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Ideology, ideas and care in the community, 1948-71
No full textTo understand the changes over the period we are examining, with dramatic policy shifts from institutional segregation to integration, then from integration to inclusion and citizenship, it is important to examine changes in ideology. In this chapter, the focus is particularly upon ideologies that led to the discrediting of the types of solutions adopted in the early part of the century—segregation, exclusion and control—and the adoption of policies with care as their central leitmotif. Dates have ideological significance. The year 1944 saw an Education Act in which, according to Sheena Rolph, ‘many of the worst aspects of the [eugenic] ideology were enshrined in legislation; segregation, “ascertainment” and the concept of “ineducability”’ (2005a–f, p. 14). In 1948 the NHS was founded, which took responsibility for mental deficiency institu-tions from local authorities, voluntary organisations and private providers, signalling the dominance of a medical model. At the end of the period these trends were to an extent reversed. In 1970 the Education Act gave all children the right to an education, and 1971 saw Better Services which is seen as a landmark in the move to community care, and signalled the end (though very slow) of the NHS’s control of services. We can see the early 1970s as a watershed, the time when policy makers adopted the relatively optimistic ideas associated with researchers who made the case for regarding people with mental handicaps as able to benefit from a comfortable environment, contact with the wider world and education
Organisations, structures and community care, 1948-71 : From control to care?
No full textThis chapter moves from the theoretical to the practical, from the ideas and ideologies considered in Part I, to organisations and structures. It moves from what was said to what was done, taking up the challenge issued by Malin, Race and Jones to chart the reasons why each affected the other, but also to explore why they so rarely appeared to be in harmony (Malin et ah, 1980, p. 65). In terms of the implementation of policy, this section also offers an opportunity to test arguments regarding the development of services for other groups of service users. Robin Means and Randall Smith, for example, have argued that it is possible to see the period 1948–71 as one of incremental progress for domiciliary services for older people; the argument was over the respective roles of the state and voluntary organisations in service provision (Means and Smith, 1985, pp. 292–3). More recently, Anne Borsay has questioned how far community care policies were able to deliver social citizenship for people with disabilities by the late 1970s. She writes of the 1970 Chronically Sick and Disabled Persons Act that ‘sustaining social rights was difficult where loss of autonomy was a precondition for the receipt of a service’ and that social citizenship was attenuated with community care because geographical access to local authority provision remained highly variable (Borsay, 2005, pp. 169, 191, 196)
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