The welfare state is but the vehicle for the provision of welfare and the latter does not necessarily entail the former. Much recent debate occasioned by government policy and rhetoric has therefore confused means and ends. This paper argues that a defence of welfare must come before a concern for protecting the welfare state. A number of foundations for guaranteed welfare provision, including justice, rights and contract are considered but the most persuasive foundation for welfare as need-meeting is found to lie in the Kantian categorical imperatives. Not only do these provide a moral prescription that welfare ought to be provided, they also dictate the ways in which it ought to be provided. It is against these requirements therefore that the necessity of a welfare state as a means of providing welfare can be tested. The second part of the paper then considers how extensive a welfare state needs to be, and how the boundaries between the public and private domains in the provision of welfare may be drawn. The equality principle, allied to the notion of equality of welfare, is found to be a useful instrument in determining the bounds of the public domain but only (so the paper concludes reluctantly) when harnessed to objective specifications of need.

Using data from the 1980 General Household Survey, differences in the provision of statutory domiciliary services to disabled elderly people are explored. Domiciliary services vary in their degree of ‘substitutability’, that is, in the extent to which the care may be performed either by state services or by other members of the elderly person's household. Domestic support services are substitutable by any available carer; personal health and hygiene services are partially substitutable depending on the relationship between the carer and the cared for; and medical services are not substitutable by informal carers. The paper shows that discrimination by statutory services against women carers is dependent primarily on the household composition of the elderly person rather than on gender per se. Taking into account the level of disability of the elderly person, younger ‘single’ women carers receive no less support than ‘single’ men carers, but carers who are married women under 65 obtain the least domestic and personal health care support. Carers who are elderly receive more support than carers under 65. Among disabled elderly people who live alone, men receive somewhat more domestic and personal health services than women.

As unemployment has risen, so has academic, professional and political interest in its possible social consequences. In recent years a large number of studies have sought to prove—or disprove—that unemployment causes ill health, with few definitive results. This paper reviews the methodological and conceptual difficulties experienced by researchers in this field. It concludes that, generally, the impact of structural factors on the shape of the analysis has been all but ignored. It suggests that an historical perspective provides useful insights into the question and ought to be given more attention.

Travellers, or Gypsies, constitute a minority group with its own culture and traditions for whom access to health care can pose problems. A study of Traveller women and children showed that the sites where they lived were often lacking in facilities and provided a poor environment in terms of cleanliness and safety. Perinatal mortality was above average, and was especially high on sites with inadequate facilities and among the more mobile families. Immunisation and preventive care of children were both inadequate, especially among the more mobile. There continues to be a need for more, and better, permanent sites for Travellers. Other responses include allowing Traveller families to carry their own medical records, providing mobile clinics for Gypsy sites, and appointing specialist health visitors to ensure that Travellers get the health care to which they are entitled.