Changing local geographies of private residential care for older people 1983-1999 : lessons for social policy in England and Wales

Gavin J. ANDREWS, David Rosser PHILLIPS

Research output: Journal PublicationsJournal Article (refereed)Researchpeer-review

47 Citations (Scopus)

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.
Original languageEnglish
Pages (from-to)63-78
Number of pages16
JournalSocial Science and Medicine
Volume55
Issue number1
DOIs
Publication statusPublished - 1 Jul 2002

Fingerprint

Geography
Wales
Long-Term Care
Public Policy
England
Private Sector
geography
Small Business
market
Age Distribution
National Health Programs
Budgets
Home Care Services
Developed Countries
Longitudinal Studies
Delivery of Health Care
small business
home care
private sector
health service

Bibliographical note

Paper presented at the 9th International Symposium on Medical Geography, Jul 03-07, 2000, Montreal, Canada.

Cite this

@article{624bd47f4cfc44ff8e39f7036d8529dd,
title = "Changing local geographies of private residential care for older people 1983-1999 : lessons for social policy in England and Wales",
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.",
author = "ANDREWS, {Gavin J.} and PHILLIPS, {David Rosser}",
note = "Paper presented at the 9th International Symposium on Medical Geography, Jul 03-07, 2000, Montreal, Canada.",
year = "2002",
month = "7",
day = "1",
doi = "10.1016/S0277-9536(01)00207-6",
language = "English",
volume = "55",
pages = "63--78",
journal = "Social Science and Medicine",
issn = "0277-9536",
publisher = "Elsevier Ltd",
number = "1",

}

Changing local geographies of private residential care for older people 1983-1999 : lessons for social policy in England and Wales. / ANDREWS, Gavin J.; PHILLIPS, David Rosser.

In: Social Science and Medicine, Vol. 55, No. 1, 01.07.2002, p. 63-78.

Research output: Journal PublicationsJournal Article (refereed)Researchpeer-review

TY - JOUR

T1 - Changing local geographies of private residential care for older people 1983-1999 : lessons for social policy in England and Wales

AU - ANDREWS, Gavin J.

AU - PHILLIPS, David Rosser

N1 - Paper presented at the 9th International Symposium on Medical Geography, Jul 03-07, 2000, Montreal, Canada.

PY - 2002/7/1

Y1 - 2002/7/1

N2 - 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.

AB - 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.

UR - http://commons.ln.edu.hk/sw_master/1779

U2 - 10.1016/S0277-9536(01)00207-6

DO - 10.1016/S0277-9536(01)00207-6

M3 - Journal Article (refereed)

VL - 55

SP - 63

EP - 78

JO - Social Science and Medicine

JF - Social Science and Medicine

SN - 0277-9536

IS - 1

ER -