Implications of the Growth of Non~Material Assistance for the Contemporary Welfare State (WPS 30,...

8/4/2019 Implications of the Growth of Non~Material Assistance for the Contemporary Welfare State (WPS 30, 1991) Ivar Ble

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Implications of the Growth of N o n ~ M a t e r i a 1 Assistancefor the Contemporary Welfare Stateby Ivar BleiklieDept of Administration and Organization TheoryUniversity of Bergen

andCES, Harvard University, 1991WorkingPaper Series #30

Building on his research at the Center for European Studies, Ivar Bleiklie of the University ofBergen analyses one of the fundamental aspects associated with the transformation of thecontemporary welfare state. He shows how non-material, as opposed to purely material,assistance has become an increasingly important component of social provision and develops aschema for describing the different types of non-material assistance that may be provided. Hegoes on to explore the implications of this development for the resilience of welfare states andfor related labor-market issues.


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1 . Introduction.

The welfare s ta te i s a complex phenomenon. The concept refers oftento a system of universal social insurance benefi ts , which aresupposed to provide economic safety for the population. However, inaddit ion to services in cash or kind l ike cash t ransfers andhousing, the welfare s ta te provides l ess tangible forms ofassis tance through the systems of education, health care and socia lservice. 1

Welfare s ta tes change. One important aspect of welfare s ta tedevelopment - be it growth or retrenchment - i s the changes whichtake place in the socia l insurance system, i t s coverage and thegenerousity of i t s benefi ts . However, the growth of the welfares ta te service apparatus i s an equally important aspect of welfares ta te development, which researchers unt i l recently have tended tooverlook (Esping-Andersen, 1990, Ramsey and Kjelsred, 1986).

In th i s a r t i c l e I wil l focus upon the consequences of thegrowth of these services to the welfare s ta te . Fi rs t ly I willdiscuss the notion of non-material assis tance and suggest a way inwhich it may be conceptual ized. Secondly, I wil l qui te br ief lycomment upon the crucia l role of the occupational groups in nonmaterial service provision. Then I wil l turn to the main topic ; theimplications of the growth of non-material assis tance for thewelfare s ta te with emphasis on the Scandinavian experience. My mainarguments are the following. Firs t ly , the occupational groups ofthe welfare s ta te cons t i tu te a s t ra tegic vantage point i f one wantsto understand the implications of non-material assis tance for thewelfare s ta te . Secondly, because these implications vary dependenton socia l and hi s to r i ca l circumstances, I bel ieve it i s importantto develop an idea about which circumstances are s ignif icant . HereI wil l focus on three se ts of circumstances. One se t i s the type ofservice tasks in question, the second i s the role of the occupat ional groups and the third i s the socia l re la t ionships in whichnon-material service provision i s embedded a t di f fe ren t levels ofanalysis .

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2. Non-material Assis tance - A Typology o f serv ice Tasks.

In order to scrut inize the consequences of i t s growth, it i snecessary to f lesh out the ra ther abs t rac t concept of non-materialassis tance: what it is ; who the service providers are ; and whatthey do when they do the i r job. Firs t of a l l therefore, l e t mebrief ly comment upon the concept of non-material assis tance.Although i t s meaning by no means i s unequivocally given, it i ssimple to draw the l ine a t the level of s ta ted policy goals.Material assis tance, as I wil l define i t , seeks to ' al locatetangible goods, such as housing and money, with the aim ofproviding immediate material securi ty for the rec ip ients , whereasnon-material assis tance does not. Non-material forms of assistanceare the l ikes of psychotherapy, social counseling and education. 2These are services the content of which i s harder to define.Furthermore, it may be dif f icu l t to discern and measure what effec tthe al locat ion of the service has on the immediate as well as thefuture si tuat ion of the recipient . Finally, as others have pointedout ear l ie r , the service i s produced and part ly consumed in thevery process of interact ion between service provider and rec ipient( W ~ r n e s s and Gough, 1985).

Yet, it i s clear tha t most services comprise material and nonmaterial aspects , and tha t they might in principle be defined bothas material and non-material assis tance. The def in i t ion may referboth to generic qual i t ies of specif ic services, and to an elementof social construct ion. Let" me br ief ly i l lus t ra te the point withexamples from two services I have studied recently (Bleiklie,1990). Consider f i r s t psychotherapy a t a psychiatr ic ins t i tu t ionfor alcohol ics . I t has the form of conversations between therapis tsand pat ients with the intent to make the patients stop drinkingalchohol. As such it i s l ikely to be counted among the non-materialservices. In my study of such an ins t i tu t ion , however, severalpotent ia l ly important material aspects turned out to be involved.

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Firs t ly , to many pat ients the most important aspects of thetreatment a t the ins t i tu t ion were the she l te r , regular meals, andgeneral physical well-being it provided, especial ly when these weregoods the pat ients otherwise would be deprived of. 3 Secondly, manypat ients r isked being f i red because of the i r alcohol problems, andvoluntary treatment was often made a precondition by the employeri f the pat ient was to keep his job. In such s i tua t ions subjectionto psychotherapy with the aim of eliminating the aloeohol problem,might be the only means whereby such a material loss could beavoided. The al locat ion of housing on the other hand, i s in theeyes of most beholders a clear case of m ater ial assis tance. Yet, inmy study of a housing office I found t ha t some cl ients , although aminority, emphasized the behavior of the housing off ic ia l s duringthe i r encounter, i . e . the manner in which the off ic ia l s t rea tedthem when they were asked to evaluate the service.

