This is an Accepted Manuscript of an article
published by Taylor & Francis in International
Review of Sociology – Revue Internationale de
Sociologia on January 22
nd
2018, available online:
http://www.tandfonline.com/10.1080/03906701.201
7.1422887
The morphogenesis of disability policies and the personalisation of
social services. A case study from Italy.
Riccardo Prandini and Matteo Orlandini
University of Bologna, Nonantola, Mo, Italy
Abstract
Across Europe, and particularly since the 2008 Financial Crisis, new demands for tailor-made services
came from different actors and perspectives: user-led organizations, intellectuals, policy makers, social
workers, advocacy organizations, which call for a new way of programming, realizing and evaluating
social policies. Personalization became a relevant part of the so called ‘welfare innovation narrative’,
which concerns – to name but a few – English personalization agenda, Scottish self-directed support,
Finnish education system, Norwegian cash-for-care policies. Even the European Commission is
addressing new social services, reshaped through users’ capabilities. The aim of this paper is to critically
explain, through a case study focused on the Sardinian disability policy, how social policy’s
morphogenetic cycles influence the governance of personalized disability plans and, consequently, the
possibility of their implementation.
Keywords
Personalisation; disability policies; co-production; morphogenesis; governance; social services
1. Introduction
European Welfare states are facing a growing demand for personalized social services, due
to – among many reasons – the de-standardization and heterogeneity of individual needs
(Valkenburg, 2007) which give room to the dramatic rise of new (Taylor-Gooby, 2005) and
non-actuarial societal risks (Sabel, 2012): harms whose incidence is so unpredictable that
it is impossible for those at risk to create an insurance pool sufficient to indemnify those
who incur losses. These changes make unsuitable the ‘one-size-fits-all’ services designed
to serve the ‘average client’ typical to traditional forms of welfare state (Rosanvallon, 2000).
Across Europe, and particularly since the 2008 Financial Crisis, new demands for tailor-
made services came from different actors and perspectives: user-led organizations,
intellectuals, policy makers, social workers, advocacy organizations, which call for a new
way of programming, realizing and evaluating social policies. Personalization became a
relevant part of the so called ‘welfare innovation narrative’ (Needham, 2011), which
concerns – to name but a few – English personalization agenda (HM, 2007), Scottish
selfdirected support (Scottish Government, 2010), Finnish education system (FNBE, 2010),
Norwegian cash-for-care policies (Christensen, 2012). Even the European Commission
(2013) is addressing new social services, reshaped through users’ capabilities.
Personalization has been basically conceived as: a very ambivalent reflexive narrative
(Needham & Glasby, 2014); something ‘in flux, making it difficult to identify a stable core’
(Needham, 2011, p. 157); being simultaneously liberal and conservative (Ferguson, 2007);
for independence/self-sufficiency and in favour of retrenchment (Power, 2014); for
citizenship rights protection and for families and communities activation (Glasby, Duffy,
& Needham, 2011). In a nutshell, personalization is generally observed as a ‘powerful
hybridization’ (Ferguson, 2012) between market consumerism and social rights discourse,
giving rise to a social policy mix constituted of counterposed values like deep citizenship
and consumerism, community support and individual choice (Mladenov, Owens, & Cribb,
2015). This ambiguity becomes a key element of its success because different actors and
services users perceive personalization differently, so that it can be extensively accepted
as an actual option by the political system (Beresford, 2014): personalization become
‘varieties of personalisation’ and it is framed differently in various national welfare regimes
(Christensen & Pilling, 2014; Needham & Dickinson, 2017).
Scientific literature and case studies have not yet fully explored the social mechanisms
that allow personalization to work properly (Reeve & Cooper, 2016). In particular, the
relation between personalization and its governance – which is one of the cornerstones
leading to the discourse – is poorly developed (Duffy, 2010). An adequate account on how
the personalization of social services has to be governed has not yet been elaborated.
