Law for Social Work Practice

The Current Crisis of Care

  • Underfunding: A £160 million cut in public spending on older people's social care in the last 5 years occurred despite a rapidly increasing demand due to the ageing population.
  • Postcode Lottery: Despite the 2014 Care Act aiming for a national system of eligibility, local variation still leaves many older people without support.
  • Unmet Need: 1.2 million people aged 65 and over do not receive the necessary care support for essential living activities.
  • Declining Access: Cuts in local authority care services have increased pressure on unpaid carers.

Social Care – A Brief History

  • National Assistance Act 1948
    • Established the Welfare State.
    • Separated local responsibilities for welfare from national responsibilities for social security.

The Creation of a Fault Line

  • National Health Service
    • Free at the point of delivery.
  • Social Care
    • Means tested.

A Patchwork of Social Care Legislation

  • National Assistance Act 1948
  • Health Services & Public Health Act 1968
  • Chronically Sick and Disabled Persons Act 1970 (but only for adults)
  • Health & Social Services & Social Security Adjudications Act 1983
  • Disabled Persons (Services, Consultation and Representation) Act 1986
  • NHS & Community Care Act 1990
  • Carers Acts (several)
  • Health & Social Care Act 2001 (the Act that concerns Direct Payments)

Social Care in the 1990s

  • Perceived as inadequate, unfair, and unsustainable.

Shift in Public Policy

  • A shift from paternalism to personalisation occurred.

What is Personalisation?

  • A move from a traditional service-led approach to a needs-led approach.
  • Individual choice and control are at the center.
  • Services should fit the person, rather than fitting people to services.

Elements of Personalisation

  • Independent living
  • Participation
  • Control
  • Choice
  • Empowerment
  • Social model of disability
  • Self-directed support
  • Person-centered planning
  • Personal budgets

Tensions in the Policy of Personalisation

  • Personalisation is a contested policy area.

Five Reasons Why Personalisation is so Contested

  1. Different Historical Reference Points
    • Dismantling paternalism or dismantling universalism?
  2. Different Vantage Points
    • Individually empowering, but who is excluded?
  3. Different Views of the Workforce
    • Who is empowered?
  4. Different Interpretation of the Evidence
    • Choice and control – or higher funding – what makes the difference?
  5. Engagement with the Broader Political Context
    • Neoliberalism and ‘responsibilisation’ vs universal citizenship and human rights.

Funding Issues

  • Funding remains a significant issue in social care.

Tony Blair's Speech (1997)

  • As Prime Minister, Tony Blair stated he didn't want children growing up in a country where pensioners have to sell their homes to afford long-term care.

Sutherland Commission Report (1997)

  • Argued for free personal care funded by general taxation and a more generous means test.