Managing the human service market: the case of long-term care in Japan
Dr Yoshihiko Kadoya
Published by the University of Sydney, 2011
Providing human service through competitive markets is inherently problematic. On one hand, quality care is critical; unsatisfactory human service greatly influences people’s quality of life. On the other hand, profit for human service providers is essential for sustainable service provision. This thesis focuses on striking a balance between human services’ need for quality assurance and market providers’ need for profit. The research primarily examines the provision of long-term care for the elderly in Japan, which has the biggest share of aged population among the OECD members. Two research questions guide the empirical research: 1. How should governments design the human service market in order to keep the capacity to ensure the quality of service? 2. How should governments set the performance measurement for quality care? The research presents and tests two models. The first model addresses market competition practices and offers an alternative care quality model, called Ideal CQM. Ideal CQM seeks to overcome deficiencies in the existing care quality model, which allows the market to accommodate poor quality care. To this end, Ideal CQM presents a theoretical market design in which quality of care is the sole basis for market competition. By implementing Idea CQM, governments can direct the market competition to enhance the quality of care and poor quality service can be automatically eliminated from the market. The second model addresses performance measurement and is a process-based model, which values the experiences of front-line care workers. The process-based performance measurement seeks to overcome deficiencies in the existing outcome-based performance measurement, which is rendered ineffectual by two unique features of human service: ambiguous policy goals and a considerable amount of front-line worker discretion. This thesis, thus, modifies the existing concept of market competition utilising public administration theory to accommodate the process-based performance measurement model. The research supports the use of market competition to provide human service for long-term care. Approving the workability and the practicability of the presented two models, the thesis concludes that governments can achieve balance between quality assurance and sustainable provision, if they are willing to meet the required conditions for implementation of the two models.
Dr Kadoya’s research was supervised by Associate Professor Joanne Kelly, Director, Australia and New Zealand School of Government (NSW). A copy of this thesis is available electronically through Fisher Library, University of Sydney.
Contracting-out and Regulating Labour Standards: NSW Government School Cleaners
Dr Sasha Holley
Published by the University of Sydney, 2013
Over the last two decades governments have increasingly contracted-out the provision of public and human services to outside organisations. These contracts were not designed to regulate the wages and other working conditions of the workers employed by the external organisation. There is increasing evidence that contracts for services are being used as a tool to regulate labour standards for workers, usurping the labour law provisions covering these workers’ labour standards. The central objective of this thesis is to analyse how labour standards are regulated through the combination of labour law and contracts for services when services are contracted-out. This is achieved with a case study of NSW government school cleaning contracts. These are amongst the largest contracts for services in the world, with more than 6,000 employees providing cleaning services. The case study reveals that government contracts for services have taken a predominant role in how labour standards are negotiated, defined, monitored and enforced, while the employment contract underpinning labour law takes a secondary regulatory role. In practice, the cleaners’ labour standards are poorly monitored and rarely enforced with minimal compliance with standards prescribed by labour law or by the contracts for services. The findings of the analysis are significant for three reasons. First, there is a dearth of research to date that considers how labour is regulated through the combination of labour law and procurement contracts. This is particularly important given the prevalence of procurement in the public services arena. Second, the thesis expands understandings of how labour standards for cleaners, as a subset of vulnerable workers, are regulated. This is significant if contracting-out is used as a strategy to undermine labour standards for the most vulnerable workers. Third, the analysis highlights the problems of labour law becoming subservient to contracts in regulating labour standards.
Dr Holley's work was supervised by Associate Professor Gaby Ramia, GSG and Associate Professor Bradon Ellem from the School of Work and Organisational Studies. A copy of this thesis is available electronically through Fisher Library, University of Sydney.