Social Policy and Comparative Studies - Essay Example

A) Chosen UK Policies i) Health and Health Inequalities The Regulation of Care (Scotland) Act 2001 was developed to provide a system of regulation of care services across the nation of Scotland. The Act is anticipated to extend care provision and welfare protection to people within the community who are in greatest need of care services, for example, the elderly. The Act complies with National Care Standards, and is monitored and evaluated by Ministers. Evaluations make comparisons of practices with National Care Standards. The standards indicate the high quality of service that is expected from social workers and other helping professionals to consistently meet the care needs and expectations of clients. The standards include the concepts of; dignity; privacy; choice; safety; realizing potential; and equality and diversity (Scottish Parliament, 2001). According to The Regulation of Care (Scotland) Act 2001, the Scottish Ministers ensure that the provision of services meets a high standard of quality service by regularly reviewing the national care standards that apply to care services, and this includes the delivery of services to the elderly (5 & 59). To enable the optimum provision of services, the standards and services are continuously evaluated with the inclusive consultation of those who are the end users of the services. Many elderly in the UK have ongoing health care costs, the need for social support, the need for education and up-to-date information pertinent to their social welfare and health needs, as well as idiosyncratic personal needs and expectations, such as assistance and support with their son going to court (ENABLE, 2006). In this respect, there is a critical need for a review of social and health provisions to the elderly who are living at home (Hill, 2006). ii) Housing and Homelessness Progressive legislation aims to improve the rights of homeless people such as the Homeless ect. (Scotland) Bill 2002 seeks to prevent and alleviate homelessness and to enhance the dignity and well being of homeless persons. Across Scotland, local authorities and associated social service staffs in formal and voluntary organisations work in collaboration with a multi-disciplinary approach to provide holistic homelessness services to those in need. In doing so, these individuals and organizations contribute to the continuous improvement of policies and protocols, as they are the front-line workers who are able to identify needs and gaps in existing systems. The Homeless ect. (Scotland) Bill 2002 (Scottish Executive, 2002) has several key and pertinent objectives; To promote social justice in Scotland and to decrease the opportunity gap (s2). To enable access to appropriate housing to ensure the social justice agenda (s2) To make a difference to the homeless situation so as to promote healthier lives or individuals (s2). To provide a solid basis from which the homeless could access employment, education and training (s2). To inform future developments of homelessness policy in Scotland (s3). To support the Homelessness Task Force established in 1999 (s3). Priority issues for this policy were identified by way of revision of the Task Forces 2001 report. It was established that once an applicant had been assessed as homeless a distinction be made as to those that are in priority and need and those who are not. A priority need category status was afforded to applicants who are were risk of domestic violence, had experienced or suffered harassment, or were at risk of violence by virtue of their ethnicity, colour, sexual orientation or national origins (s1 & 52). Applicants who experienced a physical disability that placed them in a vulnerable position were also afforded priority need category status by way of the Housing (Scotland) Act 1987 (s1 & 52) from previous policy formation. B) Relevant Policies i) The Community Care and Health (Scotland) Act 2002 In conjunction with the Regulation Act, the Community Care and Health (Scotland) Act 2002 seeks to promote equity, choice and dignity among clients like the Smiths, by shifting the focus from institutional care and promoting a collaborative approach by health and care services (Scottish Executive, 2002). However, there have been concerns voiced by critics that some of the objectives of these Acts are undermined in terms of discriminatory practices, especially toward elderly citizens. It appears that age discrimination is widespread across health and care services, present in day-to-day language where it is considered 'benign' and evident in beliefs, values and attitudes that perceive the older person as characteristically different from the rest of society. This view is reflected in the chronic under funding of social care for older people. Several service care options are available; housing support services (which provide assistance, advice, and counseling) to support the elderly to live within their home; home care services; an independent health care service; a nurse agency; respite care; and personal care services (2). Local authorities are responsible for the provision of these social work services. For example, nursing agency would include any local services that supply registered nurses, or other health visitors. Local authorities organize the personal care services are in regard to assistance with daily physical tasks and the needs of a person who is cared for. The Scottish Social Services Council's codes of practice are also taken into consideration. The code states the responsibilities of employers when regulating the activities of social service workers (Scottish Social Services Council, 2005). As a code of practice, a list of expectations of social service workers details standards for professional conduct and practice. The code ensures a standardisation of care services across