The social and economic impacts of immigration detention facilities: a South Australian case study

The negative attitudes fostered by political rhetoric against asylum seekers create significant problems when asylum seekers are housed within communities. Much of the community's opposition focuses on the perceived economic and social impacts of large numbers of asylum seekers. However, we currently lack research on the local economic and social impacts of asylum seekers. As a contribution to this evidence base our paper outlines a South Australian case study of the impact of a low security immigration detention facility on the local economy, health services and social cohesion. Our impact assessment found that community concerns were not borne out. There were increases in employment and local expenditure, no reduction in health care services or access, and tensions between residents subsided, as did initially strong reactions against the asylum seekers themselves. The minimal impacts were due to the government and community interventions such as seeking local contracts and providing onsite health services. This case study is used to provide some guidelines for other communities to effectively target the fears that matter most to the community – either through disseminating information that reduces fears and myths, or through planning and interventions that minimise negative impacts and enhance positive benefits. In this way, the arrival of asylum seekers can potentially become one that benefits all community members.     

Users as Citizens: Collective Action and the Local Governance of Welfare

Self-organization amongst users of community care services preceded the consumerist developments of the 1980s and early 1990s, but can be considered to have been "legitimized" by top-down objectives relating to "user involvement". Nevertheless, the objectives and value bases of disabled people's organizations and organizations of users (or survivors) of mental health services have not always been consistent with those of consumerism, and user groups have experienced tensions in determining the extent to which they should respond to official agendas. Drawing on theories of new social movements and of citizenship, this paper considers the developing place of user organizations within systems of local governance. It looks at the way in which groups have sought to assert the legitimacy both of experiential knowledge and of their position as citizens in the face of official responses which have constructed them as self-interested pressure groups. It draws on empirical research investigating local groups of disabled people and of mental health service users conducted in the first part of the 1990s. It discusses the significance of shared identity as a basis for collective action alongside more pragmatic motivations to influence the nature of health and social care services. In the context of appeals to "community" and "partnership" which are starting to replace the discourse of markets and contracts as the key metaphor for both policy-making and service delivery, the article considers likely future roles for groups comprising people often excluded from community.     

Linguistic services and parental involvement among Latinos: A help or hindrance to involvement?

Despite being one of the most consistent predictors of achievement among youth, parental involvement among Latinos continues to be low. In an attempt to increase involvement among Latinos, schools have implemented programs that provide linguistic services for parents who face language and cultural barriers. In order to understand the effectiveness of these programs, a subset of data are used from the National Survey of Latinos: Education to examine the relationship between four linguistic services and parental involvement. Results demonstrate linguistic services play only a marginal role in parental involvement among Latinos, and in some instances, even decrease involvement. Consequently, there is minimal support for programs that provide linguistic services to Latino parents in schools, suggesting policymakers should revisit the impact these services have on the Latino parent community.     

The Local Church as Support for the Elderly

Based on secondary analysis, interviews and participant observation in one case-study community, this study describes the emergency and on-going services provided by local parish churches around issues of loneliness, crisis readjustment, home health care, and emergency needs. The concept of a church as a surrogate family for older people is also discussed. Direct quotes, taken from the interviews, are used for the purpose of illustration.     

Creating elder-friendly communities: preparations for an aging society

Because many communities where older people live were not designed for their needs, older residents may require support to remain in the least restrictive environment. "Age-prepared communities" utilize community planning and advocacy to foster aging in place. "Elder-friendly communities" are places that actively involve, value, and support older adults, both active and frail, with infrastructure and services that effectively accommodate their changing needs. This paper presents an analysis of the literature and results of a Delphi study identifying the most important characteristics of an elder-friendly community: accessible and affordable transportation, housing, health care, safety, and community involvement opportunities. We also highlight innovative programs and identify how social workers can be instrumental in developing elder-friendly communities.     

‘Creating NHS Local’: The Relationship between English Local Government and the National Health Service

Following recent reforms of both local government and the National Health Service, there is significant emphasis in both services on improving inter‐agency collaboration, user involvement and strategic commissioning. In response, this article reviews historical debates about the relationship between local government and health care, before arguing that these two ‘partners’ need each other now more than ever. If local government is to be a ‘place‐shaper’, then it needs significant influence over local health services, while the NHS needs to learn from the best of local government if it is to gain sufficient local legitimacy to take the difficult decisions it needs to take. Against this background, the article reviews different options for future joint working, exploring various options for enacting a new relationship between local government and the NHS.     

