Arguments AGAINST..(by Jen)..

A debate AGAINST…This house believes that Community Care does is not shift responsibility onto the family…

Definition of ‘Shift’:
The act of moving from one place to another

It is incorrect to assume that responsibility of care has been shifted onto Carers.

ARGUMENT 1
The government assumes ultimate responsibility

The Structure of Care Services within Community Care, as stated by the Care and Counsel in April this year, illustrate government responsibililty : The department of Health is responsible for ‘the effective delivery of health and social care services in England.

THE GOVERNMENT IS RESPONSIBLE FOR…Maintaining the overall system
THE GOVERNMENT IS RESPONSIBLE FOR ….Developing policies and guidance and sets out how health and social services are to be delivered.
THE GOVERNMENT IS RESPONSIBLE FOR regulating and inspecting services

Even if health and social care organisations have set up their own systems of care, they must meet the National Standards set out by the government.

[Stategic Health Authorities (SHA) are responsible for managing, monitoring and improving local health services. SHA are responsible for Care Trusts.

Primary Care Trusts (PCTs) are responsible for 80% of the NHS budget, and planning of primary care services for the local population. They arrange the provision of services for the local population. They arrange provision of services like GPs, dentists, pharmacists and opticians. PCTs are also responsible for improving the health of the local population, providing screening services, mental health services and patient transport. They should also make sure that the health and social care systems work well together. More and more PCTs expected to do joint commissioned work with social and health.]

ARGUMENT 2
The Community Care model itself does not shift responsibility on to the carer but rather it empowers the carer by supporting responsibility. There is much government policy and practice guidance that supports this:

National Service Framework:
Sets out standards for carers (e.g. carers needs-assesment)
Provisions for carers (such as respite services)

Organisations commissioned by the government to run carer support programmes: Rethink (then National Schizophrenic Fellowship). Provisions such as support groups

ARGUMENT 3

The argument that Community Care shifts responsibility onto the carer suggests that any direction towards empowering people in their own homes is a bad thing! The Community Care model is a good one by virtue of its ethical standing.

Let us consider the real shift in Community Care. It is a shift away from Institutionalised Care..It is a shift towards the rights of Service Users to be treated in their own homes and to have more tailored local services..It is a shift towards Service Users having more choice, more rights and more say!
[could incorporate some of Tom’s history-stuff to illustrate this point]

If carers are supported well by the government…

ARGUMENT 4

Community Care can be improved by more resources/funding. This means that the more supported carers are in their role, the less validity the argument holds.

[Email received from Zoe Irving]
Dear Jenny,
Thanks for your message. My quick thoughts are this: in Sweden and other social
democratic welfare regimes the underlying principles are 1) the socialisation
of the 'costs' of care both in monetary and (gendered)time terms ie. accepting
that a good society should take collective responsibility for care work that
needs doing and 2) the provision of services which are of a high enough
quality to prevent those who can afford it opting out of state provision and
buying private services (so-called middle-class flight)

Sweden has higher taxation rates than the UK and has moved some way towards more
market oriented systems but nothing like we have here. For the most up to date
information you could have a look at the comparative social policy/social work
journals - you'd be best off doing an article search on the ASSIA database via
the library web pages. You could also use the swedish government site (in
english) http://www.sweden.gov.se/

If you want to come and talk to me my next office hours are: Tuesday 20th
11.30-12.30 and 3-4.

hope this helps.
b/w
Zoe


Material found since email:
‘From institution to Community Care’ (Comparative Mental Health Policy)-
http://books.google.co.uk/books?hl=en&lr=&id=ZPV2n3BcX-AC&oi=fnd&pg=PA6&dq=sweden+%22community+care%22&ots=mo8Pf-EkGx&sig=s6ZRD04B7SsBwz4u6atp8rZ7rCo#PPP1,M1
States: no relationship found between ‘high public expenditure growth’ and a tendency towards de-institution

‘Comparing Health Systems in Four Countries: lessons for the United States’ (get through Scholar)