Home care in England: markets in the context of under-funding

TY - JOUR

T1 - Home care in England

T2 - markets in the context of under-funding

AU - Glendinning, Caroline

PY - 2012/5

Y1 - 2012/5

N2 - This paper traces developments in English home care services over two decades from the early 1990s. This longer-term perspective is used to show how factors shaping the broader restructuring of the English welfare state have impacted on home care services in particular. The two most salient features of these policies have been public sector funding constraints and extensive marketisation. Despite demographic trends, home care services have been deeply affected by the structural underfunding of long-term care services in general. The sector has been further shaped by the creation first of a 'mixed economy' of supply, with local authorities purchasing services from external providers instead of their own in-house services, and by the more recent introduction of a 'mixed economy' of purchasing, as greater emphasis is placed on individual choice and personalisation. The outcomes of these dual pressures are an increasingly residual publicly funded home care service and a growing role for private funding and supply. These outcomes have potentially damaging consequences for the quality of both public and private home care.

AB - This paper traces developments in English home care services over two decades from the early 1990s. This longer-term perspective is used to show how factors shaping the broader restructuring of the English welfare state have impacted on home care services in particular. The two most salient features of these policies have been public sector funding constraints and extensive marketisation. Despite demographic trends, home care services have been deeply affected by the structural underfunding of long-term care services in general. The sector has been further shaped by the creation first of a 'mixed economy' of supply, with local authorities purchasing services from external providers instead of their own in-house services, and by the more recent introduction of a 'mixed economy' of purchasing, as greater emphasis is placed on individual choice and personalisation. The outcomes of these dual pressures are an increasingly residual publicly funded home care service and a growing role for private funding and supply. These outcomes have potentially damaging consequences for the quality of both public and private home care.

KW - home care services

KW - social care services

KW - residential care

KW - public sector funding

KW - long-term care services

KW - personalisation

KW - choice

UR - http://www.scopus.com/inward/record.url?scp=84859957307&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2524.2012.01059.x

DO - 10.1111/j.1365-2524.2012.01059.x

M3 - Article

SN - 0966-0410

VL - 20

SP - 292

EP - 299

JO - Health and Social Care in the Community

JF - Health and Social Care in the Community

IS - 3

ER -