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Organisations, structures and community care, 1948-71: From control to care?

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This chapter moves from the theoretical to the practical, from the ideas and ideologies considered in Part I, to organisations and structures. It moves from what was said to what was done, taking up the challenge issued by Malin, Race and Jones to chart the reasons why each affected the other, but also to explore why they so rarely appeared to be in harmony (Malin et ah, 1980, p. 65). In terms of the implementation of policy, this section also offers an opportunity to test arguments regarding the development of services for other groups of service users. Robin Means and Randall Smith, for example, have argued that it is possible to see the period 1948–71 as one of incremental progress for domiciliary services for older people; the argument was over the respective roles of the state and voluntary organisations in service provision (Means and Smith, 1985, pp. 292–3). More recently, Anne Borsay has questioned how far community care policies were able to deliver social citizenship for people with disabilities by the late 1970s. She writes of the 1970 Chronically Sick and Disabled Persons Act that ‘sustaining social rights was difficult where loss of autonomy was a precondition for the receipt of a service’ and that social citizenship was attenuated with community care because geographical access to local authority provision remained highly variable (Borsay, 2005, pp. 169, 191, 196).