community care(redirected from primary health care)
Also found in: Dictionary, Thesaurus, Medical, Legal, Acronyms, Wikipedia.
community carethe care ofindividuals within the community as an alternative to institutional or long-stay residential care. It has its origins in relation to mental illness and the critique of institutionalization in the 1950s which led, in 1963, to the publication of Health and Welfare: the Development of Community Care. Since then, the term has been applied to provision for other groups, such as children and older people. In the 1980s, ideas about community care were developed by governments as a means of providing support for a growing number of needy people. This trend was initiated in 1982 with the publication of Social Workers: Their Roles and Tasks, The Barclay Report. Of more significance was the Green Paper by Sir Roy Griffiths entitled Community Care: Agenda for Action, which led to a White Paper in 1989 called Caring for People: Community Care in the Next Decade and Beyond. In this White Paper, community care is defined as the means of providing: ‘the services and support which people who are affected by problems of ageing, mental illness, mental handicap or physical or sensory disability need to be able to live as independently as possible in their own homes, or in “homely” settings in the community’. The White Paper also recognized the need to give support to carers.
A further important dimension to the Griffiths Report and the White Paper was the philosophy that community care should be provided within the context of welfare pluralism; that is, that the WELFARE STATE and local authorities should not be the principle providers of care, rather, community care should be provided by a mixture of local authority, private and voluntary organizations. Although community care has been celebrated as a means of providing an alternative to institutional care (which is seen to lead to dependency), it has been criticized in a number of ways:
- its definition is unclear and commentators point to the difficulty in deciding whether community care is dichotomous with institutional care or whether they lie on a continuum of welfare provision;
- its lack of definition may mean that community care is little more than caring undertaken by relatives, friends and neighbours for little or no remuneration;
- feminist sociologists, in particular, have argued that community care is euphemistic for the work that women do in the family and in the community, and to promote community care is to reinforce the ideology of women performing the caring role in society;
- the sources of funding of community care are often unclear, and some critics have suggested that community care is a strategy for reducing the costs of welfare provision.
A number of empirical studies have demonstrated that most caring is undertaken by women, usually daughters and daughters-in-law. However, the number of male carers increased during the 1980s and some authors have speculated that the proportion of male carers might increase further as more women are encouraged to ‘return to the labour market’ to fill the shortage of labour predicted for the 21st century On the other hand, historical analyses of womens work demonstrate that women have often been expected to undertake paid work whilst also caring for others in the family A cynical observation about community care, therefore, is that it is a means of providing for the welfare of others at a minimum of government expense. However, community-care programmes in other countries, such as Sweden, have demonstrated that community care can be a very good means of enabling needy people to live with some independence in the community although the evidence from these schemes shows that effective community care can be more expensive than institutional care.