Can we rely on the public service ethos to deliver high quality public services? Are professionals such as doctors and teachers really public-spirited altruists—knights—or self-interested egoists—knaves? And how should the recipients of those services, patients, parents, and pupils, be treated? As passive recipients—pawns—or as active consumers—queens?
This book offers answers to these questions. It argues that the original welfare state was designed on the assumptions that those who worked within it were basically altruists or knights and that the beneficiaries were passive recipients or pawns. In consequence, services were often of low quality, delivered in a patronising fashion and inequitable in outcome. However, services designed on an opposite set of assumptions—that public service professionals are knaves and that users should be queens—also face problems: exploitation by unscrupulous professionals, and overuse by demanding consumers, especially middle class ones.
The book draws on evidence from Britain and abroad to show that, in fact, public policies designed on the basis that professionals are a mixture of knight and knave and recipients a mixture of pawn and queen deliver better quality and greater equity than policies based on more simplistic assumptions about motivation and agency. In particular, contrary to popular mythology, the book shows that policies that offer choice and competition within public services such as education and health care can deliver both excellence and equity. And policies aimed at building up individual assets and wealth ownership can empower the poor and powerless more effectively than those aimed simply at bolstering their current income.