Abstract
This chapter focuses on the 1990 NHS and Community Care Act. The Act had its genesis in increasing concerns about the funding of care for older people within an increasing market of private care homes. The Act led to a purchaser-provider divide within adult social services, the introduction of care management within social work, and a separation of adults and children’s services within the personal social services. This chapter also notes the move away from confinement of disabled people in large institutions and the impact of the disability movement and the move towards independent living and direct payments.
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Notes
- 1.
The radical nature of the Griffiths’ proposals generated a flurry of activity. When the subsequent White Paper was published in 1998 on how the government intended to respond to and implement the proposals, I was deputy director of social services in Berkshire. Following the 1990 legislation providing the statutory framework for the implementation of the proposals I was, in 1992, director of social services in Wiltshire when the first ‘Community Care Plan’ for the county was being prepared and published. Much of the attention and action during 1988 to 1992 was focused on the implications and implementation of what Griffiths had proposed in 1987. Indeed, in 1990, my role and title within Berkshire County Council’s social services department changed from deputy director of social services and director of operations to ‘senior assistant director (purchasing)’ within an organisation which introduced a purchaser-provider organisational separation within its social services. Ted Unsworth, who had a similar role change in another county, described himself as ‘head of shopping’!
- 2.
It was the regressive community charge, a flat rate local tax levied on all adults (hence the term ‘poll tax’) which impinged on poorer people while the rich paid less than before. The public dissent and demonstrations it generated were to lead to the downfall of Margaret Thatcher in 1990 and her replacement by her chancellor of the exchequer, John Major, as prime minister.
- 3.
In 1985 a committee was commissioned by Norman Fowler, then secretary of state for health and social services, chaired by Gillian Wagner and administered by the National Institute for Social Work, to ‘review the role of residential care … and what changes, if any, are required to enable the residential care sector to respond effectively to changing social needs’. Their report (National Institute for Social Work (1988) Residential Care: A Positive Choice, London, HMSO) noted that although the national policy thrust was towards giving younger and older disabled people assistance to live at home residential care could and should still be an available positive option and choice.
- 4.
It may be surprising that in 1983 it was still necessary to make the point that ‘a person may not be dealt with under the [Mental Health] Act as suffering from a mental disorder purely by reason of promiscuity, other immoral conduct, sexual deviance or dependence on alcohol or drugs’. When the large mental handicap hospital on the Berkshire/Oxfordshire border north of Reading was closed in the early 1990s I was then the deputy director of social services for Berkshire. I was passed the large leather-bound legers which recorded the admissions of patients to the hospital and for them to be held by the county council records office. <?IndexRangeStart ID="ITerm88"?>They recorded that in the 1960s there were still young women aged 14–18 years of age admitted and detained at the hospital with the diagnosis of ‘moral defective’, that is they had what was termed as an ‘illegitimate child’ as they were not married. They became long-stay patients and 25 years later when the hospital was closed they had become totally institutionalised and as a consequence had come to have a significant mental impairment<?IndexRangeEnd ID="ITerm88"?> .
- 5.
In the 1990s and into the 2000s, I had frequent direct contacts with members of the disability movement. Locally, in Wiltshire, as director of social services I had professional contact, and increasing personal friendships, with disabled people who had combined together to form the Wiltshire Users Network, led by Clare Evans, a disabled person who was also a qualified social worker (https://www.theguardian.com/society/2018/dec/03/clare-evans-obituary) . Nationally, for the Association of Director of Social Services I had convened and chaired the ADSS Disabilities Network of social services senior disability services managers and policy officers. Through this role I met, and led on practice and policy negotiations, with NCIL and with DAN (the Disabilities Action Network). It was DAN who organised a demonstration of disabled people at an annual ADSS conference attracting much media coverage. I was also in the early 2000s the chief executive of the Social Care Institute for Excellence—Jane Campbell was the chair, and both Mike Oliver and John Evans were to be SCIE board members.
- 6.
The Disabled Parents Network, with leadership from Michele Wates, was active in emphasising that assisting disabled parents to undertake their parenting role was primarily a task for adult services not children’s services [Morris, J. and Wates, M. (2006) SCIE Knowledge review 11: Supporting disabled parents and parents with additional support needs, London, Social Care Institute for Excellence].
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Jones, R. (2020). A Drama in Two Parts: Part II—The 1990 NHS and Community Care Act and Adult Social Services and Social Work. In: A History of the Personal Social Services in England. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-46123-2_10
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DOI: https://doi.org/10.1007/978-3-030-46123-2_10
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