Social policy

This Viewpoint, written by Caroline Glendinning at the University of York and David Bell at the University of Stirling, draws on the experiences of other countries to argue that social care is a collective, welfare state responsibility rather than an individual, private responsibility.

Other key points include: 

• social care arrangements in many other countries are equal and universal: everyone is eligible regardless of wealth, and people with similar levels of disability receive care no matter where they live;

The first part of the paper argues that the care relationship is crucial to securing care quality, which has implications for the way in which quality is achieved and measured. However, for more than twenty years, governments have emphasised the part that increasing market competition and, more recently, user choice of services can play in driving up the quality of care. The second part of the paper analyses the development of social care services for older people, from the reform of 1990 to the changes following the general election of 2010.

Employment and social policies continue to be based upon a gender template that assumes women, especially mothers, are or should be natural carers. Invariably, policies that seek to promote women's entry to paid work do so by facilitating their management and conduct of caring work, thus reinforcing the gender template. In addition, contemporary debates around concepts of citizenship emphasise the obligation to paid employment but fail to tackle the gendered division of caring activities and organisation of care.

This article examines the government's strategy for carers and considers its significance for people in informal caring relationships. It argues that although it contains important and innovative measures, the strategy does not address adequately the complex nature of caring relationships nor does it take account of the perspectives of people who receive care. There is a danger, therefore, that the strategy will be divisive. However, the recognition that caring is a widespread activity is welcomed.

This chapter explores working partnerships with carers of older people and particularly carers in full or part-time employment who may have many stresses and conflicting demands in their lives. The legal and social context of caring is traced from The NHS and Community Care Act (DH, 1990) and subsequent care in the community initiatives. Another milestone was The National Strategy for Carers (DH, 1999a), though there has only recently been a government commitment to partnership with carers against very patchy previous provision.

Mainstream literature on paid care for children, frail elderly people and people with chronic illness or disability, and unpaid care provided usually by family members within households and kin networks tends to establish dichotomies: formal/informal, commodified/non-commodified. Recent feminist literature rejects these dichotomies, developing models of social care in which the interconnections of paid and unpaid care are mapped within policy frameworks.

When faced with changes in physical health, cognition, and daily functioning, older adults most frequently rely on family members for instrumental support and more intense care activities. Using a life span perspective as our guiding framework, we identified several developmental themes across the late-life caregiving research including individual well-being, relational effects, and caregiver growth.

Discusses the concept of social exclusion in relation to carers and asks why it has taken so long to link carers with the social exclusion agenda.

Examines whether carers could be successfully brought to the scope of tax credit schemes. The article explains how tax credits work, and looks at the advantages and disadvantages of providing tax credits for carers.

This chapter opens with the movement to long-term care benefits in Germany in 1994 with a two-tiered system of employment-related, contribution-based long-term care insurance (LTCI) and a last resort of tax-funded social assistance. The goals were to reduce the financial burden on the states and municipalities, lessen poverty for care clients, increase long-term care services, expand home- and community-based services and support informal caring, and to prevent or delay institutionalisation.