Policy Makes Labor Politics, Too: How Public Sector Workers Form and Sustain Social Policy in the Post-Industrial Economy

What sustains social policy? Scholars of the welfare state have identified several factors that help to reproduce existing policies in the face of increasing fiscal strain. One of the most important mechanisms of reproduction is policy feedback, whereby policies alter the political behavior of actors, who then come to reinforce these policies. This paper draws attention to a little-studied actor in the policy feedback literature: public sector workers. The development of the welfare state expanded public employment over the latter half of the twentieth century. Yet who these workers were, and how they organized, varied. A comparison of French, British, and American mental health policy illustrates how prewar policies biased mental health workers’ organizations toward either private or public sector practice, with varying effects for the development of mental health policy. Where these organizations were biased toward public sector care, the postwar expansion of public employment included psychiatric workers, who in turn successfully resisted cutbacks to mental health care in periods of fiscal crisis. Where workers’ organizations were biased toward private sector care, however, the postwar expansion of public employment included few jobs in psychiatry, leaving most of that labor to the private sector. Attempts to retrench public mental health services were left unchallenged as a result. This paper thus demonstrates that the workers who provide social services can have a path-dependent impact on their structure, generosity, and sustainability.