Learning Lessons from the Past or Re-Visiting Old Mistakes: Social Work and Community Development in Northern Ireland

Correspondence to Dr Deirdre Heenan, School of Policy Studies, University of Ulster, Magee Campus, Londonderry BT48 7JL, UK. E-mail: DA.Heenan{at}ulster.ac.uk Summary In recent years there has been a re-emphasis on community developmentapproaches in health and social work in Northern Ireland. Underpinningthese approaches is the belief that local communities can beorganized to address health and social needs and to work withgovernment agencies, voluntary bodies and local authoritiesin delivering services and local solutions to problems. Thesemethods of working challenge the traditional social work focuson individual and family casework interventions. Governmentin Northern Ireland has stressed that community developmentshould no longer simply be an afterthought in key aspects ofHealth and Social Services, but should instead be at the coreof their work. It is now officially recognized that communitydevelopment has the potential to make a significant impact ona broad spectrum of policies and programmes, which are deliveredthrough agencies in both the statutory and voluntary sectors.This commitment to community development has been outlined ina number of key documents and reports. This paper assesses therelationship between social work and community development inNorthern Ireland. The first section looks briefly at the historyof community development and social work and then sets out thecontext in which this move towards the promotion of a communitysocial work approach is occurring. Against this backdrop, acase study of a Family Support Team, which provides a rangeof services in a community setting, is used to illustrate howthe strategy has already been adopted and the lessons of thisexperience are explored and discussed. It is concluded thatwhile this approach has a lot to offer it is not without itsdifficulties. Far from being a new philosophy, community developmentis being reinvented and reapplied. It is therefore crucial thatold mistakes are not revisited and old prejudices rekindled.It is hoped that this article will provide a useful contributionto the current important and necessary debate.     

Public Participation in the New NHS: No Closer to Citizen Control?

Over the last decade support for increasing public participation in decisions regarding the planning and delivery of health services has become a familiar feature of the policy agenda for the UK National Health Service. This paper reviews current Labour policy towards public participation and reports on the response of primary care groups (PCGs) to recent Labour directives to make patient and public involvement an integral part of the way they work, presenting the findings of a survey conducted in one English health region. The experience of these PCGs suggests that, despite the diverse backgrounds of board members, there is marked consensus between local and central decision makers as to their understanding of public participation. Whilst academic debates have tended to conceptualize participation in dualist terms as a form of consumerism or of citizenship, the survey data suggest that in the context of local implementation public participation is framed within a new public management perspective which values it as an aid to organizational learning. The findings of this study highlight obstacles to securing effective public participation, including a lack of substantive guidance regarding policy implementation that produces uncertainty amongst local decision makers as to how best to proceed. The inherent limitations of public participation within the new public management paradigm suggest that democratic renewal, one of the goals of the government's modernization agenda, is unlikely to be achieved.     

Rwanda's Health System and Sickness Insurance Schemes

After the war and the 1994 genocide, Rwanda drew up a national health policy with a view to realigning its health system. The reform, which was designed to remedy the deficiencies of the previous system, focused on community involvement in managing and financing health services. Achieving this objective was never going to be easy, but thanks to a growing number of initiatives 37.8 per cent of the Rwandan population now have some degree of sickness insurance cover. However, the system in general, and more particularly the mutual associations organized around the community, needs to be strengthened.     

The role of "Theatre for Development" in mobilising rural communities for primary health care: the case of Liwonde PHC Unit in southern Malawi

The improved health conditions that are essential for development may depend more upon the self-help motivation of local people than upon the provision of Western-style health facilities. Such motivation can be created by the culturally-appropriate dissemination of health education at the community level. This article describes an effective health improvement strategy implemented in three villages in southern Malawi during the late 1980s. After an introduction, the paper presents an overview of current strategies used in Malawi for the dissemination of primary health care information and notes that these strategies have failed to reach the rural population. Next, the paper describes the health status of two of the villages, Mbela and Mwima, before the introduction of the Liwonde Agricultural Development Division Primary Health Care Program. None of the three village involved had access to modern health care facilities. This program involved the joint efforts of the community, a primary health care team, and the Chancellor College Theatre for Development. The paper continues by presenting a conceptual model of the process. Community involvement was assured by the election of the members of village health committees and the delivery of health training to two members of each committee. The Theatre for Development used interactive dramatic techniques and participatory research activities in Mwima and Mbela to help the communities assess their health needs and possible solutions in conjunction with the introduction of primary health care activities. The article also contrasts the Theatre for Development technique with the focus group approach and notes that the latter may not be successful in motivating self-help efforts. Finally, the relative success of the Theatre for Development methodology used in the two villages is described by comparing health indicators with those before the intervention and with those in the third village where this approach was not used in conjunction with introduction of primary health care services.     

