Book contents
- Frontmatter
- Contents
- Acknowledgements
- one Introduction
- two Evacuation and elderly people in the Second World War
- three Civilian morale and elderly people: the emergence of ‘reforms’ in residential and domiciliary welfare services
- four The 1948 National Assistance Act and the provision of welfare services for elderly people
- five Issues in residential care
- six Avoiding institutional care: the changing role of the state, the family and voluntary organisations
- seven The restructuring of welfare services for elderly people
- eight Community care and older people: reflections on the past, present and future
- Bibliography
- Appendix
- Index
five - Issues in residential care
Published online by Cambridge University Press: 05 July 2022
- Frontmatter
- Contents
- Acknowledgements
- one Introduction
- two Evacuation and elderly people in the Second World War
- three Civilian morale and elderly people: the emergence of ‘reforms’ in residential and domiciliary welfare services
- four The 1948 National Assistance Act and the provision of welfare services for elderly people
- five Issues in residential care
- six Avoiding institutional care: the changing role of the state, the family and voluntary organisations
- seven The restructuring of welfare services for elderly people
- eight Community care and older people: reflections on the past, present and future
- Bibliography
- Appendix
- Index
Summary
Introduction
Reference was made in the last chapter to the optimism in both central and local government associated with the passing of the 1948 National Assistance Act. The 1949 Ministry of Health Report claimed that the workhouse was doomed and that local authorities were busy planning and opening small, comfortable homes, where old people, many of whom were lonely, could live pleasantly and with dignity. The report claimed “the old ‘master and inmate’ relationship is being replaced by one more nearly approaching that of a hotel manager and her guests’’ (Ministry of Health, 1950b, p 311). Similar views were expressed by a public assistance officer from Middlesex County Council:
The old institutions or workhouses are to go altogether. In their place will be attractive hostels or hotels, each accommodating 25 to 30 old people, who will live there as guests not inmates. Each guest will pay for his accommodation – those with private income out of that, those without private income out of the payments they get from the National Assistance Board – and nobody need know whether they have private means or not. Thus, the stigma of ‘relief’ – very real too, and acutely felt by many old people – will vanish at last. (Garland, 1945, p36)
This chapter discusses some of the reasons why such hopes were never realised. The first half is concerned to explain how bed shortages in residential homes and hospitals led to a constant questioning of the boundaries between NHS and local authority provision. What was meant by in need of care and attention? Did it include those with physical and mental impairments? The second half of the chapter explores issues about the quality of life in residential homes, including the general criticism which emerged of all forms of institutional provision. Why did such criticism fail to lead to a reassessment of the priority given to residential care as opposed to domiciliary services for elderly people?
The organisation of welfare services
Before developing a detailed analysis of residential care for the period, it is important to outline briefly the main organisational arrangements that emerged during this period for welfare services. The Ministry of Health was responsible for local authority services under the 1946 National Health Service Act (for example, home helps, home nursing) and the 1948 National Assistance Act.
- Type
- Chapter
- Information
- From Poor Law to Community CareThe Development of Welfare Services for Elderly People 1939-1971, pp. 155 - 218Publisher: Bristol University PressPrint publication year: 1998