Remember Me
Or use your Academic/Social account:


Or use your Academic/Social account:


You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.


Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message


Verify Password:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Winsor, Tony
Languages: English
Types: Doctoral thesis
In the 1950s the term community care was associated with the movement of people with mental health problems from longstay institutions into the community. More recently,\ud however, the term has applied to services to a much wider range of groups including older people. The thesis is concerned with community care services for this group and in\ud particular, domiciliary care. It seeks to evaluate claims made in the White Paper: 'Caring for People' that its preferred model of community care can provide both increased service\ud effectiveness for consumers and cost control.\ud \ud The thesis argues that community care policy was shaped by 'managerialist' assumptions and that improved performance could be delivered by organisational change, in particular the quasi-market and the use of managerialist techniques. Thus, the two phenomena of 'managerialism' and 'quasi markets' are conjoined, the latter offering to the former the possibility of competition between providers, which in turn is seen to provide greater user choice and value for money.\ud \ud Two key reports from the Audit Commission are analysed as exemplars of managerialism and community care. The connection between the reports and government policy is\ud discussed and the evidence presented in them for community care, as a cost containment policy, is scrutinised. The consumer effectiveness argument for community care is\ud examined by considering, in particular, the relationship between consumer choice and the market model of community care advocated in the Griffiths report: 'Community Care: Agenda for Action' (1988) and the White Paper: Caring for People (1989). It is argued that both the government proposals and much of the critical academic commentary fail to examine various underlying premises, in particular, the salience of 'choice' as a universally desirable objective.\ud \ud The themes outlined above are explored in empirical work undertaken in the case study local authority. The consumer effectiveness issue is analysed with reference to a survey of\ud users of domiciliary care services. The survey is used to examine how far the assumptions made by both government and many academic commentators, with regard to user\ud satisfaction, correspond to those of users. The analysis questions these assumptions showing that 'consumerist' notions of choice of service are much less significant than\ud personal aspects of the service such as 'caring manner' and continuity of relation with carer. Cost control issues are examined by considering an example of 'value for money'\ud auditing in the authority. Analysis of this project suggests the difficulties which such exercises have in generating appropriate norms for service provision in domiciliary care.\ud The thesis concludes by relating the themes explored to current problems in community care policy, in particular the increasing significance of rationing and eligibility criteria.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • Baldock, J. and Ungerson, C. (1994a). 'Community care: consumer power', Community Care, 15-21 September, p26-27.
    • Baldock, J. and Ungerson, C. (1994b). 'Becoming consumers of community care'. York: Joseph Rowntree Foundation.
    • Dean, H. and Hartley, G. (1995). 'Complaints: listen to learn', Community Care, 30th March 1995, p22-23.
    • Francis, J (1993). 'Purchasing Dilemmas: shouldering the burden', Community Care, Purchasing: 5, 25th November, p24-25.
    • King, J. (I99Ia). 'Daunting deadlines', Community Care, 21st February, pI5-17.
    • King, J. (199Ib). 'Sharing the power game.' Community Care, lIth July, pI5-18.
    • Klein, R. (1982). 'Performance, Evaluation and the NHS: a Case Study in Conceptual Perplexity and Organisational Complexity', Public Administration, 60, (4), p385-407 McSweeney, B. (1988). 'Accounting for the Audit Commission', Political Quarterly) 59, (1), p28-43.
    • Marchant, C. (1993). 'Toughening out tendering', Community Care, 1 July, p14-15.
    • Thornton, P and Tozer, R (1995). Having a say in change: older people and community care'. University of York: Social Policy Research Unit.
  • No related research data.
  • No similar publications.

Share - Bookmark

Cite this article