the Scottish community. Hence, an employer must ensure that a competent social worker is part of the services workforce, and this means they must understand the responsibilities of their role. Policies, procedures and protocols must exist in hard document form to enable social workers to meet the code of practice standards. Training and ongoing professional development opportunities must be made available to social worker staffs. Policies must address issues of discrimination and dangerous or exploitive behavior. And finally the code must be promoted among social workers as well as the wider community. ii) The Task Force for Homelessness; and the Homeless Monitoring Group The Task Force revision identified that those who had priority needs and who were unintentionally homeless are eligible for permanent accommodation, and those who are not seen as having priority need have less entitlement to temporary accommodation. The report also suggested that by 2012 the priority category be extended to be inclusive of all homeless people (s 9). This would allow policy to be developed that would service all homeless people with offers of permanent accommodation. However, for those intentionally homeless, the right to permanent accommodation might be suspended. This extension of services would be phased in to enable local authorities and other providers to provide an adequate housing supply and to put in place support services (s 10). As such, policy development can be considered a gradual process, that builds on existing knowledge and practices that have results, modifying areas identified as needing change. The Homeless Monitoring Group, other homelessness strategies and local housing strategies informed the development of The Homeless etc. (Scotland) Bill 2002 to ensure that additional accommodation needs would be met (s 10). In this way the Bill would be able to widen categories of those individuals who could be assessed as being in priority need. Local authorities could still draw on the Code of Guidance of Homelessness, in which they "have regard" when evaluating persons as to which category they are most suited to (Scottish Executive, 2005). As well, local authorities would need to be highly aware of the vulnerability of those placed in the priority need category. By including all groups into the Bill existing practices and protocols become codified and allowed for better confirmation that those who were most in need would be provided with legislative protection (s 11). The Bill clearly stipulated that its provisions were not discriminatory practices based on gender, ethnicity, disability, marital status, religious affiliation or sexual orientation (s 52). In this way, the Bill met the overall goals of UK social policy in that it was non-discriminatory and paid attention to minority and/or marginalised groups. The Bill recognized the importance that all homeless be considered to be in priority need within existing policy, so as to provide better supports for those most at risk of ongoing complications due to their homeless situation. Comparison with Australian Policy The Australian policies for the elderly in Australia reflect the differences in governmental structure as in the UK. For example, there are three levels of government in Australia: Commonwealth (national), State and Territory governments (six and 2 respectively), and local governments (which have no constitutional status) (Commonwealth of Australia, 2000). The Commonwealth collects a majority of the taxes used to implement policies such as those for aged care. The States are responsible for most of the administration of public services. Hence, health policy-making is identified by ongoing negotiations between the Commonwealth and States and Territories. The complexity of the health-care system is reflected in the numerous types of services and providers as well as the range of funding and regulatory mechanisms. For example, the Commonwealth funds the bulk of aged residential care in the form of nursing homes and hostels. The States draw on Commonwealth financial assistance to fund and administer services such as public hospital care to the aged, and to provide them with mental health and community health services. The aged in Australia have access, as do other Australian's, to a universal health care system that does not take into account their ability to pay. There is also a government health insurance system, called Medicare (Department of Health and Aging, 2005). There are an array of services and support available to the elderly in Australia. All three levels of government are involved in the provision of services and support. Policy makers in Australia seriously consider the impact of the rapidly aging population of the nation and their response to it now, and in the future. However, due to the fact the aged can access all mainstream services and support that are also available to the rest of the population, it is difficult to establish exactly what services and supports are provided to the aged alone, and to determine actual costs. Policy focuses on assistance and support to the sections of the aged that are in most need, such as the very frail and the disabled. With a trend of people living longer and living healthier lifestyles for longer, policy tends to focus on assistance and support for the 'older' aged; or those over 70 years of age. Policy also accounts for the greatest need of support being in the anticipated final two years of life. In November of 1997 the Commonwealth released its 'National Strategy for An Aging Australia' (Department of Health and Aging, 2005). The Strategy aims to evaluate a range of long term issues that are seen to be associated with an aging population. The Strategy includes provision for a wide range of consultations with all levels of government and the community and private sectors. A