NHS and Community Care Act | Critiques

NHS and Community Care Act | Critiques Community Care is really care by families which is really care by women; and it always will be! Discuss Introduction When Margaret Thatcher came to power in the late 1970s one of her Government’s primary aims was to roll back the welfare state and cut spending on services. They argued that state services, and the health service in particular, were inefficient and costly. They further maintained that the introduction of market principles into welfare provision would increase efficiency, provide better services, and reduce costs. The Conservatives were anti-institutionalisation and began closing geriatric wards and psychiatric hospitals. The 1982 Government White Paper Growing Older emphasised the role of the family and that the role of Government was to enable, rather than replace that care. There was an implicit assumption here that much of this care would be provided by women. Twigg (1993) maintains that the 1988 Griffith Report which advised on more effective use of Government funds for community care also recognised that public services would only have a role where community and family su pport had broken down. Large numbers of the elderly and the disabled have always been cared for in the community, the state took over where this became a burden and the Tories were keen to discourage too much state provision. In 1990 the NHS and Community Care Act was introduced where the state was no longer the sole provider of care. Community care is the term used for both social and health care. Voluntary and Charitable organisations would also play a part and care packages would be organised by local authorities. This might include provision of services in a person’s home, residential care, respite care, day care and family placements, sheltered housing and group homes and hostels. This Act placed a much greater burden of care on those professions associated with healthcare e.g. social work, and at the same time resulted in further inequalities as care provision differed depending on what region of the country a person was in. It was argued that this kind of care would al low individuals to live with dignity and independence in their own communities. This paper therefore, aims to assess the statement that Community Care is really care by families which is really care by women and it always will be. Under the terms of the 1990 Act, responsibility for care in the community became the responsibility of local authority social services. Each authority has a duty to publish its care plans and has a duty to assess all those people who might need care. It is the authority’s responsibility to provide care and to promote the work of voluntary and charitable organisations by purchasing care from them. Local authorities are also bound to establish a complaints procedure and have the responsibility of checking out care packages.[1] There have been a number of problems with the terms of the Act. Since 1993 the number of old people need support has continued to grow while NHS short and long term care has continued to shrink (Filinson, 1997). At the same time it is actually cheaper for social services departments to keep a person in residential care than to support them in their own home. New policies such as the Carers Representations and Services Act 1995 and the introduction of Direc t payments which were intended to empower users and give them greater choice have been implemented without all the additional resources. Thus demands for service have increased while budgets have remained much the same. While there has been a lot of rhetoric about the needs of pensioners the focus has, necessarily been on the user, and carers needs are largely ignored. Unell (1996) points out that changes in community care: †¦simultaneously raised the profile of carers and made their needs more difficult to meet in the short term (Unell, 1996:9). Community Care and Familial Obligation Since the 1970s there has been an increasing emphasis on care in the community and care within the family. This does not always work well and the greatest burden usually falls on those families with the least resources. Familial obligation is defined in law. In the UK it usually refers to the nuclear family of husband and wife, parents and children and benefits and taxes almost always recognise these relationships (Millar and Warman, 1996). The provision of services are intended to support, rather than take the place of the care and support that is expected of the family. Although Britain and most other European countries give some recognition to gender equality much policy making stems from post-war understandings within the welfare state, of the male breadwinner and the female housewife/carer. Community care and familial obligation are based on these hidden gendered assumptions. In Britain these obligations only extend downwards i.e. parental obligation to their children. In some c ountries adult children have familial obligation to their parents but this is not the case in the UK (Millar and Warman, 1996). In spite of this the decreasing number of acute hospital beds means that there are more older people with chronic conditions in the community. They receive care from the local authority in their own homes but in many instances they rely heavily on informal carers, usually members of the family. Informal care involves a number of different activities and relationships and has been explained in the following way. Informal care: †¦normally takes place in the context of family or marital relationships and is provided on an unpaid basis that draws on feelings of love, obligation and duty (Twigg, 1993:2). Thus, this kind of care normally occurs within the family and Kirk (1998) states that data from the General Household Survey tends to suggest that the bulk of this kind of care is undertaken by women. Phillips and Bernard (1995) maintain that the kind of caring that many women give are the difficult tasks of physical and personal care. These carers may also have contact with a range of other community services and district nurses who might be involved in the caring process. The meaning of community care changes over time and during the 1970s and 1980s policy in this