Organization matters: contracting for service provision and civicness

Abstract

Introduction The main question that this chapter will deal with regards the influences that different ways of organizing social and health-care services may have on civicness, understood as a quality of the relationships between citizens and institutions. I develop my analysis in the framework of the “new” social policies in Italy. Italy on the whole is not exactly famous for its civic virtues, as Putnam recently reminded us, and also the Italy’ s “Mediterranean” welfare system appears to be affected by a lack of civicness. This scenario functions as a starting point to clarify, in the first section, how the civicness issue enters the picture of the research on social policies. In this section I also argue the choice of focusing attention on the operative level of practices and relationships between service operators and users, in order to define the questions I’ll deal with for investigating the civic qualities on this level. In the second section, I will briefly outline the background of research on which I base my discussion. Regional devolution and the diversification of welfare regimes (another specific feature of the Italian case) have made it possible comparative research on social and healthcare policies in various Italian Regions. The main results of the comparison of two Regional welfare regimes –the Lombardy ‘s and Friuli’ s ones – are synthesized, to frame the more specific comparison between two corresponding service provision systems I’ll develop in the following section. The approach and analytical tools I also draw from this research are presented and discussed in this second section. As we shall see, the focus on policy instruments in action and on their “organizational effects” in policy arenas, gives several relevant insights on the organizational shapes of service relationships and on the values and norms these shapes nurture. This is the analytical terrain that I propose to explore in search of civicness in service relationships. This exploration is developed in the third section, where I analyze two different yet comparable policy instruments and compare the service relationships that take shape through their use. The analytical material that the research has produced on these instruments in action gives many indications on the civic qualities of relationships between services and recipients and on the organizational conditions in which these qualities are played out. There is a thread that gradually emerges over the course of my reasoning, and that gets reinforced by the immersion in this in-dept analysis: the recipients and the role they play in these service relationships turns out to be a key issue for inquiring on the civicness of these relationships. I will argue the relevance and implications on this key issue in the conclusion.