Key legislation, papers and reports
The Poor Law (1601) allowed each parish to collect a poor rate to give a little money to the ‘impotent poor’ (such as the elderly and the blind) and to provide ‘poor-houses’ or ‘almshouses’ for the chronically sick and the insane. On the other hand, the ‘able bodied’ were set to work on hemp or other appropriate materials in a ‘house of correction’. Finally, children in need of relief were given apprenticeships so that they could become useful, self-supporting individuals, whereas the ‘idle poor’ were whipped and returned to their place of birth.
The Poor Law Amendment Act (1834) stated that no able-bodied person was to receive money or other help from the Poor Law authorities except in a workhouse. ‘Wasteful’ outdoor relief was cut and it was determined that conditions in the workhouse would be extremely harsh so that life in the workhouse would be less comfortable than life on the lowest wage rung (thus establishing the principle of ‘less eligibility’ as a deterrent to claiming relief). Workhouses were to be built in every parish and, if parishes were too small, parishes had to group together to form Workhouse Unions. Poor Law Commissioners were made responsible for overseeing the implementation of the Act in parishes nationwide.
The Report on Social Insurance and Allied Services Cmd. 6404 (1942) (aka. The Beveridge Report) emphasised the importance of work in the paid labour market and advocated for a national scheme of social insurance that required contributions to be paid at a ‘flat rate’ during times of employment in return for a ‘flat rate’ of (adequate) subsistence benefit during periods of unemployment.
The Disabled Persons (Employment) Act (1944) attempted to secure employment rights for disabled people or ensure that all disabled people were provided with a variety of rehabilitation services and vocational training courses.
The Education Act (1944) specified that disabled children should be educated alongside their non-disabled peers and obliged local authorities to provide special educational treatment for those thought to need it.
The National Insurance (Industrial Injuries) Act (1946) enabled the provision and maintenance of equipment and appliances for those injured at work.
The National Insurance Act (1946) acted upon some of the details contained in the Beveridge Report (1942) with its similar emphasis on the importance of work in the paid labour market. Likewise, universal ‘flat rate’ contributions were expected during times of employment in return for ‘flat rate’ benefits during unemployment.
The National Assistance Act (1948) made some provision for meeting the financial needs of disabled people and mandated local authorities to provide residential facilities and services in both the community and institutions.
The National Health Service Act (1948) provided hospital based treatment, long-term care for disabled people and helped facilitate local authorities to supply the necessary medical aids for disabled people to live in their own homes.
The Report of the Royal Commission on Mental Deficiency of 1954-7 considered the problems arising from outdated mental hospitals and the stigma associated with in-patient treatment.
In 1962, A Hospital Plan was published by the Ministry of Health. This was followed by Health and Welfare: The Development of Community Care (1963), which was generally referred to as The Community Care Blue Book. Both provided a sketchy outline of plans for community-based services, including proposals for increases in the numbers of general practitioners, home helps, district nurses, health visitors, sheltered housing schemes and sheltered workshops.
The Seebohm Report (1968) was commissioned as a response to a number of critical investigations into institutional life and a spate of sensational public expositions over treatment of in-patients. Among its principal conclusions were recommendations that local authorities should accumulate data relating to the nature and size of the problems associated with disability, and that they should develop and/or expand services in conjunction with those already provided by the health service and the voluntary sector.
Local Authority Act (1970) and the Chronically Sick and Disabled Persons Act (1970) incorporated the recommendations of the Seebohm Report (1968) and the establishment of social service departments in their present form quickly followed. These new departments were responsible for the provision of social workers, occupational therapists, residential and day centre facilities, holidays, meals on wheels, respite services, and disability aids and adaptations.
Community Care: Agenda for Action (1988) was a report put forward by Sir Roy Griffiths, the Vice Chairman of the National Health Service management board at that time. Following on from the Audit Commission’s 1986 observation that there was urgent need for wide-ranging organisational changes if community provision was to become reality, the report advocated for the ‘ring-fencing’ of available funding so that community based services from private and statutory agencies could be cultivated. The coordination of which would fall within the remit of local authorities.
Caring for People (1989) and the NHS and Community Care Act (1990) announced and instigated some of the Government plans for the development of community based services. The White Paper Caring for People proposed measures to end the confused and fragmented nature of service provision (from social security, health, local authorities and from private and voluntary agencies). An increase in consumer choice and to make service providers more accountable was also earmarked. Responsibility for planning, coordinating and paying for services was to be handed to local authorities yet no ring ‘fencing’ of funds was put forward in the Paper: nor was there any suggestion of an increase in funds. Funding was a major issue in to formation of the NHS Community Care Act itself. The overarching aim of the Act was to help people live safely in the community. Social Services were assigned to assess the needs of people and arrange for the provision of social care services to meet those needs. Other responsibilities included the creation of procedures for receiving comments and complaints, organising registration and inspection procedures and, crucially (given the concerns over cost), the assessment of an individual’s ability to contribute.
The Disability Discrimination Act (1995 amended in 2005) and The Equality Act (2010) were passed into legislation with the specific aim to protect disabled people and prevent disability discrimination. From the 1st of October, 2010 the Equality Act replaced most of the Disability Discrimination Act but most of the Disability Equality Duty in the original act remains. Such legislation has meant that disabled people have the right to goods, services, facilities and premises. It is illegal for Disabled People to be discriminated against or harassed in accessing everyday goods and services in shops, cafes, banks and cinemas to name but a few. The same applies when renting land or property or when becoming a member of a private club of 25 or more members. The Equality Act also makes it illegal for an employer to discriminate against or harass a disabled person. Employers also have to make ‘reasonable’ adjustments to their premises and/or working practices to assist disabled people in their work.
The Community Care (Direct Payments) Act (1996) gave disabled people the legal right to receive payment of community care funds to purchase their own assistance. Disabled people can get Direct Payments if they are 16 or over and have been assessed by Social Services as needing a service. In agreement with the social worker assigned to the disabled person, Direct Payments can be used to purchase personal help with, for example, getting dressed, having a wash or eating meals. Payments can also be used for practical needs including help with shopping, collecting prescriptions or for assistance in preparing meals. Other purchases could be for assistance with transport needs, day time activities and help in the working environment. In addition, payments can be used to give ‘carers’ respite from their responsibilities.