3.1 ‘Contracting out’ services
‘Contracting out’ services from the state to independent providers is identified as a main process of marketisation of care across welfare states. For example, Knapp et al (2001) argue that contracting out of services is one of the major changes of social care in 1990s in England.
The ‘contracting out’ process shows trade-offs between actors in the care diamond in terms of care provision, financing and regulation. Private providers of care for older people are increasing due to ‘contracting out’ care services from the state provision to both for-profit and non-profit providers (Greener, 2008) and spontaneous participation of private providers into the care provision market. After years of attempts of ‘contracting out’ services from public provision to the market, Nyssens et al. (2012) point out that the ‘for profit’ sector is larger in Germany and England, while ‘not for profit’ sector is increasing in Italy. In urban China, Ding (2013) argues that ‘not for profit’ organizations are encouraged to provide the labour support for home care services through ‘contracting out’ policies.
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Brennan, et al., (2012) propose inequalities problem after ‘contracting out’ to independent providers. As Ungerson (1999) and Shutes and Chiatti (2012) argued, the contracting-out of care services resulted in the dualisation of the care services and care labour market of one care market within the public provision and the other within private provision. Ding (2013) propose the urgency of establishing standards for home care agencies and care qualities after the application of ‘contracting out’