The Other Invisible Hand

Delivering Public Services through Choice and Competition

by Julian Le Grand, David Lipsey, Alain Enthoven

How can we ensure high-quality public services such as health care and education? Governments spend huge amounts of public money on public services such as health, education, and social care, and yet the services that are actually delivered are often low quality, inefficiently run, unresponsive to their users, and inequitable in their distribution. In this book, Julian Le Grand argues that the best solution is to offer choice to users and to encourage competition among providers. Le Grand has just completed a period as policy advisor working within the British government at the highest levels, and from this he has gained evidence to support his earlier theoretical work and has experienced the political reality of putting public policy theory into practice. He examines four ways of delivering public services: trust; targets and performance management; "voice"; and choice and competition. He argues that, although all of these have their merits, in most situations policies that rely on extending choice and competition among providers have the most potential for delivering high-quality, efficient, responsive, and equitable services. But it is important that the relevant policies be appropriately designed, and this book provides a detailed discussion of the principal features that these policies should have in the context of health care and education. It concludes with a discussion of the politics of choice.

  • Princeton University Press; January 2009
  • ISBN: 9781400828005
  • Read online, or download in secure PDF or secure ePub format
  • Title: The Other Invisible Hand
  • Author: Julian Le Grand; David Lipsey (other); Alain Enthoven (other)
  • Imprint: Princeton University Press

In The Press

"Le Grand's main themes revolve around the provision of genuine choice to users of public services and the incentives for improved service delivery that such provision puts in place. Provision of choice to users—especially in health and education—is controversial, partly because of doubts about user ignorance and because it runs in the face of professional norms. Le Grand delivers a very persuasive case in favor of user choice. This is a wise, imaginative, and eminently readable book."—Geoffrey Brennan, Australian National University

About The Author

Julian Le Grand is the Richard Titmuss Professor of Social Policy at the London School of Economics and Political Science. From 2003 to 2005 he was senior policy adviser to the British prime minister. His books include Motivation, Agency, and Public Policy: Of Knights and Knaves, Pawns and Queens.