Abstract
This thesis aimed to further our understanding of how and why our welfare systems rely on economic growth, and what can be done to alleviate that reliance. We took a sector focused approach to this task, using a combination of case studies, document analysis and reflexive thematic analysis to investigate the role of marketised, privatised and financialised provisioning systems in generating growth dependencies in the adult social care sector.
We found that the organising principles of competition, consumer choice and profit tend to drive dysfunctional dynamics and poor outcomes for workers and service users in the care sector. We identified the specific financial structures through which growth dependencies enter the UK’s adult social care system. Further, we drew a tentative link between the pursuit of economic rents and specific harms caused to care workers and service users in the residential and nursing home sector. Ultimately, we argue that investment firms are engaging in deliberate and extreme cost-shifting behaviours that transform and transfer financial costs that sit on the balance sheets of care companies to social costs that are born by workers and residents.
We then developed a framework for systematically analysing growth dependencies across the welfare state, distilling three core processes that are responsible for creating growth dependencies in the care sector: the pursuit of needs satisfaction for all; the pursuit of labour productivity growth; and the pursuit of economic rents. We found that where these growth dependencies emerge, they are typically supported and propagated by a set of specific underlying financial, social, legislative and cultural factors. We argue that these underlying conditions can be identified and transformed to mitigate growth dependency, articulating how this can be achieved in the adult social care sector. Future research is now needed to expand this work to other sectors, and to connect it to the literature looking at macro-level growth dependencies.