Article contents
Equity and Efficiency in Community Care: Supply and Financing in an Age of Fiscal Austerity*
Published online by Cambridge University Press: 14 November 2008
Abstract
From the confrontation of fiscal austerity and growing needs in the United Kingdom has come a new ideology: ‘efficiency-focused mana-gerialism’. Common arguments and the adaptation of structures to reflect them can be seen in all areas of policy, but nowhere more clearly than in the long-term social care of the elderly, the subject of this paper. Perhaps the strand of policy analysis which most influences and epitomises the new managerialism is the work of the Audit Commission for Local Authorities in England and Wales, whose arguments and proposals have gained great and widespread influence. The commission's ‘three Es’ – economy, efficiency and effectiveness – have become among the most fashionable slogans of our time.
- Type
- Research Article
- Information
- Copyright
- Copyright © Cambridge University Press 1987
References
NOTES
1 Audit Commission, 1975, op. cit.
2 Audit Commission, 1975, op. cit.
3 Davies, B. P.Social Needs and Resources in Local Services. Joseph, London, 1968.Google Scholar
4 Davies, B. P.Planning Resources for Personal Social Services. Department of Social Administration, Edinburgh, 1982.Google Scholar
5 Bebbington, A. C. and Davies, B. P.Equity and efficiency in the allocation of the personal social services. Journal of Social Policy, 12 (1983), pp. 289–308.CrossRefGoogle ScholarPubMed
6 Audit Commission, 1975, op. cit.
7 Davies, B. P. and Challis, D. J.Matching Resources to Needs in Community Care. Gower, Aldershot, 1986.Google Scholar
8 Goldberg, E. M. and Connelly, N.The Effectiveness of Social Care for the Elderly. Heinemann, London, 1982.Google Scholar
9 Bebbington, and Davies, , 1983, op. cit.Google Scholar
10 Bebbington, and Davies, , 1983, op. cit.Google Scholar
11 Bebbington, A. C. and Tong, S.-Y. (1984). ‘Trends and changes in old people's homes: provision over twenty years’, in Judge, K. and Sinclair, I., Residential Care for Elderly People: Research Contributions to the Development of Policy and Practice. H.M.S.O., London, 1986, pp. 67–82.Google Scholar
12 Gorbach, P. and Sinclair, I.Pressure on Health and Social Services for the Elderly. National Institute for Social Work, London, 1981.Google Scholar
13 Davies, B. P., Barton, A. J., McMillan, I. S. and Williamson, V. K.Variations in Services for the Aged. Bell, London, 1981.Google Scholar
14 Bebbington, A. C., Davies, B. P. and Tong, S.-Y.Supporters of the Dependent Elderly. Discussion Paper 326, Personal Social Services Research Unit, University of Kent, Canterbury, England.Google Scholar
15 Audit Commission, 1985, op. cit.
16 Darton, R. and Knapp, M. J.The cost of residential care for the elderly. Ageing and Society, 4 (1984), 157–183.CrossRefGoogle Scholar
17 Davies, B. P. and Knapp, M. J.Old People's Homes and the Production of Welfare. Routledge, London, 1981.Google Scholar
18 Bebbington, A. C., Charnley, H., Davies, B. P., Ferlie, E. B., Hughes, M. D. and Twigg, J.The Domiciliary Care Project: Meeting the Needs of the Elderly, Interim Report. Discussion Paper 456, Personal Social Services Research Unit, University of Kent, Canterbury, 1986.Google Scholar
19 Bebbington, A. C., Charnley, H., Davies, B. P., Ferlie, E. B., Hughes, M. D. and Twigg, J.Needs, Resources and Outcomes: a Comparative Study of Community-Based Services for the Elderly. Gower, Aldershot, Surrey, (1987).Google Scholar
20 Latlo, S.The Coventry Home Help Project. Coventry Social Services Department, Coventry, 1984.Google Scholar
21 Golding, K. and Cooper, M.Alternatives to Residential Provision for the Elderly: Final Report. Essex County Council Social Services Department, Chelmsford, 1981.Google Scholar
22 Davies, and Challis, , 1986, op. cit.Google Scholar
23 Larder, D., Day, P. and Klein, R.Institutional Care for the Elderly: the Geographical Distribution of the Public/Private Mix in England. Bath Social Policy Papers no. 10, University of Bath, Bath, Wilts. 1986.Google Scholar
24 Day, P. and Klein, R.Towards a new health care system? British Medical Journal, 291 (1985), 1291–1293.CrossRefGoogle ScholarPubMed
25 Webb, A. L. and Wistow, G.Planning, Need and Scarcity. Allen and Unwin, London, 1986.Google Scholar
26 Audit Commission for Local Authorities in England and Wales, Making a Reality of Community Care. H.M.S.O., London, December 1986.
27 Davies, B. P., ‘Strategic goals and piece-meal innovations’, in Goldberg, E. M. and Hatch, S. (eds.), A New Look at the Personal Social Services. Policy Studies Institute, London, 1981, pp. 46–67.Google Scholar
28 Davies, B. P. and Ferlie, E.Efficiency-promoting innovation in social care: social services departments and the elderly. Policy and Politics, 10 (1982), Table 1.CrossRefGoogle Scholar
29 Ferlie, E., Challis, D. J. and Davies, B. P.Models of innovation in the social care of the elderly. Local Government Studies, 10 (1984), 67–82.CrossRefGoogle Scholar
30 Ferlie, E., Challis, D. J. and Davies, B. P.A Guide to Efficiency-Improving Innovations in the Social Care of the Frail Elderly. Personal Social Services Research Unit, University of Kent, Canterbury, 1984.Google Scholar
31 Capitman, J., Evaluation of Coordinated Community-Orientated Long-Term Demonstration Programs. Berkeley Planning Associates, Berkeley, California, 1985.Google Scholar
32 Davies, B. P. and Challis, D. J., 1986, op. cit., pp. 3–17.Google Scholar
33 Davies, B. P. and Challis, D. J., 1986Google Scholar, ibid., p. 22.
34 Hodgson, J. H. and Quinn, J. L.The impact of the TRIAGE health care delivery system upon client morale, independent living and the cost of care. The Gerontologist, 20, (1980), p. 370.CrossRefGoogle ScholarPubMed
35 Weinrobe, M.Home Equity Conversion for the Elderly in the United States: an Examination of the Initial Experience. Clark University, (1984).Google Scholar
36 Wheeler, R. (1985), Don't Move: We've Got You Covered. Institute of Housing, London.Google Scholar
37 Davies, and Challis, , 1986, op. cit., pp. 537–542.Google Scholar
38 Davies, B. P. (1986a), American lessons for British policy and research on the long-term care of the elderly. Journal of Social Affairs, 2, 321–355.Google Scholar
- 3
- Cited by