To what degree have the British community care reforms met the pre-reform criticisms of targeting?

Abstract

It was not until the late 1980s that there was evidence for detailed analysis of the relations between resources, needs, andoutcomes: persons in what need-related circumstances obtained publicly-subsidised and/or brokered access to how much of what kind of service, with what effects on whom, and at what costs to whom. Very soon we shall comparison of resources, needs and outcomes for users recruited in 1984/5 with those recruited in 1995. In what follows, I shall risk some tentative generalisations from the half-analysed results of a before-after evaluation of the community care changes. The study was based on two cohorts of persons assessed and allocated community social services. One cohort was recruited during 1984/5 [hereafter, 1985], and was followed for at least 117 weeks. The second cohort was recruited during 1995, and is still being followed. The evidence is particularly rich about the circumstances and perceptions of field-level triads of users, principal informal caregivers, and their care managers. Data are still being collected and analysed, making some comparisons impossible as yet. The generalisations must be tentative. The analyses for the second cohort are still in progress, and there has not been the analyses for both cohorts simultaneously to get the highest degree of precision achievable with respect to the precise question asked, the definition of variables, and model