Empowerment in welfare markets

The NHS and community care reforms have been promoted as a means of boosting efficiency and making services more responsive to clients. The government has urged health and social services to establish processes by which clients’ views are identified but with no firm requirement that these are prioritized within the commissioning process. Whilst it is expected that the NHS and local authorities will respond to government exhortations, this paper suggests that there are compelling political, financial and organizational reasons why the opportunities for power sharing may differ between the two types of authority.