range of discussion papers have been released as part of the Strategy. More recently, thee has been a pattern of policy to increase its emphasis on early intervention, or prevention of poor health, and to promote healthy aging that is combined with 'ageing in place,' or in other words keeping elderly people out of the health and residential homes as long as can be done. This is more cost efficient for all levels of government, puts less stress on the health and social care workforce, and allows the elderly to maintain inter-generational and inter-community ties, as well as feelings of autonomy and independence that contribute to their quality of life. Staying out of formal care appears to be the desire of many elderly people in Australia. They rely on Commonwealth payments in the form of pensions as well as other health care support that is aimed specifically at the aged community to maintain their ability to stay at home safely and healthily (Department of Health and Aging, 2005). This is enabled through policies that provide: age pensions rent assistance and disability payments residential services (for example, the funding of residential aged facilities and veterans residential facilities) medical and pharmaceutical benefits public housing (with the States and Territories via the operation of the Commonwealth-State Housing Agreement) acute care (with the States and Territories) disability services (with the States and Territories via the operation of the Commonwealth-State/Territory Disability Agreement) hospital and home and community care support (with the States/Territories and local government) Also, the Commonwealth provides aid to the carers of the elderly, by way of payments such as the Carer Payment and the Carer Allowance, and through support services, such as funding for carer respite centres and carer resource centres (Commonwealth of Australia, 2000). Other services written into policy in Australia directly or indirectly support and aid the aged population: financial counselling health promotion programs rehabilitation services retirement assistance for farmers advocacy services support for consumer organisations a range of information related to government programs Further, the States and Territories assist with a variety of housing and welfare services focused on aged care (Commonwealth of Australia, 2000). In general, the States and Territories proved a number of residential aged facilities as well as collaborating with Commonwealth funding to provide services and support such as: respite care carer assistance dementia support programs transport assistance home help information services Seniors' Cards that allow discounts on a range of products and services As such, policy emphasises that: health and aged care service providers need to listen and appropriately respond to the needs, wishes and concerns of older people; health and aged care services need to become more responsive to the special needs of older people from rural and remote areas, diverse cultural and linguistic backgrounds and older Aboriginal and Torres Strait Islander people; despite substantial growth in older age groups over the last two decades, population ageing has only contributed a minor proportion to growth in health expenditure; measures to achieve quality and cost-effectiveness in the health system include an emphasis on evidence-based medicine and mechanisms to ensure that the uptake of new technologies is clinically appropriate; support for increased choice through private health insurance and the option of long term care insurance; in the future, cost-effective quality care provision will require that formal services are readily available to support frail older people in retaining their independence and maintaining their health as long as possible. Flexibility and better coordination will enable the health and aged care system to respond flexibly and appropriately to the needs of older people with complex and chronic care needs. (Department of Health and Aging, 2005). Part of the prevention focus advocates improvements in the health status of older Australians and the dependence on policies that will aid in the improvement of population health (Department of Health of Ageing). Initiatives include the promotion of healthier lifestyles, for example 'Active Australia,' and the Food and Nutrition Policy. Also, policy seeks to prevent illness and chronic disease such as drawing on the National Health Priority Areas initiative under the National Public Health Partnership. References Commonwealth of Australia (2000) The National Strategy for an Ageing Australia. http://www.health.gov.au/internet/wcms/publishing.nsf/Content/ageing-ofoa-healthcare-wcchilite.htm/$FILE/world1.pdf ENABLE (2006) Health Committee Adult Support & Protection (Scotland) Bill Inquiry. Retrieved March 7 from the Scottish Parliament website http://www.scottish.parliament.uk/business/committees/health/inquiries/adultSupport/he-asp-10-ENABLE.htm Department of Health and Aging (2005) Helathy Aging Discussion Paper. http://www.health.gov.au/internet/wcms/publishing.nsf/Content/Positive+and+healthy+ageing-1 Scottish Parliament (2001) Regulation of Care (Scotland) Act 2001. Retrieved March 8, 2007 from http://www.opsi.gov.uk/legislation/scotland/acts2001/20010008.htm Scottish Executive (2002) The Regulation of Care (Scotland) Act. Retrieved March 7, 2007 from http://www.scotland.gov.uk/Publications/2002/12/16068/16020 Scottish Executive (2002) Homelessness etc. (Scotland) Bill. Retrieved MArch 12, 2007, from http://72.14.253.104/searchq=cache:p6hK_jxO400J:www.scottish.parliament.uk/business/bills/billsPassed/b63s1pm.pdf+homelessness+(scottland)+%2Bpolicy&hl=en&ct=clnk&cd=8 Scottish Executive (2005) Code of Guidance on Homelessness. Retrieved February 12, 2007, from http://www.scotland.gov.uk/Publications/2005/05/31133334/33376 Read More