing heat’. Journal of Health Economics, 10: 4, 475–80.CrossRefGoogle ScholarPubMed
Murphy, J. (1981), ‘Class inequality in education: two justifications, one evaluation, but no hard evidence’, British Journal of Sociology, 32: 2, 182–201.CrossRefGoogle Scholar
O 'Donnell, O. and Propper, C. (1991), ‘Equity and the distribution of NHS resources’. Journal of Health Economics, 10, 1–19.CrossRefGoogle Scholar
O 'Higgins, M. (1985a), ‘Inequality, redistribution and recession: the British experience 1976–1982’. Journal of Social Policy, 14: 3, 279–307.CrossRefGoogle Scholar
O 'Higgins, M. (1985b), ‘Welfare, redistribution and inequality: disillusion, illusion and reality’ in Bean, P., Ferris, J. and Whynes, D. (eds.) In Defence of Welfare, Tavistock, London.Google Scholar
O'Higgins, M. (1987), ‘Egalitarians, equalities and welfare evaluation’, Journal of Social Policy, 16: 1, 1–18.CrossRefGoogle Scholar
Pereira, J. (1993), ‘What does equity in health mean?’. Journal of Social Policy, 22: 1, 19–48.CrossRefGoogle ScholarPubMed
Powell, M. A. (1991), ‘Territorial justice and RAWP’. Health Policy, 18, 49–56.CrossRefGoogle ScholarPubMed
Propper, C. and Upward, R. (1991), ‘Need, equity and the NHS: the distribution of health care expenditure 1974–1987’, Fiscal Studies, 13: 2, 1–21.Google Scholar
Puffer, F. (1986), ‘Access to primary health care: a comparison of the US and the UK’, Journal of Social Policy, 15: 3, 293–313.CrossRefGoogle ScholarPubMed
Rae, D. (1981), Equalities, Harvard University Press, Cambridge, MA.Google Scholar
Robinson, S. (1989), ‘R. H. Tawney's Theory of Equality’, unpublished Ph.D. thesis. University of Edinburgh, Edinburgh.Google Scholar
Roche, M. (1992), Rethinking Citizenship, Polity, Cambridge.Google Scholar
Room, G. (1979), The Sociology of Welfare, Blackwell/Martin Robertson. Oxford.Google Scholar
Scott-Samuel, A. (1981), ‘Social class inequality in access to primary care: a critique of recent research’. British Medical Journal, 283. 510–11.CrossRefGoogle ScholarPubMed
Seldon, A. (1982), ‘Preface’ in Green, D. (ed.) The Welfare State: For Rich or For Poor?, Institute of Economic Affairs. Occasional Papers 63, London.Google Scholar
Senior, M. (1991), ‘Deprivation payments to GPs: not what the doctor ordered’. Government and Policy, 9, 79–94.CrossRefGoogle Scholar
Spicker, P. (1988), Principles of Social Welfare, Routledge, London.Google Scholar
Sullivan, M. (1992), The Politics of Social Policy, Harvester Wheatsheaf. Hemel Hempstead.Google Scholar
Tawney, R. H. (1964 [1931]), Equality, George Allen and Unwin, London.Google Scholar
Taylor-Gooby, P. (1991), Social Change, Social Welfare and Social Science, Harvester Wheatsheaf. Hemel Hempstead.CrossRefGoogle Scholar
Terrill, R. (1973), R H Tawney and His Times, Andre Deutsch, London.Google Scholar
Titmuss, R. M. (1963), Essays on the ‘Welfare State’, George Allen and Unwin, London.Google Scholar
Titmuss, R. M. (1968), Commitment to Welfare, George Allen and Unwin, London.CrossRefGoogle Scholar
Titmuss, R. M. (1974), Social Policy, George Allen and Unwin, London.Google Scholar
Townsend, P. and Bosanquet, N. (1972), ‘Introduction’ in Townsend, P. and Bosanquet, N. (eds.), Labour and Inequality, Fabian Society, London.Google Scholar
Townsend, P. and Davidson, N. (1982), Inequalities in Health, Penguin, Harmondsworth.Google Scholar
Uusitalo, H. (1985), ‘Redistribution and equality in the welfare state’, European Sociological Review, 1: 2, 163–76.CrossRefGoogle Scholar
Wagstaff, A., van Doorslaer, E. and Paci, P. (1991), ‘On the measurement of horizontal inequality in the delivery of health care’. Journal of Health Economics, 10, 169–205.CrossRefGoogle ScholarPubMed
Webster, C. (1988), Problems of Health Care. HMSO, London.Google Scholar
Whitehead, M. (1992), ‘What does equity in health mean?’. International Journal of Health Services, 22: 3, 429–45.Google Scholar
Wilding, P. (1986), In Defence of the Welfare State, Manchester University Press, Manchester.Google Scholar
Wilkin, D., Hallam, L., Leavey, R. and Metcalfe, D. (1987), Anatomy of Urban General Practice, Tavistock, London.Google Scholar
Williams, F. (1977) (ed.), Why the Poor Pay More, Macmillan. London.CrossRefGoogle Scholar
Wright, A. (1984), ‘Tawneyism revisited: equality, welfare and socialism’ in Pimlott, B. (ed.) Fabian Essays in Socialist Thought, Heinemann, London.Google Scholar