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Equity and Efficiency in Community Care: Supply and Financing in an Age of Fiscal Austerity*

Published online by Cambridge University Press:  14 November 2008

Bleddyn Davies
Bleddyn Davies
Affiliation:
Director, Personal Social Services Research Unit,, University of Kent at Canterbury,, CT2 7NS, England and Professor of Social Policy
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Abstract

From the confrontation of fiscal austerity and growing needs in the United Kingdom has come a new ideology: ‘efficiency-focused mana-gerialism’. Common arguments and the adaptation of structures to reflect them can be seen in all areas of policy, but nowhere more clearly than in the long-term social care of the elderly, the subject of this paper. Perhaps the strand of policy analysis which most influences and epitomises the new managerialism is the work of the Audit Commission for Local Authorities in England and Wales, whose arguments and proposals have gained great and widespread influence. The commission's ‘three Es’ – economy, efficiency and effectiveness – have become among the most fashionable slogans of our time.

Type
Research Article
Information
Ageing & Society , Volume 7 , Issue 2 , June 1987 , pp. 161 - 174
Copyright
Copyright © Cambridge University Press 1987

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References

NOTES

1 Audit Commission, 1975, op. cit.

2 Audit Commission, 1975, op. cit.

3 Davies, B. P.Social Needs and Resources in Local Services. Joseph, London, 1968.Google Scholar

4 Davies, B. P.Planning Resources for Personal Social Services. Department of Social Administration, Edinburgh, 1982.Google Scholar

5 Bebbington, A. C. and Davies, B. P.Equity and efficiency in the allocation of the personal social services. Journal of Social Policy, 12 (1983), pp. 289–308.CrossRefGoogle ScholarPubMed

6 Audit Commission, 1975, op. cit.

7 Davies, B. P. and Challis, D. J.Matching Resources to Needs in Community Care. Gower, Aldershot, 1986.Google Scholar

8 Goldberg, E. M. and Connelly, N.The Effectiveness of Social Care for the Elderly. Heinemann, London, 1982.Google Scholar

9 Bebbington, and Davies, , 1983, op. cit.Google Scholar

10 Bebbington, and Davies, , 1983, op. cit.Google Scholar

11 Bebbington, A. C. and Tong, S.-Y. (1984). ‘Trends and changes in old people's homes: provision over twenty years’, in Judge, K. and Sinclair, I., Residential Care for Elderly People: Research Contributions to the Development of Policy and Practice. H.M.S.O., London, 1986, pp. 67–82.Google Scholar

12 Gorbach, P. and Sinclair, I.Pressure on Health and Social Services for the Elderly. National Institute for Social Work, London, 1981.Google Scholar

13 Davies, B. P., Barton, A. J., McMillan, I. S. and Williamson, V. K.Variations in Services for the Aged. Bell, London, 1981.Google Scholar

14 Bebbington, A. C., Davies, B. P. and Tong, S.-Y.Supporters of the Dependent Elderly. Discussion Paper 326, Personal Social Services Research Unit, University of Kent, Canterbury, England.Google Scholar

15 Audit Commission, 1985, op. cit.

16 Darton, R. and Knapp, M. J.The cost of residential care for the elderly. Ageing and Society, 4 (1984), 157–183.CrossRefGoogle Scholar

17 Davies, B. P. and Knapp, M. J.Old People's Homes and the Production of Welfare. Routledge, London, 1981.Google Scholar

18 Bebbington, A. C., Charnley, H., Davies, B. P., Ferlie, E. B., Hughes, M. D. and Twigg, J.The Domiciliary Care Project: Meeting the Needs of the Elderly, Interim Report. Discussion Paper 456, Personal Social Services Research Unit, University of Kent, Canterbury, 1986.Google Scholar

19 Bebbington, A. C., Charnley, H., Davies, B. P., Ferlie, E. B., Hughes, M. D. and Twigg, J.Needs, Resources and Outcomes: a Comparative Study of Community-Based Services for the Elderly. Gower, Aldershot, Surrey, (1987).Google Scholar

20 Latlo, S.The Coventry Home Help Project. Coventry Social Services Department, Coventry, 1984.Google Scholar

21 Golding, K. and Cooper, M.Alternatives to Residential Provision for the Elderly: Final Report. Essex County Council Social Services Department, Chelmsford, 1981.Google Scholar

22 Davies, and Challis, , 1986, op. cit.Google Scholar

23 Larder, D., Day, P. and Klein, R.Institutional Care for the Elderly: the Geographical Distribution of the Public/Private Mix in England. Bath Social Policy Papers no. 10, University of Bath, Bath, Wilts. 1986.Google Scholar

24 Day, P. and Klein, R.Towards a new health care system? British Medical Journal, 291 (1985), 1291–1293.CrossRefGoogle ScholarPubMed

25 Webb, A. L. and Wistow, G.Planning, Need and Scarcity. Allen and Unwin, London, 1986.Google Scholar

26 Audit Commission for Local Authorities in England and Wales, Making a Reality of Community Care. H.M.S.O., London, December 1986.

27 Davies, B. P., ‘Strategic goals and piece-meal innovations’, in Goldberg, E. M. and Hatch, S. (eds.), A New Look at the Personal Social Services. Policy Studies Institute, London, 1981, pp. 46–67.Google Scholar

28 Davies, B. P. and Ferlie, E.Efficiency-promoting innovation in social care: social services departments and the elderly. Policy and Politics, 10 (1982), Table 1.CrossRefGoogle Scholar

29 Ferlie, E., Challis, D. J. and Davies, B. P.Models of innovation in the social care of the elderly. Local Government Studies, 10 (1984), 67–82.CrossRefGoogle Scholar

30 Ferlie, E., Challis, D. J. and Davies, B. P.A Guide to Efficiency-Improving Innovations in the Social Care of the Frail Elderly. Personal Social Services Research Unit, University of Kent, Canterbury, 1984.Google Scholar

31 Capitman, J., Evaluation of Coordinated Community-Orientated Long-Term Demonstration Programs. Berkeley Planning Associates, Berkeley, California, 1985.Google Scholar

32 Davies, B. P. and Challis, D. J., 1986, op. cit., pp. 3–17.Google Scholar

33 Davies, B. P. and Challis, D. J., 1986Google Scholar, ibid., p. 22.

34 Hodgson, J. H. and Quinn, J. L.The impact of the TRIAGE health care delivery system upon client morale, independent living and the cost of care. The Gerontologist, 20, (1980), p. 370.CrossRefGoogle ScholarPubMed

35 Weinrobe, M.Home Equity Conversion for the Elderly in the United States: an Examination of the Initial Experience. Clark University, (1984).Google Scholar

36 Wheeler, R. (1985), Don't Move: We've Got You Covered. Institute of Housing, London.Google Scholar

37 Davies, and Challis, , 1986, op. cit., pp. 537–542.Google Scholar

38 Davies, B. P. (1986a), American lessons for British policy and research on the long-term care of the elderly. Journal of Social Affairs, 2, 321–355.Google Scholar