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Aspirations and realities: community care at the crossroads *
Author(s) -
Wistow Gerald
Publication year - 1995
Publication title -
health and social care in the community
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.984
H-Index - 68
eISSN - 1365-2524
pISSN - 0966-0410
DOI - 10.1111/j.1365-2524.1995.tb00024.x
Subject(s) - service delivery framework , public administration , robustness (evolution) , public relations , control (management) , nursing , political science , service (business) , sociology , medicine , economics , management , economy , biochemistry , chemistry , gene
The community care reforms in the United Kingdom were a response to a broadly based critique of the policy's failure. After an apparently successful first year's implementation, their robustness is increasingly under question. This paper reviews evidence about the early implementation of the reforms. While attention has focused on erecting a structure of systems and processes, the foundations of community care are in danger of being undermined by internal and external policy contradictions. The twin objectives of improved service access and expenditure control are already proving difficult to reconcile. In addition, radical changes in the delivery of acute services are creating additional pressures which the reforms were not designed to bear.