In Chapter One Michael Hill addressed the broad concepts of care, citizenship and community and their interface nationally and globally. In this chapter the focus is on recent policy developments in the UK that have revived concepts of citizenship and community within the context of care. The next chapter from Alison Petch will then look at some of the distinctive developments in Scotland.

Background

In the UK, central government policy has regularly emphasised the importance of community in the provision of social care. Both the Seebohm (1968) and Barclay (1982) Reports saw communities as fundamental to the provision of local social care services, the latter advocating a system of ‘patch-based social work’ to utilise community resources and meet local needs effectively. The demise of community social work in the 1980s coincided, ironically, with the growth of community care policies, the closure of long-stay mental hospitals and the growing popularity of policies for enabling people with complex needs to remain independent in their own homes for as long as possible. Parallel policies for children and families saw a major reduction in the number of children's homes and an emphasis on foster care.

Community social work became a victim of centralisation and cost-cutting in local government just as Sir Roy Griffiths (1989) was preparing his report on community care. As a result, ‘community care’ never became a community-based system of care, but rather a policy for deinstitutionalisation. In spite of this the 1980s saw a rapid growth in residential and nursing homes, particularly after 1984 when legislation enabled individuals receiving social security benefits to receive state funding for residential care if assessed as in need, fuelling an unplanned growth in privately owned homes.

The 1990 NHS and Community Care Act, implemented in 1993, transferred the entire state funding for residential and nursing care for older people to local government social services departments and effectively closed the financial loophole that had encouraged many into residential care. The Act designated the local authorities as ‘enablers’, purchasing residential, day and home care services, mainly from the private and voluntary sectors rather than providing them themselves.