The Other Invisible Hand: Delivering Public Services through Choice and Competition

Front Cover
Princeton University Press, Jan 10, 2009 - Political Science - 208 pages

How can we ensure high-quality public services such as health care and education? Governments spend huge amounts of public money on public services such as health, education, and social care, and yet the services that are actually delivered are often low quality, inefficiently run, unresponsive to their users, and inequitable in their distribution. In this book, Julian Le Grand argues that the best solution is to offer choice to users and to encourage competition among providers. Le Grand has just completed a period as policy advisor working within the British government at the highest levels, and from this he has gained evidence to support his earlier theoretical work and has experienced the political reality of putting public policy theory into practice. He examines four ways of delivering public services: trust; targets and performance management; "voice"; and choice and competition. He argues that, although all of these have their merits, in most situations policies that rely on extending choice and competition among providers have the most potential for delivering high-quality, efficient, responsive, and equitable services. But it is important that the relevant policies be appropriately designed, and this book provides a detailed discussion of the principal features that these policies should have in the context of health care and education. It concludes with a discussion of the politics of choice.


What people are saying - Write a review

User Review - Flag as inappropriate

public service delivery
but don't provide right incentives
=> choice and competition (quasi-markets users don't pay but funds follow them)
studies showing the less-well off /disadvantaged wanting more choice in public services (school and health)
+abildgaard and vad 2003. direct payments in scandivnavia for healthcare
belgium and holland had parental choice
high quality: operated and managed efficiently in terms of opportunity costs what otherwise could have been prodived with that moeny
responsive to needs and wants of users. philosophical justivfication in brinign about condition where can realize autonomy. see weale 1993 p42.
but users don't pay for the service taxpayers do and should be responsive to them too
accountalbe to taxpayers
deliverd equitably



Other editions - View all

Common terms and phrases

About the author (2009)

Julian Le Grand is the Richard Titmuss Professor of Social Policy at the London School of Economics and Political Science. From 2003 to 2005 he was senior policy adviser to the British prime minister. His books include Motivation, Agency, and Public Policy: Of Knights and Knaves, Pawns and Queens.

Bibliographic information