This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The thesis aims to build on what is known about large and internationalized welfare firms, and to make a contribution to the debate about social policy and globalization, through an empirical and exploratory study of large and internationalized firms within the UK market in long term care for older people. The thesis utilizes two levels of analysis: a micro level analysis based on case studies of the three largest private providers of long term care in the UK; and a meso level analysis of the relationships between these firms and three other actors: the state and its agencies, staff and unions, and older people themselves. The findings of the thesis contradict deterministic claims concerning the loss of power by the state. The state is found to be the most powerful actor in the sector in ten-ns of its ability to regulate the sector and influence its overall structure. In contrast, the relative weakness of unions and older people's organizations leads them to attempt to exert influence on private providers through the medium of the state. State policies, however, are likely to facilitate greater concentration and internationalization within the sector, an outcome which is in the long term interests of those firms which are already large and internationalized. The parallel processes of concentration and internationalization in the sector have significant implications for the delivery of care