Adult Social Care Policy and Practices in the UK - Article Example

Adult Social Care Policy and Practices in the United Kingdom During the Victorian era, the British blamed idleness as cause of poverty and unemployment. For this reason, together with the existence of a wide variety of charitable institutions, establishing a comprehensive system of welfare support was not a priority. Not until the rise of the Labour movement challenging the state’s notion of involvement in social policy did government introduce measures to address the welfare of the sick, impoverished and the unemployed. But these measures, such as the Old Age Pensions Act of 1908 and the National Insurance Act of 1911, was not wide in scope and favoured only “deserving” sick, referring to those who were previously employed and unemployed. Between the years 1914 and 1945, the principle of state intervention was established more firmly. “Social Insurance and Allied Services” was published by the wartime coalition government in December 1942 (National Archives, n.d.), outlining the plan for social service in post-war Great Britain. The plan, according to Skehill (2010), also “influenced the development of professional social work services within the broader welfare services that developed from 1948 onward. In particular it reformed the Poor Law system and introduced what is called the modern welfare system” (p. 14). Aiming to provide a comprehensive social insurance system “from cradle to grave,’ it proposed that all working people pay a weekly contribution to the state which in return will pay the sick, widowed, unemployed and retired people (National Archives, n.d.). The National Insurance Act and the National Health Service Act, was created in 1946 and 1948, respectively. The former created a comprehensive system of benefits covering sickness, maternity and pension paid for by the employees, employers, and government while the latter provided free diagnosis and treatment. All these reforms established the domestic political consensus that the state is responsible for the welfare of citizens which lasted for nearly thirty years (National Archives, n.d. para 8). Social care, for many, is most associated with the Poor Law (Glasby, 2012 p. 17.). A system where vagrancy was not encouraged and beggars were given money to stay in their own homes. The aged and sick were taken care of in almshouses, poor houses, hospitals or in their own homes, while orphans, in orphanages. This policy however, according to Townsend (1979) “was based on the welfare of the few, with poverty reduced to insignificant proportions (p. 62). The National Assistance Act of 1948 which repealed the old Poor Law resulted to social security providing cash assistance, while social services operate locally (Glasby, 2012). The 1990 National Health Service and Community Care Act’s main community care measures came into force in 1993, assigning local authority social services departments to lead in supporting disabled and elderly people. Tasked to collaborate with other agencies such as health and housing, their responsibility also included assessment of the needs of the individual and of the whole locality as well. They were also tasked to develop a system where there is mixed economy of voluntary and for-profit services, domiciliary services in particular that the local authority will be able purchase flexibly (Bauld, et. al., 2006). In trying to respond to its frustrations with regards to issues such as the length of stay of people with mental health problems in hospitals, increasing public expenditures for residential and nursing homes and the reform itself being criticized as unresponsive to individual needs of service users, “the government [was] to find the least bad option for capping social security payments to private residential care, hence the changes owed more to political expediency than to a vision of caring for people” (Bauld, et. al., 2006 p. 16.) A significant action which brought the issue of social care into the limelight, and thus, contributed largely to policy development was the disability movement. Society’s deep-seated view about disability: the inability of the disabled to function socially and the need for life-long care and professional expertise can be traced back to eighteenth century, until the enlightenment and industrial revolution of the nineteenth century, when disabled people were scrutinized, categorized and segregated by doctors and other professionals. Confinement in residential homes was accepted as a perfectly rightful way of caring for the disabled for a long time (Finkelstein, 1991). This “eugenic legacy” continued until the first half of the twentieth century (Colin, 2004). The disabled however, saw it as a struggle to attain basic citizenship rights: the right to control their personal lifestyle and the right to have a say in the running of the community in which they belong to (Finkelstein, 1991). The global development of the movement during the post-war era resulted to a close collaboration between the academic study of disability and those in disability movement. Two approaches to disability have been popularly advanced, one of which was the social model of disability. It discussed disability in terms of society’s response towards it (Lang, n.d.). The movement has had the desired effect: government committing itself to achieving independent living for disabled people and setting out new proposals for delivering this aim (Morris, 2005). One was ‘Improving the Life Chances of Disabled People’. Published by the Prime Minister’ Strategy Unit (PMSU) in 2005, it sets a radical new policy agenda focusing in improving the quality of life of the disabled with its vision of providing full opportunities and choices, respect and acceptance as equal members of society by the year 2025 (Adams, 2005). The Direct Payment campaign, started in 1989 by the British Council of Disabled People’s Independent Living committee (Evans and Hasler, 1996), was implemented in 1997. The Direct Payments Act provides a person or individual, after being assessed as requiring community care service, cash from local authorities, and health and social service trusts to be able to purchase services on their own behalf (Pearson, 2004). According to the Department of Health, Social Services and Public Safety (n.d.), the campaign promoted increasing choice and independence among beneficiaries. It helps them decide when and how care services will be provided and who will be involved in the care services and in personal aspects of their everyday life, such as helping around the house, outside activities such as shopping and other social activities. With regards to promoting an increased choice and independence, the Department of Health (2010), said that there is a “shared goal across government’ in putting the physically and mentally challenged to go through public service reforms first.  This is what the ministerial concordat entitled Putting people first: a shared vision and commitment to the transformation of adult social care is all about. The “holistic approach” aims to enable people to live their own lives according to their choices; to be confident and assured of high quality services, are safe and to promote their own individual needs for independence, good welfare, and dignity. Personalisation, combined with intervention and prevention, will result to people having the choice and ability to control over their support arrangements, provided either by statutory services or by themselves (Department of Health, 2010). The need to integrate policies of social and health care services, particularly care trusts and intermediate care, was realized by the year 2005, and was supported by health and local authorities, hospitals, and primary care groups enabling the elderly to lead more independent lives (Leathard and McLaren, 2007). In the past, the government’s role for elderly’s care was inconsistent and selective in terms of needs, social and geographical inequitability (Baldock, 2003). Over the years, various steps have been taken by the government in order to improve the plight of the disabled. Social care has made a huge improvement. Laws have been passed and implemented favouring the welfare of the disabled, clearly identifying specific steps and action towards the improvement of their plight. Although historical influences can still be seen in the way social care is practiced today, this remains only in situations where an individual cannot be left to fend for himself and is in need of institutional care. In such cases, they are cared for in institutions, but only until they are able to fend for themselves. The government’s aim of empowering the disabled, the elderly and the physically and mentally challenged, is a sign that society’s view and attitude towards the disabled has changed. Acceptance has resulted to the government’s ultimate goal of making them independent, functional and contributing members of society. The difference between social care today and social care in the past is the increased respect for the disabled in terms of challenging discrimination, promotion of equality and their human rights as the Performance Assessment of NHS trusts in the book the State of health care and adult social care in England showed. The Care Quality Commission (2010) stated that “Ninety-one per cent of trusts met the standard in 2008/2009, an improvement from the previous year’s score of 83%” in terms of challenging discrimination, promotion of equality and respect for human rights (p. 40). With all the laws, acts, and applications of new concepts that has been mentioned above, including their successes and setbacks, adult social care policy and practice today has taken a big leap towards a more participatory approach which is quite, if not totally effective. This means easier, clearer and defined roles for health authorities, primary care groups, hospitals, local authorities and other social work practitioners. Bibliography Adams, S. 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