The conclusion I draw from th i s i s t ha t the seemingly simpledist inct ion between material and non-material assis tance turns outto be ra ther complicated upon closer scrutiny i f we want to use itto draw cl,ear boundaries between specif ic public service agencies.In stead of t rying to separate service agencies which providematerial from those which provide non-material services in anunequivocal manner, it may be well advised to point to speci f ica l lydefined non-material and material forms of assis tance. We may thenfind tha t these forms are provided by different service agencies invarying combinations. In the following I wil l use the dist inct ionbetween material and non-material assistance as a purely heurist icdevice. Two cr i te r ia wil l be emphasized in th i s connection: 1 )whether the s tated policy goal concerns material or non-materialforms of assistance and 2) what forms of assis tance c l ients andoff ic ia l s regard as important aspects of the service in question.

This approach ca l l s , however, for a somewhat more precisenotion about non-material assis tance in public service provision.I wil l t ry to develop such a notion by means of a typology. Thetypology i s based on the manner in which the service providersre la te to the i r c l ients along two different dimensions. 4 On the one

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hand the orientat ion of the _ ela t ionship may vary according: towhether the of f ic ia l ' s main concern i s to achieve some kind ofspecified resu l t aided by expert knowledge, 9r whether the c l ients 'current personal condition i s accepted as a given fact . On theother hand the off ic ia l may define h is re la t ionship to the ,c l ientsas more or l ess comprehensive or delimited in scope. By combiningthe two dimensions I have constructed a typology of four maj ortypes of non-material assistance characterized by different aims,expectations and role defini t ions, as presented in table 1.

Z. Goal oriented assis tance combines resul t orienta t ion and adelimited, special ized relationship to the c l ien ts . I t i s typicalof a modern resu l t oriented health service and of the way in whicha special ized physician re la tes to h is pat ients . The task i s to,solve a specified, diagnosed problem. The cl ients represent problemcases, and the service providers as expert professionals areexpected to apply the expert knowledge required to solve them. Inresponse to effective treatment the c l ien t , defined as a problemcase i s expected to show improvement.

Table 1. Types of Non-material assis tanceorienta t ion of Relationship

delimitedscope of Relationshipcomprehensive

resu l t oriented condit ion orientedI GOAL ORIENTED I I I INSTRUMENTALaim: problem solving aim: confinementcl ient= " i l l" /prob.case client= inmatecl ient .exp: improvement cl ient .exp: obedienceprovider= expert provider= custodianprovider.exp: effect iven. provider.exp: jus t iceI I PATRZARCHAL IV CARE ORIENTEDaim: socia l izat ion aim: pers . ass is tancecl ient= pupil client= personcl ient .exp: at tent iveness cl ient .exp: reciproci typrovider=educator provider= caregiverprovider.exp: insight provider.exp: sentience

I I . patr iarchally oriented assistance i s characterized by resul torienta t ion and a comprehensive relationship to the cl ients .

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Primary educat ion may serve as the typical and most importantexample of th i s type of assis tance. The aims are broadly definedand the service provider as an educator re la tes to the ent i repersonal i ty of the cl ient . The task of the educators i s thus notonly the development of academic sk i l l s , but more broadly tosocia l ize t he i r c l ients in to good c i t izens . The c l ien ts are humanraw material and the educators are expected to apply the i rpedagogic insight in the socia l izat ion of the i r pupi ls who in turnare expected to show at tent iveness .

III . Instrumentally oriented assistance i s condition orientedand delimited. I t i s typical for s i tua t ions in which c l ients areconfined to ins t i tu t ional care for the i r own protect ion or for t ha tof the i r surroundings as in the case of committal of pat ients tomental hospi ta ls o r the placing of the elder ly in o ld-s ty le storagehouse types of old people's homes. To the extent tha t protection i sthe main purpose, the s ta te of the pat ient as an inmate i s acceptedas given and the aim of the custodian i s l imited to administer andcontrol his behavior by means of rules and rout ines and i fnecessary by physical coercion and medication in order to securethe smooth functioning of the ins t i tu t ion . The service providers ascustodians are expected to show jus t ice and in turn receiveobedience from the i r c l ients .

IV. Care oriented assistance i s condit ion oriented and compre-hensive. Typical services aiming a t giving personal assis tance arehome at tendant care and community nursing. The service provider ascare giver i s supposed to respond to the personal needs of thec l ien t , but the needs themselves are more or less taken for grantedand the i r sat isfact ion does not imply ambitions beyond thesi tuat ion here and now. As caregivers the service providers aresupposed to show sentience, in return fo r which the c l ients aresupposed to show reciproci ty and/or grat i tude.

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3. The service Providers - AD occupational perspective.-In the above presentation of the typology, I also pointed to someservices which may serve as fa i r ly typical examples of thedi f ferent forms of assis tance discussed. There can be l i t t l e doubttha t the occupational groups of the welfare s ta te have been keyplayers in the formation, development and daily running of theseservices and the i r tasks as they present themselves today (Bert i ls-son, 1990, Erichsen, 1990, McGovern, 1985, s ta r r , 1982). Thereforeit i s not possible to study non-material service provision withouta d d r ~ s s i n g the question of the occupations.

One of the major "lessons" one can draw from the l i te ra tureabout the occupations of the welfare s ta te i s tha t the defini t ionof the occupational tasks, such as medicine, teaching and socialwork, i s affected by the social and his tor ical context in which iti s made. The defini t ion of a specif ic type of occupational task i snot constant , it changes over time and it tends to vary from onesocial context to another (Collins, 1990, Davies, 1982, Erichsen,1990, Goldstein, 1987, Grostad, 1984, Larson, 1990, Sadler, 1978,Starr , 1982, Vetlejord, 1990). These variat ions are furthermore,only par t ia l ly due to the evolution and diffusion of sc ien t i f i cknowledge in the different occupational f ie lds . Put somewhatdifferent ly; nei ther in principle nor in pract ice do the nonmaterial service tasks of the welfare s ta te appear as c lear ly ,unequivocally defined ac t iv i t ies . They are more or l ess constantlydefined and redefined, and they seem to be driven by complexforces, part icular ly important among which are public pol ic ies ,occupational in teres ts and educational systems.

