LEGAL FRAMEWORK -CARE

1. LEGAL FRAMEWORK -CARE Legislation and the Care System

2. Legislation and the Care System The creation of the ‘welfare state’ in the 1940s was a turning point in the history of the care system in our country. The proposals made by Beveridge became a reality through social legislation. A number of key acts served as a foundation for the welfare state.

3. ACTS • Family Allowance Act 1945 - giving an allowance to each child except the first • National Insurance Act 1946 – a funding plan for all who would be losing pay as a result of unemployment, illness, disability or being widowed. • National Health Service Act 1948 – creating a free health system for all who needed it • National Assistance Act 1948 – a safety net for poor people who were not receiving money from the national insurance system. It also enabled local authorities to create care services.

4. ACTS Since then, the government has passed more and more acts which, by now • Establish care services and set standards • Create a system which monitors the services • Establish rights for service users • Defend the rights of service users and workers within the care establishments

5. NHS and Care in the Community Act (1990) This act brought about some of the greatest changes since the Second World War. As a result of this act, the NHS no longer had a monopoly over all the care services. Instead, the ‘internal market’ was introduced to the provision of public care. The country therefore was ‘enabling’ these services rather than providing them, i.e. it placed more emphasis on the private and independent sectors and gave them more influence.

6. NHS and Care in the Community Act (1990) Health: The creation of NHS Trusts, i.e. establishments which provide care and agree contracts with family practitioners (who manage their own finances) for health care provision for people in the locality.

7. NHS and Care in the Community Act (1990) Social Care: Also arranged so that the internal market was able to operate. The local authority’s social services departments were divided into provision sectors and purchasing sectors. The purchasing sectors assessed the needs of individuals and then purchased a ‘care package’ from private, voluntary or statutory establishments.

8. NHS and Care in the Community Act (1990) Perhaps the greatest change brought about by the act was the way that needy adults were cared for in society. The idea was that adults with long term needs would no longer be locked away in large institutions, but instead would remain in the community – either in their own homes or in a ‘homely’ centre.

9. NHS and Care in the Community Act (1990) As a result of the act, each local authority must assess the needs of every individual who has a: • Physical disability • Disabling illness • Terminal illness • Sensory impairment • Learning disability • Mental health problem

10. NHS and Care in the Community Act (1990) Following the assessment, the authority must decide whether the individual requires care and must purchase a care package to meet the needs. Therefore, this act ensures • Care in the Community • Mixed economy Care

11. NHS and Care in the Community Act (1990) Discuss - • What are the advantages and disadvantages of this Act? • Two examples of legislation which seeks to defend the rights of vulnerable groups in our society. • How did the NHS Care in the Community Act (1990) bring about a change in the structure of the care system in the UK? • Why should care workers be aware of the Civil Rights Act (1998)?

12. The New NHS - Modern and Dependent • The government brought out a white paper, The New NHS (1997) which noted its plans to modernise the NHS over the following 10 years. • Family practitioners were organised into Primary Care Groupswhich were accountable to the local health authority, and social services began to work closer with health sector workers. • The partnership between doctor and patient was considered all important.

13. HEALTH ACT, 1999 As a result of this act, Primary Care Trustswere created which compelled hospitals to improve their services. The following were introduced: • drop in centres • more day-case surgery in health centres • health check and advice in clinics • better partnerships between GPs, pharmacists, counsellors and dentists so that a range of services could be offered on one sight

14. NHS PLAN 2000 This is a 10 year health services plan designed around the patient. Its targets are as follows: • 7,000 extra beds in hospitals • 100 new hospitals • Clean wards with ‘matrons’ and better food • Modern IT systems in each hospital and GP surgery • 7,500 extra consultants and 2,000 extra GPs • 20,009 extra nurses and therapists • Child care support for NHS workers The idea is that waiting lists for treatment will decrease

15. Main Principles of the NHS The NHS will: • offer services to all, based on need and not on the ability to pay • offer a comprehensive range of services • arrange its services around the needs and choices of the patient, his / her family and carer • respond to the varying needs of different populations

16. Main Principles of the NHS The NHS will: • work daily to improve services and reduce errors • support and appreciate its staff • work with others to offer a seamless service • respect patient confidentiality and provide open access to services, treatments and performance. • each trust within the NHS is required to produce an annual report

17. The Social Services • Local government in England and Wales is responsible for a wide range of social services including personal services, housing and education. • The government determines the powers and responsibilities of local councils. • The council has a duty to provide accommodation to certain groups in society e.g. people with mental illness who have recently left hospital.

18. The Social Services • They have a duty to keep specific records e.g. a register of every person who is ill or disabled in the area. • They have the power to decide what level of service they provide and how much to charge for it. • The social services are monitored with regard to performance and spending by central government and the Social Service Audit Commission

19. Funding of the Social Services • Central government provides funding by employing a Spending Assessment formula (SSA). • The amount of money given depends on the area’s profile e.g. number of older people, single parents, numbers of ethnic groups and population density etc. • The council collects local taxes and also charges for some of its services • Services are provided according to need but are sometimes means tested

20. The Social Services • Recent changes mean that social services buy services from others instead of providing the services themselves • The local authority is responsible for ensuring that the standard of services purchased by others is acceptable. • In 2005, the government published a Green Paperwhich suggests changes to social services in the future.

21. The Social Services • The ‘Green Paper’ emphasises: • Keeping people in their own homes and respecting their wishes with regard to their care. • Promoting collaboration between the services and other partners, including YGC? along with the private and voluntary sectors in order ensure cost-effectiveness and in order to meet the needs of different communities. • Ensuring that no-one is pushed to the fringes of society and that every service includes everybody • Ensuring that the services are of a high standard • Using modern IT • Ensuring the necessary care for those with needs