Discursive constructions of consumer choice, performance measurement and the marketisation of disability services and aged care in Australia

Patrick O’Keeffe & Christina David (2020)

Australian Journal of Social Issues. Online first

Abstract. We show how policy discourses construct consumer choice, performance measurement and quality standards as key technologies in the marketisation of disability services and aged care in Australia. The emergence of performance outcome measurement and increased consumer access to these through diverse consumer facing and interactive platforms enables the state to “govern at a distance” through the management and shaping of outcome indicators rather than delivery of services. The state does this by creating market competition and establishing outcomes which reflect the construction people using services as informed and rational consumers rather than citizens. This construction and operationalisation frame marketisation as a rational solution to broken systems, assume choice is unproblematic and ignore diverse capacities to access and use information, resource differentials and contextual variables such as market maturity and service availability. The benign marketisation of human services thus discriminates against those who are already marginalised and disadvantaged unless equity strategies are clearly in place.

Extract. “2.3 | Technologies of performance and quantification The logic of making information about services available is that this enables the rational consumer to make informed choices. This then leads to how this information is constructed, and how the technologies used to capture and communicate this information are employed to represent a particular reality as a truth (Diaz-Bone, 2016; Le Gales, 2016). Performance objectives, audit, calculation and outcomes help make the rationality of markets and competition operable (Miller & Rose, 1990; Le Gales, 2016). In this relationship, both parties are constructed as “choosers,” shaping services, efficiencies and driving competition (Watson & Ryan, 2010, cited in Chesters, 2018). While policymakers claim to use technologies such as performance objectives and outcomes to enhance accountability and transparency, Dean (1999) and other theorists in this field (Miller & Rose, 1990; Power, 1996) have suggested that these technologies primarily serve to coerce and control. Quantification, coupled with technologies of government, is central to this subtle coercion. Quantification constructs a narrow, simplified reality, which is founded on the positivist perception of numbers as being apolitical, disinterested and objective (Desrosières, 2011). As quantification has developed in prominence, quantification of the social world has become established in many instances as a process for creating acceptable knowledge (Russell & Frame, 2013). The numbers created through quantification are held as having power unto themselves, creating a reality which is taken to be self-evident (Espeland & Stevens, 2008). In advanced liberal governing, quantification creates knowledge which can be acted on, and operationalised through, assemblages of technologies such as audit and outcomes that make this knowledge, and this reality, amenable to governing (Diaz-Bone, 2016; Le Gales, 2016). (p. 3-4)

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