The study of how such processes are related to ,the contemporary welfare s ta te and i t s development is only in i t s inception.In the following I wi l l discuss a possible agenda for the development of a pol i t i ca l science perspective t ha t brings together theprocess of service provision with the processes of policy makingand policy implementation (Bleiklie 1990: 188). The agenda ca l l sfor the piecing together of a puzzle many parts of which are ready

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for use and some of which wil l have to be craf ted specif ical ly forthe purpose a t hand. I t wil l , I shal l suggest, aim a t 1 inkingtogether welfare s ta te research, research on public policy and thestudy of professions and occupational groups, and it wil l prof i tfrom a his to r ica l and comparative approach. In the following I wil lconcentrate on the development of some of these l inks by means ofan analysis of the recent history of the development of the welfares ta te service apparatus in Scandinavia, where I rely primari ly onNorwegian data . 5 After a br ie f descript ion of the growth of non-material services, I wil l focus on the implications of service-growth for the welfare s ta te in terms of three di f fe rent socialrelat ionships into which it i s integrated: 1) The relat ionshipbetween the welfare s ta te and the labor market. 2) The relat ionshipbetween the occupational groups and the welfare s ta te serviceapparatus. 3) The relat ionship between the service providers andthe service recipients .

4. Implications o f Service Growth - A Scandinavian Experience.

The growth of the welfare s ta te the l a s t three decades can bedescribed as a story of growth in i t s systems for the delivery ofsocial services , and in the associated growth in the number ofemployees engaged in the delivery of services. The growth i s anin ternat ional phenomenon, but it has been stronger in the Scandina-vian countries than in other western countries, such as Germany andthe USA, both in terms of the re la t ive s ize of welfare serviceapparatus and the extent of "public responsibi l i ty for it (Esping-Andersen, 1990: 158 table 6 .3 . ) . In table 2. the Norwegian develop-ment from 1960 to 1980 i s i l lus t ra ted in some deta i l .

In addit ion to the steep growth in a l l categories of welfares ta te employment and a divers i f ica t ion which has added newcategories of employees to the welfare s ta te workforce, the table

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~ a b l e 2. Welfare s ta te oCCuRations in Norwa:!.1960 1980OccuRations thous. % % women thous. % % women %incrNurses 22.2 35 91 115.9 42 93 422Home attendant 29.8 11 98Social Worker .7 1 55 10.9 4 66 1457Teacher 32.0 51 43 96.3 34 52 201Medical occ. 6.0 10 14 11.8 4 19 97Physiother. 1.0 2 82 .9 3 80 590Psychologists .9 0 39Others 1 .1 2 47 7.1 3 74 57Sum. 63.0 101 58 279.6 101 74 343(Based on Ramsay and Kjalsrad table 8 .1 . , in Allden, Ramsay and Vaa(eds. ) 1986: 236).

shows tha t we are increasingly dealing with a female workforce. Thepercentage of women has increased in a l l employment categories butone, the physiotherapists , and the overal l growth has beenst rongest in the employment categories where the percentage ofwomen was the highest . Final ly it shows tha t the overal l composi-t ion and re la t ive s ize of services have changed.

Table 3 shows the changes in the s ize of welfare s ta teoccupations on the basis of the di f fe ren t types of service taskspresented in table 1. The major change which has taken place i stha t the welfare s ta te has become more care oriented. In 1960nurses const i tuted 35% of the welfare s ta te workforce. In 1980 theyhad become the most numerous group with 42%. Together with homeattendants as the second major care giving occupation, they made upmore than hal f (53%) of the welfare s ta te personell . In spi te of as izeable absolute increase, teaching has a diminishing share ofwelfare s ta te employees, down 17% in the course of the two decades.Even more str iking i s the shrinking and re la t ive ly diminutive shareof the medical, academic male dominated occupations (primarilyphysicians and dent is ts) from 10 to 4%. Therapy's to ta l share ofwelfare s ta te personell (medical occupations, physiotherapists andpsychologists) shrank from 12 to 7%. This development has severalimplications, and they may be described as they affec t society and

,.the welfare s ta te a t several levels of analysis .8


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Table 3. Welfare s ta te occupations by t ask . 61960 1980thous. % thous. %care 22.2 35 145.7 53teaching 32.0 51 96.3 34therapy 7.0 12 19.6 7others*) 1.8 3 18.0 7Sum 63.0 101 279.6 101*) includes socia l workers

The welfare s ta te , the labor market and socia l services. Let mebegin a t the macro-level, focusing on the role of the welfare s t a t eins t i tu t ion in socie ty . I f we look a t the Scandinavian developmentthe l a s t couple of decades, the implicat ions of the growth of thewelfare s ta te service apparatus for non-material ass is tance, i sclosely associated with the increased public in tergra t ion andrespons ibi l i ty for the labor market and the family.

I f we look a t the labor market there has been a major s h i f t inmodern welfare s ta te pol ic ies according to Esping-Andersen (1990:1 4 0 f ) ~ The sh i f t i s based on a movement from a minimalist welfares ta te philosophy where the core idea of socia l policy was always tosafeguard persons against the exigencies and r i sks t ha t confrontthem in t he i r l i fe -cycle , by means of a safety net , a haven of l a s tresor t for those demonstrably unf i t or unable to par t ic ipa te in alabor market which i s bas ica l ly seen as a se l f - regula t ing organism.This minimalis t philosophy i s now del iberately abandoned. Themodern welfare s ta te espouses new principles with regard to theproper role of the welfare s ta te in the l i fe -cycle , by oftencomitting i t s e l f to optimize-peoples' capaci t i t ies to work, to findwork and even count on a good job with good pay and workingenvironment. The movement has been motivated the goal t ha tindividuals should be allowed to harmonize working l i f e withfamilyhood, to square the dilemmas of having children and workingand to combine productive ac t iv i ty with meaningful and rewardingle isure .

