Contenu du sommaire : Accessibilité et non-recours aux services publics

Two factors weigh on failure to resort to social security benefits, penalizing those who most lack security: the lack of legitimacy of the principal standards used and the complicated rules and institutions that surround them. The targeting of benefits has fed criticism for a long time but does not seem to be the main problem. The article aims to explain this. The solution put forward is a return to a more universal availability of benefits.

National Health systems are changing in all the countries of Europe. These changes combined with the economic crisis are having a big impact on the use of health services. They depend on a number of factors, e.g. the characteristics of the systems themselves, the social and economic condition of the citizens and their differing patterns of health needs. The case of Italy provides evidence for decreasing recourse to the health service, particularly amongst the lower middle class, and increasing inequalities in care.

Established in the aftermath of the Second World War and based on a scheme of universal contributions that provided the main defence against want caused by old age, unemployment, injury, sickness and/or widowhood, the British welfare system continued more or less unchanged for the first 30 years of its existence. An examination of the recent evolution of British systems of health and social security shows that its universalistic logic has been largely called in question by the liberal reforms current since the 1980s. As regards the social security system priority is given to the laws of the market. However this course of action tends to restrict access to social security services for the poorest categories of society. Furthermore, an analysis of the development of the national health system shows that the application of the principles of the new public management since the end of the 1990s has made it more possible to access the health services but has worsened working conditions. The objective of improving people's health has been lost sight of because of the accent placed on efficiency. In order to get round these difficulties, the present tendency is to develop the management of the health system by a ‘governance' that is supposed to give more attention to local concerns and competences.

The author focuses on issues linked to the coming into operation in France since the end of the 1990s of a policy of access to rights that depends primarily on informing and advising citizens about the law. When and why did the lack of socialization of the law come to be considered the main explanation of the citizens' difficulties in asserting their rights ? In what degree has the framing of this policy in terms of accessibility influenced the direction given to the measures set in place since the end of the 1990s ? The replies are supported by a qualitative survey carried out between 2006 and 2010.

The information on the physical and mental health of the male population that is available allows us to recognise a considerable number of problems. Unfortunately there is a very long time-lapse between the collection of the data and the moment when the political agenda catches up with them. It is worrying to realise that no matter what the intensity and nature of the problems or the crisis, there are too many men living alone who do not receive help. The explanations emphasize the socio-cultural aspects. Understood in this way the mental and physical health of men is seen to be the affair not just of the individual but a genuine social problem. The way social services are made available needs to be reviewed as a matter of urgency so as to reach out to the male population.

The analysis of causes of non take up of social benefits and rights shows that there is a discrepancy between how potential beneficiaries are “recognized” and expectations about them as felt by those concerned. Recognition of the target beneficiaries is based on principles of categorization and targeting. However target groups perceive them as depreciative, inappropriate or unsatisfactory. The analysis presented in this article brings out a conflict of social norms. Conceptions of autonomy, solidarity and integration and claims for participation are determining factors in the understanding of potential beneficiaries' attitudes to the supply of public benefits. In some cases, and perhaps paradoxically, renouncing claims is felt to be the most relevant available strategy necessary to maintain self respect and self esteem (A. Honneth, 2006).

The Rassemblement de la Jeunesse Citoyenne (RAJE) aims to improve conditions of access to social aid for young adults lacking job security. They provide a space where young people can join in, and where there can be training and experimentation in the practice of concerted action for those who work for community youth bodies. This innovative strategy has made it possible to challenge the public authorities about the limits of the measures of social aid and put forward concrete solutions. Three and a half years after it started, it is now possible to have a better idea of the circumstances of the successes and failures of the RAJE, the courses followed by the young people engaged in it, the part played by contributors, and the material and symbolic feasibility of maintaining and developing collective action within community youth organisations.

That everyone should have equitable access to social services and benefits is recognized as a political principle. In Switzerland, however, little has been done to see whether this goal has been realised. When consulted, the professional social workers of the canton of Fribourg confirmed that part of the public had difficulty in obtaining their rights. The government has therefore decided to make it easier for people to obtain their social rights, in particular the most destitute, by setting up an independent social agency that will serve people across the board.

The question of failure to have recourse to benefits is more than just a matter of welfare payments. It concerns welfare provision in its entirety and many other areas of public intervention besides. The variety of explanations given for this do not allow us to identify the problem clearly, particulary because the failure to take up benefits concerns a priori every social category. Any description has to recognise the free choices of individuals and express the lack of interest, the disagreements and the insuperable obstacles that cannot be overlooked in defining the ‘social demand'. In other words, the raising of the question may help to estimate public policies that should be purposefully addressed to the recipients, particularly those who are missing.