The dire economic situation has inescapable consequences for public services. While politicians talk of the need for substantial, even ‘savage’ cuts, they are equally adamant that ‘frontline’ services must be protected. But can the necessary savings be made simply by cutting red tape, or is a more serious reshake of public services inevitable? Talk of reform in recent years has tended to focus on increasing choice, but does this address the real problems? From Surestart to public health, is welfarism now more about behaviour change than a safety net? Should we take on ‘dependency culture’? Put bluntly, is it time to rethink the very idea of the welfare state?

The recent British Social Attitudes survey found the public is less sympathetic to welfare claimants now than in the 1980s. And despite the undoubted achievements of the welfare state in providing material security for those who might otherwise be destitute, few now defend a situation in which some children grow up not knowing anyone who works for a living. Health and education remain popular priorities, though the public increasingly doubts the government’s ability to manage these services effectively. Conventional wisdom has it that the British people are passionately devoted to the NHS, and no credible party now dares challenge it. But do we confuse the idea that healthcare should be available to all with a specific form of state provision? Is the idea that it is immoral to make money from health provision a political principle or an irrational prejudice? Can market reforms and ‘personalisation’ make vital services work under changing circumstances? Can we rethink institutions like the NHS without simply exposing everyone to the ravages of capitalism? Or is the welfare state a non-negotiable social good?