"Bridging the Gap": New Relationships between Primary Care Groups and Local Authorities

Current policy places great emphasis on the development of "partnerships", particularly between NHS and local authority services, with the aims of increasing service coordination and delivery and improving health. To this end, primary care groups (PCGs), at the forefront of NHS organizational developments, are required to include a social services representative on their governing boards; similarly, primary care trusts (PCTs) have a social services representative on their executive committees. Drawing on a representative longitudinal national survey of English PCGs, the paper evaluates the contribution of these new governance arrangements to the development of inter-agency partnerships. Despite poor histories of collaboration and some major organizational barriers, there are some signs of progress, with social services representatives playing an active part in PCG affairs and having clear lines of communication about PCG matters with their employing authorities. Equally significantly, PCGs have also quickly established a wide range of contacts directly with other local authority services and departments. However, these early gains risk being limited by traditional professional inequalities between social work and medicine and, in particular, by the prospect of further organizational upheaval as PCGs merge with each other and/or acquire trust status.     

The End of the World Designed with Men in Mind

According to Derrida, the European self-understanding marking the name “Man” is governed by eschatology and teleology. Man is that being on its way towards its proper end. The times of science seemed to Kant and others to be evidence of just such progress. For Freud, by contrast, the great scientific achievements of Copernicus, Darwin and Freud have cumulatively contributed a series of de-centring blows to our “self-love”. This paper explores the nature of great scientific achievements, and raises the possibility of a further devastating blow to Man, this time in the twentieth century, and connected to the name of Marx.     

Increasing Choice and Control for Older and Disabled People: A Critical Review of New Developments in England

This paper critically examines new policies currently being implemented in England aimed at increasing the choice and control that disabled and older people can exercise over the social care support and services they receive. The development of these policies, and their elaboration in three policy documents published during 2005, are summarized. The paper then discusses two issues underpinning these proposals: the role of quasi‐markets within publicly funded social care services; and the political and policy discourses of consumerism and choice within the welfare state. Despite powerful critiques of welfare consumerism, the paper argues that there are nevertheless very important reasons for taking choice seriously when considering how best to organize and deliver support and other services for disabled and older people. A policy discourse on consumerism, however, combined with the use of market mechanisms for implementing this, may be highly problematic as the means of creating opportunities for increased choice and, on its own, risks introducing new forms of disadvantage and social exclusion.     

Researching Children: Methods and Ethics

The appropriateness and desirability of researching children have been issues of some debate. Children may be perceived as non-competent or vulnerable, and proxies have been used as children's representatives. Increasingly researchers are speaking to children directly. Why is this so and what are the methodological and ethical implications of researching children's views? In this paper the authors draw on their own experiences of researching children in the fields of child carers and the impact of the Child Support Act 1991. A number of social, political and legal trends are identified which form a background to the growing interest in children as potential and actual participants in the research process. The theoretical, methodological, ethical and practical issues involved are then identified and described, using examples from two separate studies conducted by the authors.     

Dependency and interdependency: the incomes of informal carers and the impact of social security

Consideration of the income and social security needs of informal carers has remained conspicuously absent from discussions about 'community care'. Similarly, carers have been more or less invisible in the development of social security policies. This paper reports on a study of the financial circumstances of a sample of working age carers, who were living with and providing substantial amounts of help and support to a disabled person in the same household. The study highlights first, the substantial work-related costs incurred by carers with full time employment; and second the financial dependency of carers without full time earnings, on their spouse, sibling or on the person being cared for. The implications of these findings are discussed in the light of recent developments in social security policies.     

Model selection for infinite variance time series

In this we consider the problem of model selection for infinite variance time series. We introduce a group of model selection critera based on a general loss function Ψ. This family includes various generalizations of predictive least square and AIC Parameter estimation is carried out using Ψ. We use two loss functions commonly used in robust estimation and show that certain criteria out perform the conventional approach based on least squares or Yule-Walker estima­tion for heavy tailed innovations. Our conclusions are based on a comprehensive study of the performance of competing criteria for a wide selection of AR(2) models. We also consider the performance of these techniques when the ‘true’ model is not contained in the family of candidate models.     

When was secularization? Dating the decline of the British churches and locating its cause1

Dating the decline of Christianity in Britain has a vital bearing on its explanation. Recent work by social historians has challenged the sociological view that secularization is due to long‐term diffuse social processes by asserting that the churches remained stable and popular until the late 1950s and that the causes of decline lie in the social and cultural changes associated with the 1960s. We challenge this interpretation of the evidence. We also note that much of the decline of the churches is explained not by adult defection but by a failure to keep children in the faith. Given the importance of parental homogamy for the successful transmission of religious identity, the causes of decline in one generation may well lie in the experiences of the previous generation. We focus on the disruptive effects of the 1939–45 war on family formation and use survey data to argue for a staged model of decline that is compatible with the conventional gradual view of secularization.     

Choice: what,when and why? Exploring the importance of choice to disabled people

Extending choice and control over public services is central to current policies in England. Such policies have immense potential for independence and well‐being. However, it is still not clear how disabled people conceptualise choices, what choices are important, for which groups of people, in what areas of life and why. This paper presents findings from the first phase of a longitudinal qualitative study of choice and control over the life‐course. Semi‐structured interviews were carried out with 111 participants including disabled young people with progressive conditions; their parents; adults and older people with fluctuating support needs and those experiencing sudden deterioration in health. The findings suggest that while most people across all study groups wanted to be able to make choices in all areas of their lives, there are significant differences in the importance they attach to specific choices. The findings have implications for service reforms and identify some policy and practice issues that need to be addressed.     

Principles and practice of social security payments for care

This article examines the dimensions which determine whether national social security systems make payments towards the costs of long-term care needs and whether they do so where these needs are met within the family; what kinds of payments are made and to whom; and what levels these payments are set at. The article is based on empirical material from five European Union countries (the United Kingdom, Ireland, France, Italy and Germany). We argue that differences between countries along three dimensions account for most of the diversity between national systems in this field. These dimensions are the allocation of responsibilities and powers to local versus central levels of government; assumptions of to whom long-term care represents a "risk"; national principles of subsidiarity and the relationship between the family and the State. This is, however, a field undergoing change (albeit mostly incrementalist and ad hoc) in the face of the demands placed on social welfare systems by growing levels of disability (related to the growth of elderly populations) and demands from women's movements and disability movements for recognition of their needs within social welfare systems.     

Representing the Views of Disabled People in Community Care Planning

The 1990 NHS and Community Care Act requires social services departments in Britain to involve representatives of service users in the preparation of their annual community care plans. This paper gives a critical account of the different ways in which the views of disabled people are sought and represented in community care planning; and of the organisational and practical barriers which disabled people and their organisations are likely to encounter in representing their views to service planners. People with learning disabilities, older disabled people, people with sensory impairments and disabled people from Black and ethnic minority communities are particularly likely to be excluded from current consultation procedures. The paper concludes that present methods of representation place considerable burdens on both individual disabled people and on their organisations. Consequently, disabled people may increasingly question the effectiveness and usefulness of their involvement in community care planning, in the light of the many other issues which are important to them.