Bridgen, Paul and Lewis, Jane
Elderly people and the boundary between health and social care 1946-91: Whose responsibility?,
London, UK, Nuffield Trust, 124pp.
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Since the 1990s, the boundary between health and social care has increasingly been recognised as a major policy issue with regard to provision for elderly people. Yet the boundary is far from new: a division between the two services has existed since 1946. This study presents a thorough investigation of central government's policy, based on archival sources. It shows that while the problem has been defined differently over time, there has been more continuity than change. The boundary issue has manifested itself as a struggle over the respective responsibilities of health and local authorities, with both seeking to avoid caring for a growing group of people in need of nursing and/or medical attention on a regular, but not constant, basis. Health officials, worried about the growing costs of hospital care and influenced by hospital doctors, increasingly sided with the health authorities, but without openly discussing the implications of a shift of responsibilities to local authorities.
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