An analysis of the factors influencing the implementation of health and personal social service policies for elderly people in Northern Ireland.

Abstract

Community care has been an explicit policy goal in the United Kingdom since the end of the 1940s. The policy had traditionally taken the form of the provision of help and support in non-institutional settings, usually in the individual's own home. The services provided are intended to keep the individual in the community and out of institutions. Statistical data would suggest that there has been a huge expansion in domiciliary welfare provision. However, recent studies of such services suggest that the real gains made have not increased to the same degree as the per capita expansion in-services might suggest. Alongside the observations about the outcomes of the explicit policy goal for community care there has been a growing awareness that policy implementation is not simply a continuation of the process of policy formulation ie implementation starts where policy stops. It has been argued that policy may be a response to pressures and problems experienced on the ground and it is essential, therefore, to look at implementation not solely in terms of putting policy into effect but also in terms of observing what actually happens or gets done and to seek to understand how and why. The development of domiciliary services over the years has relied largely on professional judgments but despite this there has been relatively little research into decision-making related to the provision of the services and the closely related service of residential care. For this reason two case studies were conducted which examined, inter alia, the home help service and residential care decision-making processes. Fieldwork for the study was carried out in the area of the Western Health and Social Services Board during 1982. Data collection involved interviews with the senior staff involved in the management and supervision of the social work assistants responsible for the provision of the home help service, the distribution of self-completion questionnaires to social work assistants in respect of recipients of the home help service and to officers-in-charge of old people's homes in respect of the residents in those homes. In addition information was also collected from the files of people newly admitted to old people's homes. The study raises questions about current Government policy, the rationing of services and the targeting of services to particular groups of the population.

Date of Award	1985
Original language	English
Awarding Institution	University of Bath