TY - JOUR

T1 - Pathways of dependency : the impact of helath and social care restructuring : the volunatary experience.

AU - Milligan, Christine

PY - 1998

Y1 - 1998

N2 - The current emphasis on community over institutionally based modes of health and social care delivery in the UK, together with legislative change, has placed a renewed emphasis on the role of the informal sector in service provision. Simultaneously, there has been an attempt to modify the provider-role of the statutory sector, in favour of an evolving role as purchaser and enabler of independently provided services. Drawing on material that forms part of a 3 year study into health and social care restructuring, and its effect on the caring networks of elderly dependent populations, this paper focuses on the changing role of the voluntary sector. Using empirical material drawn from the Scottish environment, it illustrates how the restructuring process may be modifying the voluntary sector and contributing to a growth in geographical inequity in voluntary service provision. In doing so, it considers four main factors affecting local voluntary organisations—the growth of contracting, external constraints on voluntary provisioning, the influence of the local authority and Wolch's concept of the “Shadow State”. It highlights the emerging social and spatial manifestations arising from such change, and how these modifications may also be contributing to a growth in geographical inequity for service recipients linked within the dependence network.

AB - The current emphasis on community over institutionally based modes of health and social care delivery in the UK, together with legislative change, has placed a renewed emphasis on the role of the informal sector in service provision. Simultaneously, there has been an attempt to modify the provider-role of the statutory sector, in favour of an evolving role as purchaser and enabler of independently provided services. Drawing on material that forms part of a 3 year study into health and social care restructuring, and its effect on the caring networks of elderly dependent populations, this paper focuses on the changing role of the voluntary sector. Using empirical material drawn from the Scottish environment, it illustrates how the restructuring process may be modifying the voluntary sector and contributing to a growth in geographical inequity in voluntary service provision. In doing so, it considers four main factors affecting local voluntary organisations—the growth of contracting, external constraints on voluntary provisioning, the influence of the local authority and Wolch's concept of the “Shadow State”. It highlights the emerging social and spatial manifestations arising from such change, and how these modifications may also be contributing to a growth in geographical inequity for service recipients linked within the dependence network.

KW - voluntary organisations

KW - restructuring

KW - dependence networks

KW - contracting

KW - Shadow State voluntary organisations

KW - Shadow State

U2 - 10.1016/S0277-9536(97)00172-X

DO - 10.1016/S0277-9536(97)00172-X

M3 - Journal article

VL - 46

SP - 743

EP - 753

JO - Social Science and Medicine

JF - Social Science and Medicine

SN - 0277-9536

IS - 6

ER -