Any service operates within various contexts that together help define and delineate its underlying philosophy and its boundaries. A service will be affected by a wide range of factors, embracing historical, economic, social, geographical, political, ideological, cultural and professional considerations. Such factors may operate at local, national and (increasingly) international levels. The interrelationships between different factors may be complex and are likely to alter over time. Changes in this policy environment will almost certainly impact on service providers, service users and the interaction of front-line staff with their clientele. To understand services fully, we would need to delve into the history of the NHS, speech and language therapy and aphasia services in the UK. Our aim in this chapter is more limited, namely to place aphasia services in their current context in the mid 1990s. We begin the chapter by summarizing recent changes in the organization and management of health care in Britain and identifying some of the implications for speech and language therapy and aphasia services.
KeywordsIncome Expense Toll Aphasia
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