Changing local geographies of private residential care for older people 1983-1999 : lessons for social policy in England and Wales
Document Type
Journal article
Source Publication
Social Science and Medicine
Publication Date
7-1-2002
Volume
55
Issue
1
First Page
63
Last Page
78
Publisher
Pergamon Press
Keywords
Homes, Markets, Older people, Private sector, Residential care, UK
Abstract
The population structures of many developed countries are changing and shifts towards much older age distributions are common. One way of meeting the resulting increasing demand for long-term care is through small business private sector provision allocated through market systems. However, the private residential care sector in England and Wales demonstrates some of the potential problems of leaving long-term care to the market. During the 1980s, the private residential sector for older persons enjoyed substantial state financed support. Since the 1990 National Health Service and Care in the Community Act introduced markets in social care in 1993, homes have had to compete amongst each other for a much smaller number of clients funded by limited local authority budgets. This impacted on their business and caring operations. Based on a three-stage quasi-longitudinal survey of over 100 residential care homes in one county, this paper considers changes in the overall size and structure of a local sector, discusses the specific management strategies that have been adopted by proprietors and the development of a purchasing and providing market culture. The paper also highlights the importance of interdisciplinary perspectives on the topic by illustrating how changes in social policy can influence local and national geographies of long-term care provision and how, in turn, an understanding of these geographies can inform the sensitive implementation of future social policy initiatives.
DOI
10.1016/S0277-9536(01)00207-6
Print ISSN
02779536
E-ISSN
18735347
Publisher Statement
Copyright © 2002 Elsevier Science Ltd
Access to external full text or publisher's version may require subscription.
Additional Information
Paper presented at the 9th International Symposium on Medical Geography, Jul 03-07, 2000, Montreal, Canada.
Full-text Version
Publisher’s Version
Language
English
Recommended Citation
Andrews, G. J., & Phillips, D. R. (2002). Changing local geographies of private residential care for older people 1983–1999: Lessons for social policy in England and Wales. Social Science and Medicine, 55(1), 63-78. doi: 10.1016/S0277-9536(01)00207-6