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Implementing Caring for People? Draft guidance circulars from the Department of Health

Published online by Cambridge University Press:  02 January 2018

Frank Holloway*
Affiliation:
Camberwell Health Authority, St Giles Hospital, St Giles Road, London SE5 7RN
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Throughout the 1980s concern mounted over the provision of health and personal social services. As a result of inflation, an expansion in demand and technical advances, the increasingly expensive hospital services became more and more obviously threadbare, while the perceived failures of the community care movement were widely canvassed. As the decade ended the Government embarked on two bold initiatives aimed at increasing the efficiency, effectiveness and accountability of health and social care. These proposals, set out in the White Papers Caring for People (HMSO, 1989a) and Working for Patients (HMSO, 1989b), have now become law in the National Health Service and Community Care Act 1990. Another paper (pp. 641–645) somewhat critically reviews Caring for People from a psychiatric perspective (Holloway, 1990). At the heart of the ‘reforms’ is an attempt to create the conditions of a market. To achieve this a sharp distinction is to be drawn between the purchasers of care (Health Authorities, Local Social Services Authorities and Family Health Services Authorities) and service providers, with whom the purchasers will let contracts. It is envisaged that eventually a plethora of providers will compete within a “mixed economy of care”, becoming ever more efficient.

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Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 1990

References

Godber, C. & Higgins, J. (1990) Care for the infirm elderly. British Medical Journal, 300, 555556.Google Scholar
Holloway, F. (1990) Caring for People: a critical review of British government policy for the community care of the mentally ill. Psychiatric Bulletin, 14, 641645.Google Scholar
Her Majesty's Stationery Office (1989a) Caring for People. London: HMSO.Google Scholar
Her Majesty's Stationery Office (1989b) Working for Patients. London: HMSO.Google Scholar
Stein, L. (1990) Comments by Leonard Stein. Hospital and Community Psychiatry, 41, 649651.Google Scholar
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