Following the Second World War the government brought in legislation to
combat poverty and social inequality, by enacting the National Health Service
Act 1946, with the purpose of creating the National Health Service which would
provide free health care to all.
The National Assistance Act 1948 followed two years later, which contained
important rights to services for the ill, disabled and elderly. The aim of the
new legislation was to meet the care needs of vulnerable people, which could not
simply be met by accommodation. Community care services are supposed to meet
those needs, for example, the need for home help, equipment to help people with
disabilities to live independently, additional financial help with getting
around, counselling, supported residential accommodation etc.
The 1948 Act also provided for housing for the homeless and for financial
benefits for those on low or no income, although some of these rights have now
been provided for by later legislation, such as the Housing Acts.
In the 1970s and 1980s there were widespread closures of mental health
hospitals, and the Mental Health Act 1983 was brought in to provide for the care
and support of patients being discharged from hospital. Section 117 of that Act
allows for care and accommodation free of charge to certain patients following
their discharge from hospital.
Later legislation, such as the Chronically Sick and Disabled Persons Act 1970
and the National Health Service and Community Care Act 1990 also gave additional
rights to the disabled and people with care needs. Importantly, both of those
Acts gave vulnerable people the right to an assessment of their needs, with the
idea that once a full assessment had taken place, it would be possible to plan
how those needs would be met.
The provisions for Community Care rights and services are now contained in
numerous sources: Acts of Parliament, secondary legislation, caselaw, decisions
of the Local Government and Health Services Ombudsman, Directions, Guidance and
policy documents. In the recent case of Grogan, the Court of Appeal
criticised the National Health Service for vague and misleading guidance, which
is confusing not only to members of the public, but also to those assessing the
care needs of the vulnerable. New guidance and criteria for access to Community
Care services has finally been published by the Department of Health, which has
created some transparency about how decisions are made. This is called the NHS
Continuing Care Framework.