Community care in London: the prospects.

Abstract:

:Elderly and disabled people have been led to expect great improvements in the quality of community care after April 1993. The choice to live safely at home is to be offered as an alternative to residential care. The financial and organisational relationships are all intended to support this in practice. The Tomlinson recommendations will create instability for providers, and much new and overdue investment in primary and community services is needed if the community care reforms are to work. There are, however, other obstacles looming which pose an even greater threat to the smooth transition after April 1993. The formula by which government money for implementation will be distributed discriminates against London. The sheer complexity of the organisational transformation has also been underestimated; the machinery of government both locally and centrally is ill equipped to maintain the precedence of the consumer. There are examples of good practice in London boroughs, but the dangers of Londoners ending up with the worst of all worlds are great.

journal_name

BMJ

authors

Jowell T

doi

10.1136/bmj.305.6866.1418

keywords:

subject

Has Abstract

pub_date

1992-12-05 00:00:00

pages

1418-20

issue

6866

eissn

0959-8138

issn

1756-1833

journal_volume

305

pub_type

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