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The sh i f t has manifested i t s e l f in di f ferent ways. Firs t ly , ithas affected our conception of fu l l employment, from referr ing onlyto able-bodied men, to encompass a l l women and indeed anyone whowishes to work. Subsequently the population for which a fu l l -employment guarantee obtains has increased substantial ly and madeit an increasingly di f f i cu l t obligation to meet. Expandingret i rement programs and the education system have been instrumentalin reducing the economically act ive population. Social programs cana t the same time become an important instrument for the absorptionof new, especia l ly female, labor force entrants . 7

Secondly, the welfare s ta te i t se l f has become a formidableemployment machine with 20 to 25% of the to ta l nat ional employment,often being the only s ignif icant source of job growth, and it hasbeen the major vehicle for the growth in female employment (EspingAndersen, 1990 , Elfr ing, 1988 , OECD, 1980) , . The welfare s ta te thusabsorbs labor supply not only to uphold promises of fu l l employment, but also because the welfare s ta te ' s own economic logicdemands tha t as many as possible work. For the welfare s ta te it maybe more cost effective to employ excess labor than to subsidize itnot to work.

In sum the emerging new pat terns of re la t ions between welfares ta te and labor market mean that socia l policy and labor markethave become interwoven and mutually dependent ins t i tu t ions . Thewelfare s ta te has to some extent become a major agent of labor-

'"market clearing. I t eases ex i t of women with family programs and ofolder people with early ret i rement . I t fac i l i ta tes female laborsupply by providing necessary socia l services . I t helps peoplereconcile the i r role as economic producers, socia l c i t izens , andfamily members by granting workers paid vacations and temporaryabsence from work. By extending re la t ively high benefi ts for abroad variety of contingencies, including sickness, maternity,parenthood ( for mother and fa ther) , education, trade-union re la tedinvolvement, and vacation, legisla t ion has del iberate ly sought toemancipate the individual from work-compulsion. Exit from employment - be it employers decisions to ra t ional ize by laying off

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workers or workers ' decisions to qui t , re t i r e or change jobs - i sthus guided by'the programs offered by retirement, unemployment oractive manpower pol ic ies . For women such decisions are even moreint imately patterned by the welfare s ta te , in terms of servicedelivery (child care) , t ransfer system (abi l i ty to ut i l i ze theoption of absenteeism), tax system and labor demand (social welfarejobs) . By the establisment and expansion of socia l services thewelfare s ta te also i s enabeled to af fec t employment in another way.I t provides a forceful mult ip l ie r-effec t par t icular ly for femalelabor because socia l services both allow women to work and createa large labor market within which they can find employment. Thismeans tha t a big chunk of the labor market i s no market a t a l l in

. a t radi t iona l ly defined sense, but a pol i t ical ly organized systemof col lec t ive goods-production. A l t h ~ u g h welfare s ta te employmenti s based on a labor' contract in which labor time i s exchanged forwages, i t s logic i s (usually) quali ta t ively dif ferent . The conceptof productivi ty hardly obtains (although attempts to measure it areintroduced) ; wages are to a degree determined pol i t ical ly : jobs aretypica l ly tenured: and employees normally enjoy substantial ly moreautonomy, freedom, and authori ty over how they al locate the i r time,do the i r jobs and make the i r work-welfare choices. This signif iestha t the growth of non-material assistance might imply t ha t thewelfare s ta te i s in the process. of becoming a separate job-marketwithin a new dual economy or tha t it will simply a l te r the exist inglabor market radical ly . However th is may be, it i s c lear tha t ithas been the main vehicle in the transformation of the Scandinavianemployment s tructure the l a s t three decades.The occupations of the welfare state. The next se t of implicationsto be discussed unfold themselves a t the organizational level ofthe occupational groups and the i r mutual re la t ionships. The mosts t r ik ing facts concerning the occupational groups have been the i rgrowth, the i r divers i f ica t ion and the i r feminizat ion. For the mostpowerful of them, the academic professions, the i r centra l posi t ionin the provision of non-material services i s jus t i f i ed by the i r

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posess ion of a specif ic kind of theore t ica l ly based knowledge.s t i l l , the occupational groups l i s t ed in table 2, excepting homeat tendants , a l l claim the i r own more or l ess speci f ic theore t ica lbasis whether entrenched in univers i t ies and research ins t i tu t ionsor not.With regard to th i s t lprofessional tl aspect of the occupationsof the welfare s ta te , service expansion has had two consequences.Fi r s t ly , we have already noticed tha t the growth of non-materialwelfare s ta te services has implied t ha t the ra t io of academicprofessionals among welfare s ta te employees has taken a downwarddip. In a superf ic ia l sense, therefore , the welfare s ta te has beendeprofessionalized. Secondly, service expansion has typical ly beenaccompanied by questions being ra ised about the qual i f ica t ions ofthe service providers and the necessi ty of improving the i rqual if ica t ions through bet te r formal education (Ramsey andKjelsred, 1986). In addi t ion several groups have been pushing, withvarying degrees of success, to have the i r educat ion improved andult imately elevated to univers i ty level . In th is sense the welfares ta te has become more professional ized to the extent tha t occupat iona l groups have become academic or a t l ea s t have establishedacademic e l i tes in the i r own midst. As an overal l t rend, however,welfare s ta te employees are bet te r educated now than some decadesago. This does not mean tha t the drive for profess ional izat ion i suncontroversial . s t i l l , there are several tensions within thedi f ferent sectors of the service apparatus, most notably in healthcare, between the s t i l l prevail ing ideology based upon the medicalprofession 's goal oriented expert roles, care oriented roleconceptions as represented among nurses and paterna l i s t ic concept ions based on public health ideologies (Berg, 1982, Fugel l i , 1982,WiErness, 1984). Within the educational system tensions can beobserved between a goal oriented teacher role aiming a t teachingchildren "basic academic sk i l l s " and more broadly orientedpaterna l i s t ic occupational ideals aiming a t a general social izat ionof the pupils . The spread of mass education a t the universi ty levelhas also deal t a blow to pr io r professional exclusiveness and the

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rewards of professional izat ion have for tha t reason been cal ledinto quest ion. 8 The choice to "professionalize" has not always beenan obvious one for the new groups of increasingly female welfares ta te employees from a non-academic or working class background(Ramsey and Kjolsred, 1986: 254). Some groups such as the nurseshave seen clashes between those who wanted to organize theoccupation as a t rade union and make it a powerful corporation insociety and those who wanted to professionalize and protec t the exclusiveness of the group.

