Executive summary
Introduction
Welfare systems, whose role is to promote the well-being of citizens through high levels of social inclusion and protection, are at the heart of the European social model. Up to the 1970s, across Europe, delivery of public services was almost exclusively the responsibility of the state. Since then, many Member States have extended the role of the private sector in delivering public services in pursuit of improved choice, quality and efficiency.
This report examines how the role of the private sector has grown in the provision of public services in four EU Member States: Lithuania, Spain, Sweden and the UK. It explores the processes by which the private sector became increasingly involved and the implications for access, quality and effectiveness of services for service users. With an explicit focus on the user perspective, the report is based on case studies in these four Member States drawn from the following sectors: healthcare, long-term care, early childhood education and care (ECEC), and employment services. The report assesses developments in the delivery of these services and also addresses the impact of the economic crisis on the changing public–private sector relationship in provision.