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Christine Milligan - Geographies of Care: Space, Place and the Voluntary Sector

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GEOGRAPHIES OF CARE For my parents Geographies of Care Space place and the - photo 1
GEOGRAPHIES OF CARE
For my parents
Geographies of Care
Space, place and the voluntary sector
CHRISTINE MILLIGAN
Institute for Health Research
Lancaster University
Lancaster, UK
First published 2001 by Ashgate Publishing Reissued 2018 by Routledge 2 Park - photo 2
First published 2001 by Ashgate Publishing
Reissued 2018 by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
711 Third Avenue, New York, NY 10017, USA
Routledge is an imprint of the Taylor & Francis Group, an informa business
Copyright Christine Milligan 2001
All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.
Notice:
Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.
Publishers Note
The publisher has gone to great lengths to ensure the quality of this reprint but points out that some imperfections in the original copies may be apparent.
Disclaimer
The publisher has made every effort to trace copyright holders and welcomes correspondence from those they have been unable to contact.
A Library of Congress record exists under LC control number: 2001088772
ISBN 13: 978-1-138-73189-9 (hbk)
ISBN 13: 978-1-315-18881-2 (ebk)
Contents
This book presents the results of a research project undertaken in the late 1990s about health and social care restructuring in Scotland and the likely impacts of reform on the informal sector.
The environment of community-based care is a complex one, in which numerous different actors and agencies operate at across various different spatial and organisational levels of the policy process. The actions and responses of these actors are in part mediated by their inter-relationships with other actors also involved in the caring process. This book has sought to tease out some of these inter-relationships through examining the experiences of statutory and informal care providers concerned with the provision of care to the frail elderly in Scotland. Taking the voluntary sector as the lens through which these inter-relationships are explored, the book examines how voluntary supports become mediated by differing local contexts of care. To do so, it explores the social and spatial implications of these linkages in two ways: firstly, it examines how deinstitutionalised care is effecting changes in the inter-relationships between formal an informal sectors in two differing local authority environments in Scotland and what this means in terms of locally-based care outcomes; and secondly, using a networked approach to analysis, it explores the social and policy environment within which community-based care is mediated. In this way, the research adds a new dimension to our understanding of the ways in which the restructuring of social care can vary between places, and across various spatial scales, and what this can mean for those concerned with the provision of care supports to community care groups.
Lancaster
January 2001
I would like to thank Robert Rogerson at the University of Strathclyde for his invaluable help and support throughout the progress of this research. I would also like to acknowledge all those participants whose willingness to help allowed me to undertake the study. In particular, I would like to thank those informal carers who gave up their time and knowledge despite the enormous burden of care they undertake - often with very limited help and support. Finally, I would like to thank my husband who frequently found himself a pressed volunteer, listening patiently (and sometimes less patiently!) to all my ideas, moans and groans throughout the research process.
APT
Area of Priority Treatment
EU
European Union
GGHB
Greater Glasgow Health Board
JAG
Joint Action Group
JSG
Joint Strategic Group
LA
Local Authority
MISG
Mental Illness Specific Grant
MSC
Manpower Services Commission
NHS
National Health Service
PPA
Priority Partnership Area
Key to Quotes
I
Interviewer
R
Respondent
DG (+ number)
Voluntary Organisation - Dumfries and Galloway
DGC (+ number)
Carer - Dumfries and Galloway
G (+ number)
Voluntary Organisation-Glasgow
GC (+ number)
Carer - Glasgow
PDG (+ number)
Private Sector - Dumfries and Galloway
PG(+number)
Private Sector - Glasgow
H
Housing Department
HB
Health Board
LA
Local Authority
SWD
Social Work Department
VO
Voluntary Organisation
Code + (1) or (2)
Denotes sequence of interviews
Bold
speakers emphasis
[pause]
speakers pause
break in quote
****
indicates identifying name has been removed
Since the 1970s, and more evidently throughout the 1980s and 1990s much emphasis in the UK has focused on the way in which successive governments have attempted a retrenchment of publicly provided social welfare. A major change effected by this restructuring has been a shift in the location and mode of the delivery of care to service dependent populations - that is, the frail elderly and those experiencing mental, physical or sensory impairment. One element of this shift has been a move away from the prevalence of publicly provided services located within large, centralised institutional environments towards domiciliary and small community-based sites of delivery.
Hand in hand with the changing locus of care has been a change of emphasis in the mode of service delivery. Care is no longer viewed as the prerogative of public services. Rather, there is growing consensus amongst policy-makers that the informal sector (defined as comprising voluntary/non-profit organisations, the private sector and informal carers: Cm. 849, 1989) could and should play a key role in the provision of social and welfare services. Legislation from the late 1980s has thus sought to promote a mixed provision of care to include voluntary, private and informal care supports. Such options are seen as offering flexible and cost effective ways of delivering social and care services within local communities. As a consequence, provision is said to be breaking away from the binary choices of public or private sectors, toward the development of a social market that incorporates the voluntary/non-profit sector (Amin et al, 1999).
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