During the 1980s and 1990s reforms within the English public sector sought to increase value for money by increasing the scope for competition in the provision of public services in order to reduce their costs and by setting targets for service delivery. During the 2000s attention focused on giving service users increased scope for choice of both service provider and service form so as to increase further the value of public services. Increasing the scope for user choice of the form of service received is also intended to lead to the co-design and co-production of services, this implying a quite radical change in the nature of the welfare state and its system of governance. This paper assesses the rationale for these reforms and critically appraises their effectiveness.