The claim of some kind of exclusive knowledge or sk i l l hast radi t iona l ly formed the basis of an occupational groups' claim ofjur i sd ic t ion and const i tu ted the legi t imation of whatever authori tyit wields over an occupational f ie ld (Abbott, 1988). FollowingAbbott 's (1988) analysis and cas t in the medical terminology heuses, one might say tha t a core professional act ivi ty i s inference,which he defines as , the establishment of a connection between thetheore t ica l problem def int ions ( ' diagnosis ' ) and the i r prescr ipt ionof prac t ica l techniques for problem solut ion ( ' t rea tment ' ) . Themore obscure the connection between diagnosis and treatment themore important i s inference to professional legi t imacy. The degreeto which inference predominates i s a key factor in determiningjur isdict ional vulnerabil i ty . Too l i t t l e inference may s ignal therout in iza tion o f an occupational ac t iv i ty and make it a t a rge t forpoaching by other professions, occupational groups or the government (Abbott, 1988: 48-52). Too much inference, where an occupat ional group must re fer a l l i t s cases to inference, makes itdi f f i cu l t to demonstrate the cul tura l legitimacy of the basis ofi t s purported eff icacy. The 'growth of non-material assis tance hasexpanded exist ing and added new occupational tasks to the obl igat ions of the welfare s ta te where inference i s of c r i t i c a l importance.

Although an increasing number of welfare s ta te servicerecipients and welfare s ta te service providers become economicallydependent on the welfare s ta te for the i r l ivel ihood, expansion ofnon-material services does not necessari ly lead to increased

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pol i t ica l support fo r the welfare sta te . Given the ambiguous natureof non-material services, expansion of such services also affectsthe welfare s ta te in a way which makes i t s basis of leqitimacy morecomplex and diffuse; increases i t s dependence on the performance ofexperts; makes it more dependent on cul tural bel iefs in variousforms of expertise; makes it more l iable to internal dispute amonqdifferent occupational groups, or to factions within the samegroup; and makes it more exposed to encroachment of i t s authorityfrom outside forces. The growth of the service apparatus has beenparalel led by increased worries about i t s costs , a weakened beliefin professional authority, a gradual t iqhtening of pol i t ica l andbudgetary control and increased concern for the in teres ts of theservice recipients , the cl ients . The encroachment has in par t icularweakened medical authority over the health care system. However,the converqinq t rends of what Paul s t a r r has called "the generalizat ion of r iqhts" and lithe generalizat ion of doubt I - i . e . thestrengthening of cl ients r ights (which increasingly are portrayedas manifestations of the common good) and the growing questioningof expert authority (which increasingly i s presented as a.cover forspecia l interests) - have made themselves fe l throughout thewelfare s ta te service apparatus (s tarr , 1982: 379-420).

I t has become a fa ir ly commonplace assumption tha t even i f theqrowth of the welfare sta te has made it more vulnerable to attackand weakened authority in the face of challenges from poli t iciansand cl ients al ike, it has also recruited an army of staunchdefenders. The welfare s ta te employees consti tute a numerous, welleducated, well-organized and powerful aegment of society, aformidable pol i t ica l constituency and a force any retrenchmentpolicy would have great d i f f i c u l t ~ e s in defeating, part icularly ina Scandinavian context where the welfare s ta te i s so deeplyentrenched (Kolberg, 1983, Piven and Cloward, 1988). To myknowledge predictions tha t the welfare s ta te occupations will beeffect ive defenders of the welfare sta te have so fa r not been corroborated (Ramsey a n ~ Kjelsred, 1986). There i s no doubt theY'willf ight for the i r own jobs and the i r own labour market in teres ts , but

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tha t i s not the same as a defence for the welfare s ta te as such.Chances are as great t ha t retrenchment pol icies may succeed insubduing, dividing and conquering welfare s ta te professionals asthey are t ha t they wil l put up ef fec t ive res is tance against thesepol ic ies . Especially i f retrenchment pol ic ies are pursued with thecombination of forcefulness and cunning described by Paul Pierson(1991) in the cases of the Thatcher and Reagan governments of GreatBri tain and the uni ted s t a t e s , the evidence suggests t ha t defendingone's own occupational tu r f and defending the welfare s ta te are notnecessar i ly viewed as the same cause. 9

The ident i ty of many occupational groups are not l ike ly to beshaped by the fac t tha t they are counted as par ts of the welfares ta te . Some of them, l ike teachers , medical doctors and nursesexis ted as recognized occupations or professions long before thewelfare s ta te had been dreamt of . They belong to di f ferent sectorsof publ ic pol icy. Therefore, welfare s ta tes may di f fe r not only ins ize and degree of publ ic involvement, but also in terms of t he i rdi f fe ren t combinations of education, health and socia l welfarearrangements. correspondingly, the occupations may see t he i roccupational tasks, such as teaching, medicine, psychotherapy orsocia l work, as gener ical ly dis t inc t tasks tha t require speci f icqualif icat ions , and they may see the r e c i p i e n ~ s of the i r servicesas speci f ic categories of people who deserve the i r own dis t inc tt i t l e s l ike pupi ls , pat ients or c l ients . A general descr ipt ion ofthe growth and implicat ions of non-material services , needsaccordingly, to be supplemented by descr ipt ions of each individualservice beyond what I can do here. My general conclusion regardingthe occupational groups i s th i s : The question of whether the growthof the occupational groups providing non-material servicesstrengthen the welfare s ta te i s not only an ambiguous one. Thewelfare s ta te i t se l f has become a more ambiguous ent i ty and it i smore l ikely to be faced with mixed and confusing pol i t i ca l s ignalsthan before.