Assessment of a Brief CES-D Measure for Depression in Homebound Medically Ill Older Adults

Black elderly individuals represent one of the most disadvantaged groups in the United States in terms of income levels, health problems, and access to supportive services. This paper describes four major factors to be considered by social service providers to focus their programs toward needs of the black elderly population in their local communities. A research project designed to examine the social service needs and service utilization of the black elderly in a Midwestern community indicated that the following factons hould be considered if effective service programs are to be implemented: (1) Negotiation Initiative, (2) Responsible Research, (3) Symbolism, (4) Modeling.     

Facing Up to Underfunding: Equity and Retrenchment in Community Care

Local social services departments in the UK are expected to distribute their cash-limited budgets for community care in ways that achieve an equitable allocation of resources in situations where, with present levels of funding, they cannot meet all the needs with which they are presented. This paper discusses a case study of the introduction of a "needs-based" formula to allocate a local authority's budget for home care services and a follow-up survey to investigate whether services reached the people intended to benefit. The article argues that the "gatekeeping" role of community care assessments is important to safeguard equity without the inflexibility of highly standardized tests of eligibility. However, with the new Labour government seeking to reduce dependency on public expenditure, and a growing lobby for national standards of social care, it will be increasingly important that local authorities justifiy their different practices with evidence about how they relate to local needs.     

Linking Community Initiatives to National Institutions: Ghana

The ILO has developed an innovative concept of global solidarity for social security — the Global Social Trust — which supports the development of national social protection systems through international financing. The concept is ready to be tested nationally and the present paper proposes a pilot project for Ghana. The paper considers the virtues and weaknesses of developing-country social security healthcare systems and community-based voluntary insurance schemes, their lack of informal sector coverage on the one hand and their financial disequilibria on the other. It outlines the socio-economic and macro-policy context of Ghana and the current health policy environment. It argues for a fusion of the social health insurance and mutual health organization concepts in Ghana, thus linking community initiatives to national institutions, enhancing coverage and the quality of services for all. The paper outlines a basic model that could apply to Ghana, its organizational structure, practical functioning, financing arrangements and expected outputs. In particular it seeks to develop a model for the cross-subsidization of insurance premiums for the poor. It describes a concept that would combine local ownership initiatives with national responsibility and financing, arguing for a truly interrelated network of social protection. The authors welcome feedback and comments from the wider social security audience.     

GPs and Contracts: Bringing General Practice into Primary Care

This paper argues that the terms on which GPs entered the NHS, as self-employed contractors, have proved remarkably resistant to the managerial pressures which have come to dominate other sections of the National Health Service. However, this traditional mode of financing and organizing the delivery of a key element of the National Health Service has become increasingly incompatible with wider health policy objectives—the development of an integrated network of good-quality, equitable and well-coordinated primary and community health services which are responsive to local needs. Furthermore, primary health services have themselves come to play a crucially important role in securing other strategic changes in the wider health policy arena, such as securing and sustaining a shift in the traditional balance between hospital and community-based health services and controlling expenditure in a needs-led service. The paper argues that, notwithstanding the change of government, the 1997 NHS (Primary Care) Act and the White Paper "The New NHS" are both integral to the achievement of wider strategic health policy objectives, such as improving the quality and coherence of services, and increasing professional accountability for the financial consequences of clinical decisions. However, the greatest significance of these and other related measures is that they shift the emphasis of health policy from commissioning and purchasing by primary care to commissioning and contracting for primary care. They thereby extend the exposure of GP-based services to managerialist scrutiny and control.     

Practice Evaluation of Community Initiatives for Social Service Delivery in a Deprived Neighborhood in Scotland

ABSTRACT

Improving social service in local communities is a complex undertaking. Over the past few decades, the performance and sustainability of community initiatives have been questioned, while such factors as a lack of funding, insufficient community involvement, unsatisfactory community service, and lack of awareness of the impact of community initiatives have restricted community development. From a case study of community operations in Scotland, this article provides insights into how social service delivery is organized in the absence of public capital. This study utilized data from semi-structured in-depth interviews with a sample of 76 participants from a deprived area in Scotland, including community management team members (n = 6), local residents (n = 52) and community partners (n = 18). The findings illustrated how participants of all ages, local organizations, policy makers, funders and media came together to create a cohesive and responsive community environment. Residents' needs and funders' demands were identified. Results further revealed that a Community Partnership Mechanism helped strengthen the social service network and create flexible social services. Service benefits included improved resident wellbeing in the context of less government intervention. Future implications include suggestions for government and other stakeholders involved in community reform to focus on service recipient skill building and tracking changes between the indicators and service provision.     

