Eviewing The Nhs And Community Care Act Social Work Essay

Eviewing The Nhs And union C be Act Social Work EssaySince the establishment of the Welfare State in the 1940s, the National Health Service and Community Care Act is among some of the most important laws in health and social operate in Britain (Adams, 2002). Its policies, based around autonomy, empowerment and choice was support by many writers who saw it as the cure to alleviate the deep and destructive problems encountered by social care (Levick, 1992). This paper will seek to let off the impact that subsequent social policy has had on social work practice and that of the starts of elder people since the inception of the 1990 NHSCCA. The paper will attempt to crush the range of function available to aged people before and after the 1990 Act and examine some of the main policies of the Act.The term community care was scratch coined in the 1960s and was originally used to describe the relocating of people from psychiatric surroundings into less institutionalised ones (Thomas and Pierson 2002). Prior to this, however, community care policy was derived from eighteenth Century Poor Law, which was the only legislation to meet the needs of older people, until the introduction of the National Health Act 1946 and National Assistance Act 1948 (Wilson, Ruch, Lymbery and Cooper, 2008). However, disdain 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 cooking for older people in the immediate post- struggle period other than residential care, which Townsend claimed clearly varied in quality. Furthermore, Beech and Ray (2009) argue that past policies name not considered the diverse needs of growing old and the number of physical, emotional and psychological changes that are faced by older people.Subsequent post war governments became increasingly sympathetic in the shifting of care services from residential settings to community based, which became a priority of the (1979-97) Conservative government (Adams, 2002). By the mid 1980s, many political commentators and professionals were calling for policies which involved the replacement of inappropriate residential care, which was still as Townsend had commented in the 1960s as variable in quality, and the introduction of full(prenominal) quality community care (Adams, 2002). Adams adds that it was hoped that community care would tackle the segregation, isolation and the stigmatisation felt by older people who may prolong been institutionalised for long periods of time. However, Adams (2002) points out, once the Conservative government had brought about the privatisation of public services, which included a programme of social security financing that in effect, encouraged older people to enter residential care and simultaneously leave community care services under-developed due to a lack of public investment.The Audit focal point (1986) heavily criticized c ommunity care and the government appointed Sir Roy Griffiths to report on the future of community based services. This led to the Government White Paper feel for for People (Department of Health, 1989a) which ultimately transformed local authority social services departments from providers to purchasers of services to create a market economy. This had an effect on front tenor 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 malady 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 proctor services carried out by outside agencies (Department of Health, 1989 23). Furthermore, social workers were more often removed from direct work with service users and there was a sharper rivet 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 stimulate partners in services and to include voluntary agencies and housing departments, which heralded developing policy philosophy after 1990 (Braye and Carr, 2008). Furthermore, there was a belief that service users should have more control of the services available to them and being 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 development for older people, explained by Wilson et al. (2008), was the National Service Framework for Older People which placed an emphasis on independency and autonomy. To increase the levels of independence, intermediate care which was initially outlined in the NHS Plan (DoH, 2 000) 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, passably Access to Care Services (DH, 2002), which is a framework to ensure equality of access to people in need of social work intervention (Beech and Ray, 2009). imputable to financial constraints, the needs of older people are only being 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 current policy, scorn emphasising promoting independence, through the eligibility criteria, doubt surrounding the privatisation of services and the rules of assessment.This paper has charted some significant policies and services available to older people before and after the NHSCCA (1990) and has found t hat despite privatisation and the rhetoric of independence and promotion of choice, some key implications have materialised for older people. However, despite the Act, the paper suggests there are tensions between 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 rather than social workers due to there being less direct work with service users and more work creating care packages.