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The c l ient -of f ic ia l relat ionship_ The th i rd and f inal se t ofimplications are re la ted to indivdual level in teract ion betweenservice providers and recipients . A common character ist ic of theservice providing occupations of the welfare s ta te , i s tha t the i rmembers spend most of the i r time interacting with other persons,the service recipients . This sets them apart from other non-servicesector occupations (Ramsey and Kjelsrod, 1986: 248). One dis t inct ive feature of th is kind of work i s the amount of discre t ion theemployees may exercise. To a large extent non-material services aregiven the i r f inal form and content during the process of servicedelivery when cl ients and off ic ia ls in te rac t . This follows from thefact tha t they are produced and par t ly , as in the case of care forthe elderly , also consumed on the spot during the process ofc l ient -of f ic ia l in teract ion. Therefore, the process of defining andredefining services i s not only taking place a t higher administrat ive and pol i t ica l l e v e l ~ , but i s a sa l ient character ist ic of thein teract ion a t the individual level in service delivery.

The considerable discret ionary power exercised by theindividual service provider in his encounters with c l ients ra i sesthe problem of how th is power i s exercised, and it has been t reatedextensively in the l i te ra ture on s t ree t - leve l bureaucracy (Brown,1980, Lipsky, 1980, Prottas, 1979). s t i l l , the problem of off ic ia ldiscret ion does vary and appear in di f ferent guises dependent onthe type of service ' regime which characterizes an agency: i . e.according to whether whether author i ty flows from rules given bypoli t ical-adminis trat ive superiors, from professional peers or fromwhatever coping needs the service provider i s faced with whilein teract ing with c l ients (Bleiklie, 1991).

The three regime types can also be seen as representat ions ofdi f ferent types of pol i t i ca l forces which potent ia l ly influence thebehavior of service providing off ic ia l s . I wil l not suggest anyautomatic re la t ionship between regime type and what values theservice providers wil l give prior i ty . The re la t ionship between thevalues which are ostensibly supported - such as equality, eff ic iency or consumer sat isfact ion - and actual pract ice may be qui te

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complicated (Bleiklie, 1990: 192f). In terms of the service regimeconcept, the growth of non-material services has had two implicat ions . On the one hand the growth meant more of a kind of servicewhere the service providers were par t icular ly inf luent ia l comparedto those responsible for material services . In the l a t t e r case thecontent of the service i s perceived as given and service provisioni s considered a matter of f a i r dis t r ibut ion. Growth of nonmater ial , ambiguous services can thus be expected to strengthen theprofessional communities in re la t ion to the i r c l ients . On the otherhand I have pointed to the encroachment of expert author i ty frompol i t i ca l author i t ies and c l ients which has gained momentum duringthe 1980 IS . This movement has par t ly strengthened hierarchicalauthor i ty and par t ly l ent author i ty to the e l ients on the arena ofinteract ion between service providers and recipients .

Although I assume there i s no automatic re la t ionship betweenthe growth of non-material services , type of service regime and thevalues which are promoted by the service providers, I wil l suggestsome implications with respect to the re la t ionship between socia lvalues and the growth of non-material services . The most importantimplication a t the level of c l ien t -o f f ic ia l in teract ion, is t ha tthe boundaries of the welfare s ta te may become more diffuse. Thequestion of equal i y i s often ra ised in the context of howof f i c ia l s ' discret ionary decisions and the c l ien t -o f f ic ia lre la t ionship affec t the dis t r ibut ion of welfare s ta te services .controversies about the dis t r ibut ion issue tend to spring fromperceived inequit ies in the al locat ion of material services or inconnection with access to the services , be they material or not.Because equal i ty i s par t of" the defini t ion of the welfare s ta te ,the question of dis t r ibut ion occupies a centra l posi t ion in thepol i t ica l debate (Bleiklie, 1983). However, the di f ferent types ofnon-material services ra ise a ser ies of other issues in addition tothe question of dis t r ibut ion. These are re la ted to the proper goalsand organization of such ac t iv i t i es as socia l izat ion in chi ld-careand educat ion, care for the elder ly, social counsel ing, psychotherapy, hospi tal care and the general qual i ty of the t reatment of

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service rec ip ients . service provision in these se t t ings maytherefore, appear as processes of in te rpre ta t ion as well asprocesses of distr ibut ion where the mutual expectations and propersocial roles of provider and recipient are determined. The growthof non-material services has also had another impl icat ion which mayexacerbate these processes of blurr ing the boundaries of thewelfare s ta te and the pol i t i ca l : a greater share of the populationexperience during the i r l i fe-cycle the di f ferent roles re la ted tothe services, al ternat ing between the roles of service providersand recipients of various services. They wil l meet different partsof the service apparatus in di f ferent capaci t ies and fo r varyingreasons. Far from a l l of these services wil l be regarded as socialpol i t ica l or welfare related. The relat ionship between popularsupport of the welfare s ta te and popular a t t i tudes towards thedi f ferent par t s of the welfare s ta te service apparatus maytherefore be a tenuous one.

