Introduction

The legislative framework for service development for older people laid down by the 1946 National Health Service Act and the 1948 National Assistance Act placed the emphasis on institutional provision. And yet the first section of this chapter underlines how there was agreement by the early 1950s that elderly people should remain in their own homes for as long as possible. Despite this, there was no dramatic shift of resources from hospitals and residential homes to domiciliary services, housing and income maintenance schemes.

This chapter focuses narrowly on arguments about those domiciliary services that were eventually to be located in social services departments. What kind of arguments were made in their favour and how did perceptions vary about their function? What was seen as the role of voluntary organisations in service provision? How did these arguments relate to perceptions about the responsibilities of families to their elderly relatives?

Staying at home and care by the ‘family’: the arguments

There was a broad consensus throughout the 1950s and 1960s that elderly people should remain in their own homes for as long as possible for their own happiness and also to reduce financial pressure on the state. The first of these arguments was strongly put by Townsend:

The ‘financial pressure’ case was put forward by Sheldon at the 1954 International Association of Gerontology Conference. He stressed the burden of old age dependency on the rest of the community in terms of hospital and residential care provision. This created a need to encourage and support “their general vigour under natural surroundings and their craving to maintain independence up to and even beyond the best possible moment”; this would reduce “the demands on permanent accommodation” (Sheldon, 1955, pp 15-26). The Ministry of Health shared such sentiments.