Centralization and Power in Social Service Delivery Systems : The Cases of England, Wales, and the United States

In the United States and other western nations, debates rage over whether welfare, medical care, educational programs, and many other aspects of public policy should be the responsibility of central govern­ ment, local government, or the private sector. In most nations, the issues of regional autonomy and decentralization are constantly in the news, with intensity varying from mild debate to open warfare. Less visibly, battles are continuously fought in the political arena over what groups should have the right to make decisions concerning the allocation of soci­ ety's resources. In response to these concerns, social scientists have focused consider­ able attention on the causes and consequences of centralization and de­ centralization in political, economic, and social organizations. Their analyses of centralization have been varied, ranging from systems that are quite small (e. g. , the family, the firm, and the community) to those sys­ tems that are very large (e . g. , the welfare state). While centralization is a concept of major concern in most of the social science disciplines, each discipline has tended to focus on centralization with a different set of interests. Economists have been very much concerned with the causes and the consequences of the concentration of economic resources. Polit­ ical scientists have long sought to understand the origins and conse­ quences of dictatorship and democracy. Sociologists have focused on inequalities in the distribution of power. In the United States and other western nations, debates rage over whether welfare, medical care, educational programs, and many other aspects of public policy should be the responsibility of central governƯ ment, local government, or the private sector. In most nations, the issues of regional autonomy and decentralization are constantly in the news, with intensity varying from mild debate to open warfare. Less visibly, battles are continuously fought in the political arena over what groups should have the right to make decisions concerning the allocation of sociƯ ety's resources. In response to these concerns, social scientists have focused considerƯ able attention on the causes and consequences of centralization and deƯ centralization in political, economic, and social organizations. Their analyses of centralization have been varied, ranging from systems that are quite small (e. g., the family, the firm, and the community) to those sysƯ tems that are very large (e . g., the welfare state). While centralization is a concept of major concern in most of the social science disciplines, each discipline has tended to focus on centralization with a different set of interests. Economists have been very much concerned with the causes and the consequences of the concentration of economic resources. PolitƯ ical scientists have long sought to understand the origins and conseƯ quences of dictatorship and democracy. Sociologists have focused on inequalities in the distribution of power Front Matter....Pages i-xv Introduction....Pages 1-16 Centralization: A Conceptual and Measurement Strategy....Pages 17-34 The American Educational System....Pages 35-54 The Educational System of England and Wales....Pages 55-86 The American Medical System....Pages 87-108 The Medical System of England and Wales....Pages 109-133 Centralization and Power in Delivery Systems....Pages 135-164 Conclusion....Pages 165-168 Back Matter....Pages 169-202