Children living with parental substance misuse: A cross‐sectional profile of children and families referred to children's social care

Parental substance misuse is a significant public health and children's rights issue. In the United Kingdom, social workers frequently work with children and families affected by substance misuse. However, relatively little is known about this population, particularly at point of referral to children's social care. This paper reports on the largest known study of parental substance misuse as a feature of children's social care work in England. The paper provides a cross‐sectional profile of 299 children living with parental substance misuse and referred to children's social care in one local authority in England. Data were collected from social work case files at the point of referral to social care about the child, family, the wider environment, and parental substance misuse. The findings show that children affected by parental substance misuse frequently had other support needs relating to their well‐being and mental health. Children were also likely to be experiencing other parental and environmental risk factors. The significant historical—and in some cases intergenerational—social care involvement for some families indicates potential issues with the capacity of services to meet needs. Recommendations for practice are discussed with a particular focus on the need for early, comprehensive support for children and families.     

Patronage and Participation, Problem and Paradox: a Case Study in Community Work

Summary This paper describes the emergence and development of a neighbourhood-basedself-help organization. For over three years it has been staffedby self-styled community workers. For the first two years theworkers were mostly ex-students who hoped that this organizationcould be a means of effecting radical forms of social change.They have been succeeded by local people whose main purposeis to provide a social service. This transition produced disagreementbetween the different community workers. But it is a trend whichshould confound any stereotype ideas about community workersas always out of sympathy with all aspects of the establishment. The organization has moved from concern with one issue to providingvarious community services. It has passed through stages ofdevelopment characterized by the liabilities of newness, byattempts to' plan and consolidate and by efforts to resist becomingan established organization. The latter stages also became liabilitiesof 'success'. A central problem in this community work enterprise is the relationshipbetween participation and patronage. This refers to the problemof how to elicit and maintain local interest and support andthe paradox, that although outside help may be one way of ensuringthat local groups survive, it may also limit local people'sinvolvement and influence their goals. Dependence on patronsand a reluctance to organize local participation affected theorganization's development: patrons provided various resourcesbut were possibly a disincentive to the development of localinitiatives. The nature of free participation resulted in anunintended drift towards more conventional forms of social service,albeit in an unconventional setting     

The role of the voluntary,community and social enterprise sector in Early Help: Critical reflections from embedded social care research

The independent review of children's social care (2022) has proposed a radical reset of England's children's services, shifting a remote, assessment heavy system towards one that works alongside communities to help prevent statutory interventions. However, notions around the harnessing of community resources to deliver Early Help are often underpinned by assumptions regarding the voluntary, community and social enterprise (VCSE) sector and the ease with which such organizations can be integrated into preventative strategies. This paper reports findings from embedded research within a unitary authority in Southwest England during remodelling of its Early Help service to work more collaboratively with local VCSE organizations. The study generated data from ethnographic observations, semi-structured interviews and focus groups with 95 participants, including local parents, service providers, VCSE organizations and Council leaders. The findings illustrate that families value the compassionate, responsive and flexible support available within many VCSE settings. However, differences in practice cultures, regulatory pressures on statutory providers, the need to (re)build trust in communities and sensitivities around power-sharing and resourcing meant negotiating VCSE sector integration was fraught with complexities. Few studies have gained such privileged access to a Local Authority's remodelling of Early Help services, and this paper has significant insights for the debates surrounding the independent review of children's social care (2022) and its recommendation to bring services ‘closer to communities’.     

Behind the Rhetoric of Community Development: How is it perceived and practiced?

State and local governments in Western Australia increasingly identify ‘community development’ as a key approach for the delivery of community services. In this paper I explore how the concept of community development is understood and practiced by workers in the context of government community services. While definitions are most often presented as a universally understood approach, my key argument is, that there are instead, community development ‘discourses’ that are variously applied to diverse situations. Foucauldian notions of discourse and power are used to propose that, while there may be core and recognisable traits found within the language of community development, in any given situation these combine with a number of variables (most notably stemming from the organization responsible for community services) to form a ‘situated’ community development ‘discourse’.     

To be or to be trained to be: On emerging and diverging ideological traditions in organizing day care activities for people with severe mental disorders in Sweden

Organized activities for people with severe mental disorders have until recently been the societal task of one human service organization, the medical speciality of psychiatry. With former psychiatric impatients moving out into the local community and with heavier dependence on outpatient polyclinic care, the situation is slowly changing. Day care activities for people with severe mental disorder are organized with an increasing involvement of the social services. The aim of this article is, using data from a national survey carried out in 1991 in Sweden, to describe and categorize how day care units interpret their task. Results show that claims-making activities still adhere largely to a therapeutic paradigm in spite of the outspoken social character of the work of organizing everyday life activities.