Managing private residential care : the impacts of care in the community reforms in the UK and some issues for private homes policy in Hong Kong

David Rosser PHILLIPS, Gavin J ANDREWS

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


In many countries, the private sector has become a major provider of residential care for elderly people. Lessons can be drawn and experiences shared even when systems are operating on rather different, bases. This paper outlines the current situation in the United Kingdom and suggests indications for the private care sector in Hong Kong. In the UK, the 1980s witnessed a considerable expansion in the private residential sector for elderly people underpinned by guaranteed slate support for residents. Many homes opened, especially in south coastal regions. Residential homes were considered Lo be both profitable and low risk business ventures. The 1990s presents a very different situation. Care in the community legislation implemented in 1993, purports to keep people in their own homes ("in the community"') for as long as possible. This has meant the withdrawal of guaranteed state support for residents and a finite amount of public finance available for residential care. Therefore, today potentially fewer clients will be able to afford places in old people's homes. Homes are now supposed to operate within a market in health care, effectively to compete amongst each other for clients. This paper investigates the financial realities facing the private residential sector in Devon, a county in England with large numbers of care homes. It identifies trends and rises in vacancies in homes and the potential effects on the profitability of businesses. The new business climate has been in part: a source of increase levels of stress for proprietors and has changed their experiences of ownership and their future outlooks. A very different business culture is now apparent. The marketplace has been viewed by the government as an environment in which the best services can be purchased most competitively. It also held that private enterprise can thrive and deliver quality care for elderly people. However, this paper identifies inconsistencies with the vision of commercial success. Some homes are undoubtedly doing well but high proportion are facing stress, reduced profitability and are more vulnerable lo downturns in the economy. The research does not directly address quality of care but there could be impacts on home life and security. The study is interesting for the development of the private sector in Hong Kong and other Asia-Pacific countries and illustrates the effects of variations in terms of public support levels and suggests the private sector may be fragile. Price sensitivity, numbers of clients and the like can very much affect the viability of homes and can place considerable pressure on those owning and running residential care businesses.
Original languageEnglish
Pages (from-to)21-28
Number of pages8
JournalHong Kong Journal of Gerontology = 香港老年學報
Issue number2
Publication statusPublished - Dec 1996
Externally publishedYes

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