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Purpose, Principles and Profit: a Critique of the Commercialisation of Residential Aged Care Services in New Zealand
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New Zealand has been at the vanguard of neoliberal economic and social directives that have dominated commercial enterprises and social service delivery driving much global development for over three decades. The social degradations associated with this form of development are attracting increased attention from a diverse range of critics. A crisis of systemic legitimacy is evident. Legitimacy as a concept invites exploration of what are to be considered ethical behaviours and socially-desirable actions at the level of the organisations that together constitute the social organisation of our humanity. This research, located in New Zealand, is a contribution to this strengthening global critique. Perceptions of organisational legitimacy as it relates to social-purpose businesses providing residential aged care in this jurisdiction is the focus of this study. Since the introduction of neoliberal market orientations to social service delivery, the majority of residential aged care facilities in New Zealand have become controlled by commercially-orientated entities. The numbers of socially-orientated aged care providers has declined markedly. The move towards commercialised aged care arrangements has had a detrimental effect on rural regions, elderly that are financially disadvantaged, and those with special needs. Using the intent of Appreciative Inquiry as a departure point, semi-structured discussions were held with senior managers of four social-purpose businesses delivering residential aged care services to explore their understanding of their organisation’s legitimacy. Participants view their organisation’s legitimacy vested in moral procedural legitimacy, or ‘doing the right thing’. External endorsements, funding levels, meeting community needs, the values that underpin their organisations, and being seen by constituents as socially relevant, were put forward as aspects that shape their organisations’ legitimacy. Legitimacy sources were primarily viewed as the incidental by-product of their constituents’ normal duties. Specific actions that are perceived to enhance organisational legitimacy are listed, and a legitimacy typology is created. An undercurrent of despair arising from tensions participants experience in their attempts to meet conflicting views of care between funders and service providers emerged spontaneously. Concepts of critical organisational studies were reviewed to assess the neoliberalist ideas that underpin the commercialisation of aged care. This sense of despair was subsequently reviewed from both a rational and prophetic perspective. Attention to this depair offers a site for future inquiry with transformational potential. Through this study the influence of neoliberalist policies on the care for vulnerable elderly is better appreciated. This research contributes to an exploration of questions regarding the extent to which the sector is serving the ‘common good’ rather than meeting investor interests – a concern not limited to the care of vulnerable elderly. New Zealand has again an opportunity to be in the vanguard of change. This research concludes with advocacy for a potential change in direction from a commercial understanding of care to a eudaimonic understanding, perhaps emerging in the enlarged attention to wellbeing promoted by the incoming government that has vowed to tackle the degradations of the neoliberal legacy.