A Background to Community Care
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 are currently being developed by the government and the National Health Service but the consultation process is still ongoing.
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