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

Milligan, Christine (1998) Pathways of dependency : the impact of helath and social care restructuring : the volunatary experience. Social Science and Medicine, 46 (6). pp. 743-753. ISSN 0277-9536

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Abstract

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.

Item Type: Article
Journal or Publication Title: Social Science and Medicine
Uncontrolled Keywords: voluntary organisations ; restructuring ; dependence networks ; contracting ; Shadow State voluntary organisations ; Shadow State
Subjects: R Medicine > R Medicine (General)
Departments: Faculty of Health and Medicine > Health Research
ID Code: 20871
Deposited By: Mrs Janet Harris
Deposited On: 02 Dec 2008 15:07
Refereed?: No
Published?: Published
Last Modified: 09 Apr 2014 20:24
Identification Number:
URI: http://eprints.lancs.ac.uk/id/eprint/20871

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