5. Conclusion.Through the development described above the Scandinavian welfares ta te has become more entangeled in society and par t of everyc i t i zen ' s l i f e , furnishing them with a series of r ights andpromises of social and economic safety. This has been seen as asource of st rength which i s l iab le to make th i s type of welfares ta te part icular ly robust and res is tant to at tacks such asretrenchment pol ic ies of Brit ish or American type (Esping-Andersen,1990, Therborn, 1986). My analysis analysis may imply, however,thatthe apparent st rength of the Scandinavian welfare s ta te i s morevolat i le than what has been indicated by the proponents of th isview.

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NOTES.

1. The two aspects of the welfare s ta te - the socia l secur i ysystem and the services - are to some extent intervowen. In theNorwegian case about a quar ter of the nat ional social securi tyexpenditures covers services, f i r s t and foremost treatment andins t i tu t ional stays. The service providers make decisions withconsequences for the level of expenditures in the social securi tysystem. At the local level social securi ty off ices , heal th centersand social r e l i e f agencies are frequently located in the samebuilding, and the i r c l ients may be ident ica l (Ramsay and Kjalsrad,1986: 233f).2. One might argue t ha t education i s a mater ia l service to theextent it gives certain access to lucra t ive social posi t ions.Usually however, education may increase the chances, but rarelygives automatic access to such posi t ions. When it does, th i s may beaccommodated for in each specif ic instance.3. This aspect of mater ia l securi ty i s a general character ist ic ofto ta l ins t i tu t ions such as mental hospi tals and prisons andins t i tu t ions for inpat ient treatment. The Boston Globe of April 11,1991 provided a t e l l ing example, report ing from the Peruvian Sancr is tobal peni tent iary h i t by an earthquake April 4. When theearthquake toppled the prison walls the 117 inmates preferred tostay put where they were fed and rebuild the walls ra ther thanseize the opportunity to flee the prison. Hetzler (1978) offers anexample of how a Swedish mental pat ient , when not accepted as a t amental hospi tal t r ied to act mad by throwing rocks a t the hospi talwindows in order to be committed to the hospita l . The Americandebate on the consequences of de- ins t i tu t ional iza t ion has focusedon i t s relat ionship to the growing problem of homelessness(Bachrach, 1983).4. The typology i s a modified version of a typology of therapis t pa t ient relat ionships I used in an analysis of a psychiatr ic cl in ic(Bleikl ie , 1990: 126-130).5. The Scandinavian experience i s of par t icular in teres t becausethe growth of welfare s ta te services the l a s t decades i s unmatchedinternat ionally, and may serve as an example of how strong animpact it may have when it becomes as closey intervowen with thefabric of society as it i s in Scandinavia. This does not mean t ha tthe Scandinavian experience represents the most advanced stagealong the road on which a l l nations are destined to t rave l , butra ther tha t the Scandinavian welfare s ta te represents a dis t inc ttype of socia l policy arrangement compared to those of othernat ions (cf . Esping-Andersen, 1990).

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6. Instrumental tasks are excluded from the table for two reasons.No specif ic welfare sta te occupation i s responsible for th i s kindof tasks , and with the process of deinst i tut ional isat ion takingplace both within psychioatric health care and the care for theelderly, I assume tha t instrumental tasks are in sharp decline asa welfare s ta te responsibi l i ty .7. The welfare s ta te was original ly not supposed to induce anybodyto leave work for welfare. The sh i f t here, which has been comparat ively moderate in scandinavia, has occurred in connection with theexpansion and extension of retirement programs which made possibleand sometimes forced able-bodied persons into early ret irement.Although the ret irement ages in Norway and Sweden are relat ivelyhigh, early retirement programs have been expanded and labor forcepart icipat ion among older men (55-64 years) have dropped over thel a s t decades (Esping-Andersen, 1990: 151). This drop re f lec t s atendency which is considerably strQnger in other west Europeancountr ies .8. The cleares t expression of th is type of questioning is thethesis tha t professionals are about to be proletarinized (Oppenheimer, 1973, Murphy, 1990).9. I f it i s t rue as, Pierson (1991) argues, tha t retrenchment hasa logic of i t s own di f ferent from the logic of welfare sta teexpansion, then it is a l ikely hypothesis tha t the logic ofretrenchment wil l be di f ferent in welfare s ta tes with extensiveservice apparatuses from what it wil l be in those with smaller andless powerfull social services.

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LITERATUREAbbot t , A, 1988, The system o f Profess ions . An Essay on th eDivis ion o f Exper t Labor, Chicago and London: The Univers i tyo f Chicago Press .Bachrach, L.L (ed . ) 1983, D e i n s t i ~ u t i o n a l i z a t i o n , San Francisco ,

