| Abstract: | Although the use of non-government organisations to provide assistance has long been part of Australian welfare history, the principles of community-based provision have only recently been adopted as part of the mainstream philosphy of service provision. This article examines the association between the expansion of community-based provision and the fragmentation of service provision using information drawn from a study of the provision of long-term care for a group of primarily elderly people through the Home and Community Care Program (HACC) and related provisions in a suburban community. The account focuses on the structure of formal service provisions, identifying organisational features which directly affect the operation of the system of local services, fragmenting the assistance made available. First, the organisations providing care are all of relatively recent origin and their operation continues to reflect many of the characteristics associated with their initial establishment. Second, the organisations involved are essentially hybrid bodies, being the product of both national/State programs and local initiatives. A number of tensions and conflicts arising from this characteristic are discussed. Third, service providing agencies tend to be highly specialised, with the consequence that the main division of labour is between, rather than within, organisations. Finally, the system of funding and administration has tended to orient agencies vertically, towards the source of funding, limiting their flexibility and capacity to develop horizontal patterns of cooperation with other services in the local area. Overall, the emergent system of services appears to be characterised by a large number of small organisations organised under a range of different auspice bodies, struggling to preserve their own autonomy and to operate within an insecure and continually changing policy environment. Recognising that reforms are likely, a number of broad alternatives to privatisation arc canvassed in the final section of the article. |
