Eviewing The Nhs And Community Care Act Social Work Essay

Eviewing The Nhs And Community Care movement Social shit EssaySince the establishment of the Welfare State in the 1940s, the National wellness Service and Community Care Act is among whatsoever of the most eventful laws in health and brotherly service in Britain (Adams, 2002). Its policies, based near autonomy, empowerment and choice was supported by many writers who saw it as the cure to alleviate the deep and destructive problems encountered by societal share (Levick, 1992). This paper will seek to explain the impact that subsequent affectionate policy has had on complaisant spend a penny practice and that of the experiences of elder quite a little since the inception of the 1990 NHSCCA. The paper will attempt to analyse the range of function available to older concourse before and aft(prenominal) the 1990 Act and envision some of the main policies of the Act.The term community disquiet was first coined in the 1960s and was originally used to describe the relocati ng of people from psychiatric environment into less institutionalized ones (Thomas and Pierson 2002). Prior to this, however, community lot policy was derived from eighteenth Century Poor Law, which was the only legislation to meet the demand of older people, until the introduction of the National Health Act 1946 and National Assistance Act 1948 (Wilson, Ruch, Lymbery and Cooper, 2008). However, despite the new Acts, which helped to create a different world for social care (Wilson et al. 2008 623), Townsend (1962, cited in Wilson et al 2008) reported that there was little social care provision for older people in the immediate post-war compass point other than residential care, which Townsend claimed clearly varied in lumber. Furthermore, Beech and spear (2009) argue that past policies have not considered the diverse commands of exploitation old and the number of physical, emotional and psychological changes that are faced by older people.Subsequent post war governments be came increasingly sympathetic in the shifting of care services from residential settings to community based, which became a precession of the (1979-97) Conservative government (Adams, 2002). By the mid 1980s, many political commentators and professionals were life history for policies which tough the replacement of inappropriate residential care, which was still as Townsend had commented in the 1960s as variable in quality, and the introduction of high quality community care (Adams, 2002). Adams adds that it was hoped that community care would tackle the segregation, isolation and the branding felt by older people who may have been institutionalised for long periods of time. However, Adams (2002) points out, once the Conservative government had brought about the privatisation of worldly concern services, which include a programme of social security financing that in effect, back up older people to enter residential care and simultaneously render community care services under- developed due to a lack of customary investment.The Audit Commission (1986) heavily criticized community care and the government appoint Sir Roy Griffiths to report on the future of community based services. This led to the regime White Paper Caring for lot (Department of Health, 1989a) which ultimately trans kneaded topical anesthetic authority social services departments from providers to purchasers of services to create a mart economy. This had an effect on front line social workers as they were involved more in the care management of older people, like assessing needs and devising care packages (Adams, 2002). Holloway (2008 315) supports this and claims that a common complaint among practitioners is were not social workers anymore, were just care managers. This led to a contract culture with the marketisation of the public sector where social service departments would need to commission and monitor services carried out by outside agencies (Department of Health, 1989 23). F urthermore, social workers were more often distant from direct work with service users and there was a sharper concenter and greater accountability, coupled with constraints on resources and gatekeeping for those who are in the greatest need (Levin and Webb, 1997).The NHSCCA (1990) increased the recognition of the need for community care and health care to become partners in services and to include voluntary agencies and housing departments, which annunciate developing policy philosophy after 1990 (Braye and Carr, 2008). Furthermore, there was a article of belief that service users should have more control of the services available to them and cosmos able to purchase the services they want, as opposed to not taking part in decisions regarding services provided for them (Braye and Carr, 2008).Another significant policy tuition for older people, explained by Wilson et al. (2008), was the National Service Framework for Older People which placed an emphasis on independence and au tonomy. To increase the levels of independence, intermediate care which was initially outlined in the NHS Plan (DoH, 2000) was brought about in a bid to reduce the number of days older people spent in hospital and as Lymbery (2005) points out, was often an unwanted and expensive form of treatment.Policy dilemmas are evident in the national eligibility criteria, Fair portal to Care Services (DH, 2002), which is a framework to ensure equality of gateway to people in need of social work intervention (Beech and Ray, 2009). callable to financial constraints, the needs of older people are only be met if they fall into the critical or substantial (CSCI, 2008). Furthermore, as Lymbery (2005) points out, older people experience negative effects with regards to access to services and options due to underway policy, despite emphasising promoting independence, through the eligibility criteria, doubt surrounding the privatisation of services and the rules of assessment.This paper has chart ed some significant policies and services available to older people before and after the NHSCCA (1990) and has found that despite privatisation and the rhetoric of independence and promotion of choice, some paint implications have materialised for older people. However, despite the Act, the paper suggests there are tensions among limited resources and unlimited needs with the role of social work changing from provider to enabler. This has had some practitioners comment that they are now care managers kinda than social workers due to there being less direct work with service users and more work creating care packages.