Washington, London: Jossey-Bass .Berg, 0 , 1982, Helse t jenes tens 10gikk, Oslo: I n s t i t u t t fo r s t a t s vi tenskap.Bert i1sson , M, 1990, The welfare s t a t e , the profess ions andc i t i z e n s , in R. Torstendah1 and M. Burrage (eds.) The Format ion o f profess ions , London: Sage.B1eik1ie , I , 1983, The Selec t ive Providers . Organizat ion andDis t r ibu t ion Effec t s of Publ ic Serv ice Provis ion , Tidssk r i f tfo r ra t t s soc io loq i , vo1. l ,1983/84 : 55-80.B1eik1ie , I , 1990, Service Reqimes .A comparat ive organiza t iona ls tudy o f Cl ien t -Of f i c i a l Relat ions and P o l i t i c a l s teer ing inTWo serv ice Agencies , Univers i ty o f Bergen: Report no. 7,Department o f Adminis t ra t ion and Organizat ion Theory.B1eik1ie , I , 1991, A P o l i t i c a l Concept o f Publ ic Serv ice Prov i s ion , Minda de Gunzburg Center fo r European Studies , HarvardUnivers i ty .Brown, M.K, 1981, Working the s t r e e t . Pol ice Discre t ion and th eDilemmas o f Reform, New York: Russel Sage Foundat ion.Col l ins , R, 1990, Market c losure and the conf l i c t theory of th eprofess ions , in M. Burrage and R. Torstendah1 (eds . ) 1990,Profess ions in Theory and History , London: Sage.Davies , C, 1982, The Regulat ion of Nursing Work: a h i s t o r i ca lcomparison o f Bri ta in and th e U.S.A., in J . Roth (ed.)Research in th e Sociology o f Health Care , Vol. 2: Changings t ruc: tures o f Heal th serv ice , Greenwich, Conn.: JAI Press , pp.267-289.E1fr ing , T, 1988, Service Sec to r Employment in Advanced Economies,A1dershot : Avebury."Erichsen, V, 1990, Profess iona l i sa t ion and Publ ic pol icy Variat i o n s . The Case o f Denta l Care in Br i t a in and Norway, Univers i t y of Bergen: Report no. 2 , Department of Adminis t ra t ion andOrganizat ion Theory.Esping-Andersen, G, 1990, Three Worlds o f Welfare Capi ta l ism,Princeton , New Je r sey: Princeton Univers i ty Press .Foucaul t , M, 1965, Madness- and Civi l iza t ion , New York: RandomHouse.Foucaul t , M, 1973, The Birth o f th e Cl i n i c . An Archaeology o fMedical percept ion , London: Tavis tock .Fuge11i, 1982, Sondagsmedisin, samtiden, n r. 2 1982.Goldste in , J , 1987, Console and Class i fy . The French psychia t r i cProfess ion in th e Nineteenth century , Cambridge: cambridgeUnivers i ty Press .Grostad, M, 1984, Innvandrere og forva1tn ing - En s tud ie avinnvandreres t i1gang til of fent1 ige yte1se r , u n iv e r s i t e t e t iBergen: Hovedoppgave i of fen t l ig adminis t ras jon og organisasjonskunnskap.

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Hetzler , A, 1978, I behov av vird? Jlur, lagen ODL sluten psykiatisk vird t i l lampas, stockholm, Almquist & Wiksell.Kolberg, J.E, 1983, Farvel til velferdsstaten? Oslo: cappelem.Larson, M.S, 1990, In the matter of experts and professionals,or how impossible it is to leave nothing unsaid, in R.Torstendahl and M. Burrage (eds.) The POrDLation of professions, Lond,on: Sage.Lipsky,' M 1980, st reet-Level Bureaucraoy_ Dilemmas of the Individual in PUblio servioes, New York: Russel Sage Foundation.McGovern, C, 1985, Masters of Madness. Sooial origins of theADLerioan psyohiatrio profession, Hanover and London: UniversiPress of New England.Murphy, R, 1990, Proletarianization or bureaucratization: thefa l l of the professional? in R. Torstendahl and M. Burrage(eds.) The FOrDLation of professions, London: Sage.OECD, 1980, WODLen and BDLploYDLent, Paris : OECD.Oppenheimer, M, 1973, The Proletarianizat ion of the Profesional,Sooiologioal Review of Monographs, 20.Pierson, P, 1991, The Pol i t ics of Welfare s tate Retrenchment(Mimeo), Harvard University.Piven, F.F. and R.A. Cloward, 1988, Popular Power and the WelfareState, in M. Brown (ed.) ReDLaking the Welfare s ta te . RetrenohDLent and sooialo Polioy in ADLerioa and Burope. Philadelphia:Temple University Press. ,Prottas , J.M, 1979, People Prooessing,Lexington, Mass: LexingtonBooks.Ramsey and Kjelsred, 1986, Velferdsstatens yrker, in L. Allden,N.R. Ramsoy and Mariken Vaa, Det norske saDLfunn. Oslo: GyldendaleSadler, J , 1978, Ideologies of "Art" and "Science" in Medicine, inKrohn, Layton and Weingart (eds.) The Dynamics of Science andTechnology. Special Issue of Sooiology of the Soienoes, vol .2,pp. 177-215.Star r , P, 1982, The social TransforDLation of ADLerioan Medioine,New York: Basic Books.Therborn, G, 1986, Why SODLe Peoples are More UneDLployed Thanothers . The strange Paradox of Growth and UneDLploYDLent,London: Verso.Vetlejord, B, 1990, A r b e i d s m a r k e d s o p p l ~ r i n g og t i lpasning tilmarkedet - se t t i e t serviceproduksj onsperspektiv, Univers i te te t i Bergen: Hovedoppgave i admlnistrasjon og organisasjonsvitenskap.

W ~ r n e s s , K, 1984, The Rationali ty of Caring, Boonomio and Indus- 't r i a l Demooraoy, 5: 185-211, London: Sage.W ~ r n e s s , K., and R. Gough, 1985, Nar service og klientens medbestemmelse ikke st rekker t i l , in I . Bleikl ie e t ale (eds. )P01itikkens forva1tning. Bergen: Univers i te tsforlaget .

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TheMindade Gunzburg Center forEuropean Studies

The Minda de Gunzburg Center for European Studies is an interdisciplinaryprogram o r g ~ within the Harvard Faculty of Arts and Sciences anddesigned to promote the study of Europe. The Center's governing committeesrepresent the major social science departments at Harvard and theMassachusetts Institute of Technology.Since its establishment in 1969, the Center has tried to orient students towardsquestions that have been neglected both about past developments ineighteenth- and nineteenth-century European societies and about the present.The Center's approach is comparative and interdisciplinary, with a strongemphasis on the historical and cultural sources which shape a country'spolitical and economic policies and social structures. Major interests of Centermembers include elements common to industrial societies: the role of the statein the political economy of each country, political behavior, social movements,parties and elections, trade unions, intellectuals, labor markets and the crisis ofindustrialization, science policy, and the interconnections between a country'sculture and politics.

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Implications of the Growth of Non~Material Assistance for the Contemporary Welfare State (WPS 30,...

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