Introduction

In various talks and lectures to managers and practitioners from social services, health and housing, the authors have often run what they like to call a community care quiz. It usually comprises the following questions:

• • When did it become mandatory for social services authorities to provide a home help service?

• • What change was brought in by the 1948 National Assistance Act 1962 (Amendment) Act?

• • “The importance of enabling older people to go on living in their own home where they most wish to be … is now generally recognised”. What was the date of the government publication from which this quotation is drawn?

• • When did government start to include equity tied up in one's house in assessing the client contribution to residential care fees?

• • When did government introduce charges for domiciliary services such as home care?

Thorough readers of this book should be in a position to answer all these questions!

Our starting point in this chapter has to be to emphasise once again the relevance of such ‘knowledge’ to an understanding of present community care debates. In saying this, we make no claim to have offered a factual objective history of the past. This book is partial in what it has covered and the sources it has drawn upon, and the information collected has been shaped into a ‘story’ through the influence of our theoretical assumptions. Nevertheless, we believe that our study helps to undermine both ‘the Golden Age’ myths of the left and ‘the Disaster Years’ myths of the right about the early development of community care policy and practice in this country. This book concludes by considering a number of the present day issues in terms of what we have concluded about how they were or were not addressed in the past.

The health and social care interface

One of the clearest messages which emerges from our study of the development of welfare services for elderly people is that politicians and policy makers have struggled to define ‘what is health’ and ‘what is welfare’ right back into the Poor Law period. Initially the distinction was between being ill and hence not to blame for being destitute and being a welfare case and hence deserving of the label of ‘pauper’.