The aim of this paper is to explain, through a case study focused on the Sardinian
disability policy, how social policy’s morphogenetic cycles (Archer, 1995) influence their
governance and, consequently, the possibility of implementing ‘personalization’.
The paper is structured in the following way. In Section 2 we clarify the difference
between personalized and individualized social services; then (Section 3), we argument
our hypothesis, methodology and research outline; in Section 4 we present our research on
Sardinia personalized plans. In Section 5 we try to identify the morphogenetic cycle
observed in the Sardinia case, to show how varieties of governance are linked to different
ways of personalization. In Section 6 we briefly comment on the results, pointing out the
critical, controversial and contradictory aspects of Sardinian personalization policy.
2. The conceptual difference between personalization and
individualization
For policy makers, personalization is a specific and innovative way of designing,
delivering, financing and evaluating social services (Glasby & Littlechild, 2009).
Personalized social services are targeted and tailored on individual needs and aspirations,
supporting and enabling citizens in realizing autonomously their life-projects (Duffy,
2008). Personalization means that social services should be de-standardized, adapted and
tailored to the individual characteristics and their ‘circumstances in order to increase their
effectiveness’ (van Berkel & Valkenburg, 2007, p. 3).
Three drivers enhance personalization processes within social policies, especially as far
as social care is concerned. The first driver involves the historical breakdown of the
Principal-Agent model, which has been typical of welfare states after the Second World
War (Sabel, 2013). The second driver concerns the crisis of the compensatory social
insurance model of welfare, which has already been replaced by a social investment and
inclusive growth paradigm, triggered by a service-based welfare system (Hemerijck,
2012). The last driver pertains to co-production of services, which ‘deeply’ include specific
ways of articulating users needs.
(a) Postwar welfare states and their governance were characterized by the PrincipalAgent
(P/A) model. In a nutshell, Principal – i.e. a national government – appoints some
Agents – i.e. local public authorities – to implement previously defined collective
goals. In other words, general programmes and reforms – elaborated by the Principal
– are translated, through a bureaucratic ‘chain of command’, into specific actions and
policies by the Agents. Literature revealed many structural, non-contingent reasons
for the failure of the P/A model: (1) the Principal should know ‘what he wants’ ex ante,
but actually this is not usually possible, since contingencies pervade the whole
process; (2) the Principal is supposed to be able to identify all tasks of Agents: as a
matter of fact, it rather coordinates many Agents, whose interaction gives rise to new
emerging problems (and subsequent new tasks); (3) the distinction between means
(enforced by the Agents: policy implementation) and ends (enacted by the Principal:
policy making) is no longer clear, neither materially, nor socially and temporally; (4)
social issues are always contextual and mutable so that it is no longer possible to
design long-term and ‘one size fits all’ social services; (5) goods and services are often
de facto co-produced with users-customers-citizens: therefore, the distinction between
active-agents-professionals and passive-ignorant-citizens is unbearable; (6) it is not
useful to adopt simple rules because if they are too general, an interpretation is needed,
which generates conflicts that cannot be solved hierarchically; (7) Principals and
Agents are increasingly conceived as ‘search networks’, which horizontally
collaborate to solve part of the problem they face; (8) those Agents who should
implement Principal decisions often aim to protect their own interests and not the
Principal one; (9) recruitment procedures are less and less suitable for selecting the
‘best’ opportunities (under which respect Agent) and some rules (i.e. ‘the lowest price’)
are often useless for the purposes of services’ implementation.
(b) The second driver concerns a conceptual change, pointing at the emergence of the
socalled ‘new social risks’. These new risks are increasingly complex and
unpredictable (Taylor-Gooby, 2005). Old welfare risks were coupled with standard
insurance calculated on an actuarial basis, with a focus on a typical male citizen, full-
time employed, holding a steady job position that was maintained throughout the
entire career; job interruption was mainly contingent upon sickness or unemployment
(which were correlated to predictable economic cycles). These risks have completely
changed. To differentiate people included or excluded from the labour market has
become more difficult because of the proliferation and fragmentation of new
employment contracts. Moreover, categories of people previously excluded from the
labour market – e.g. women, disabled people, single mothers, elderly – have become
more and more included, while, on the other side, other categories who were included
– e.g. young people – have gradually been more and more excluded (Annesley, 2007).
