The lives of all Australians are profoundly affected by the quality of social services available, but a long list of royal commissions and public inquiries have revealed them to be failing. In The Careless State Mark Considine shows that the preferred model of reform has failed to adapt and improve.In the 1980s Australian governments faced rapidly increasing demand for services in areas like employment assistance, aged care, childcare and vocational education and training; to respond to this challenge, governments led by Bob Hawke and Paul Keating pioneered the introduction of service markets, where private companies compete with public institutions and charities in newly constructed social services. This 'choice revolution' was embraced and extended by the Howard government. Market choice continues to drive reform across a wide spectrum of programs and social services.

Considine's detailed investigation demonstrates conclusively that important aspects of the experiment with social service markets have failed. Weak quality control, systematic rorting and entrenched disadvantage have become the norm. Private business interests and shareholders' interest have often displaced established charities and commitment to quality care for all. The service systems are careless, leaving clients to make choices without real information or protection.Considine points to alternative ways that reforms could be configured to get the best from both private and public agencies, and find a new approach to save these failing services.