Old welfare systems were also founded on a tacit intergenerational solidarity pact –
involving working and retired people –, which operated with a passive financial
redistribution mechanism. On the contrary, nowadays, risks that need to be insured
against are less and less estimable on an actuarial basis (Luhmann, 2013). Such risks
are so unpredictable that it is impossible both to say ‘who’, ‘when’ and ‘how much’
should be paid, and to generate an amount of insurance sufficient to really compensate
those who suffer a loss. This new welfare constellation drives towards the notion of
social investment where costs are conceived as tools for creation of human, social and
economic capital. Instead of passive financial compensations (i.e. old-fashioned social
assistance), now capacitation and active policies are new keywords. Since risks
aggregation fails, new social services are needed to help individuals and families to
self-insure against risks, making them able to develop, throughout their life course,
skills and capabilities to tackle ever changing problems (Crosby & Duffy, 2008).
(c) The third driver is connected with the importance to capacitate people by means
ofsocial services, thus transforming their abilities into positive resources. In order to
generate a cohesive and dynamic society, welfare systems have to organize
personalized services so that the increased human and social capital can tackle
‘dependence trap’ and social isolation (Castel, 1995; Ehrenberg, 2009). The efficiency
of personalized services depends on users’ collaboration and response: users have to
personally engage in order to thrive. Activating people’s potentialities is a condition
of possibility to discover and meet unmet needs: our hypothesis is that this process
can take place only through a personalized services co-production.
These three drivers permitted and enhanced a new culture of personalization within
social policies. Though within the concept of personalization are conflated two very
different ways of thinking and designing social services. Given this conflation we need to
distinguish personalization from individualization to frame our research project. These are
two very different logics of delivering social services, usually conflated in literature.
We define individualized social service (ISS) as a top-down example of policy making,
aimed at offering a standardized and specified provision of social services, which could be
better defined as ‘customization’ of services. Goods and services are pre-arranged and
planned by professional experts and policy-makers: the whole range of customized
services is available in a ‘package’ ready to be delivered. ‘In many situations this more
individual approach is combined with a primarily top-down approach, in which the
political process has already defined the problems that have to be solved and the ways in
which this should be done’ (Valkenburg, 2007, p. 38). In ISS the designer defines the
clients’ needs and decides how to deal with their context, shaping a diverse but
standardized caseload. That is why the clients are not real co-producers: they can only
decide how to utilize the resources previously arranged by services designers.
Individualization – as a ‘set menu’ service – can reach remarkable levels of precision,
differentiation and tailoring, but it cannot develop real processes of co-design and co-
production because the client, by definition, is limited to a passive role. They are a target
defined by an ‘expert system’ which holds the powers and knowledge to decide ‘what is
the case’ and ‘who is in charge’. The client is made passive because they have no real power
to co-produce/deliver/evaluate what they need: ‘because service users and carers were
excluded from directly contributing to the original policy problem formulation, they could
not influence the proposed solutions’ (Carr, 2014, p. 30).
We can give some examples based on English personal budget and self-directed support
scheme, exactly to underline the case for ‘individualization without personalization’.
Slasberg and Beresford pointed out how need assessment, that formerly was divided into
a need evaluation (with the client) and a decision concerning which needs to meet, has
become a single process: ‘the imperative for Councils became to constrain assessments to
affordable need only. Thus “need” was always seen through the prism of resources’ (2015,
p. 480). The person-centred approach has turned into a resource-driven approach. Series
(2014) with Clemence (Series & Clemence, 2013) showed the failure based on RAS