area brought changes to services for people with disabilities, people with learning disabilities, and people suffering from the frailties of old age (Kirk, 1998). Cost concerns meant that many institutions were closed and care was focussed on the community. Lewis and Glennerster (1996) maintain that during the 1990a community care was a policy shift to aid spending cuts. There was a change from residential care for older people to care in the community. How successful the shift from residential care to care at home has been is, Wistoe (1995) maintains still unclear. In the 1990s health policies in the UK have focussed on primary care, this has come about because of cost concerns, demographic shifts and changing patterns of illness. Many services that were provided in hospitals are now operating in the primary sector. This has resulted in complex nursing care being undertaken in a domicilary context. Which shifts the burden of care to informal carers, usually female family members with the help of district nurses. In some cases informal carers and the person themselves undertake some tasks such as intravenous injections (Conway, 1996). Costain and Warner (1992) maintain that if this continues then more dependent people with complex, intensive needs will be cared for at home thus increasing the burden on the family and on community care services. Manthorpe (1994) points out that informal carers are gi ven little choice over their caring role and there is little respite as they are not often presented with an acceptable alternative. There has been little research into how this kind of caregiving affects family members although feminists (Abbott and Wallace, 1997) have expressed concern over the hidden assumptions underlying the concept of community care. The Feminist Critique of Community Care Feminists have focused on the informal caring that women do and which is often ignored by the professionals. Caring for an ageing or disabled relative for twenty four hours a day is bound to have an effect on women and yet there is little available help for respite.. Furthermore, the Community Care Act of 1990 has imposed further responsibilities on women in the role of informal carers (Abbott and Wallace, 1997). Based on the gender roles that existed in the welfare state, the discourses of health take it for granted that when members of their family are sick a woman will care for them. It assumes that women will put the needs of their children before their own. Health care is defined as care that is given by doctors, nurses, and other health professionals and the caring that women do in the home is recognised only as a part of the role that a woman plays in the home. Not only is her caring role invisible but the impact of shouldering the burden of caring is also ignored (Graham, 199 3). The Office for National Statistics reports that in 1995 there were three times the number of female informal carers to male carers. Watson et al (1999) maintain women, who are the primary care givers in the family actually negate the view that the responsibility of care should primarily be in institutional structures. This is because as wives and mothers, even if they are employed full time, they still give care to other family members. Walby (1990) contends that women have been oppressed because of their biology and this is evident in the healthcare system. However, patriarchal control of women operates through an inter-related set of structures and practices through which women are oppressed by men, the state is patriarchal in its policies and practices and its interests are biased towards men. Thus it is not surprising that implicit in discourses of care in the community is the view that women will shoulder the burden of care. Abbott and Wallace state that: While it is rarely given official recognition, and the tendency is to see paid health workers as the primary providers of health care, women provide most health care, within the confines of the family (Abbott and Wallace, 1997:170). Conclusion Care in the community is care in the home and feminists are right to suggest that this largely means care by women. The gendered nature of care giving needs to be re-examined if policy continues to shift the greater burden of care to the community. While there are such things as carer’s allowances these are very low and means tested, therefore many people do not claim them. There seems to be a stigma attached to the idea that people should claim allowances for long term care within the family. Perhaps a better option, once a person was assessed as needing long term community care would be an automatic payment for informal carers. It might also be useful if Government debate on care in the community lauded the work undertaken by informal carers and promoted a positive image of care within the family. Those families where men are the informal carers could, perhaps, be promoted as positive models for other men to follow. This might not only bring a shift in the implicit assumptio n that women will do the caring, but might give a broader and less stigmatised view of caring within the family. Assessment packages for long term informal carers should have regular respite care built into them so that carers get a regular break. Free community nursing care and domicilary care should be provided so that informal carers can go on holiday without having to worry about what was happening at home. Government may be keen to establish policies that shift even more care into the community but should also recognise that truly cost effective care takes account of all eventualities. At present it seems as though the notion that problems may arise in informal care settings is ignored, so that when these problems do occur it actually costs more to rectify than if an allowance for such eventualities was made in the first place. Too much strain is placed on many women because of the expectation that they will be informal carers, community care, it would seem needs much more care ful planning than is presently the case. References Abbott and Wallace, 1997 An Introduction to Sociology: Feminist Perspectives. London, Routledge Conway A.1996 Home intravenous therapy for bronchiectasis patients. Nursing Times 92(45), 34 35 Costain D. Warner M.1992From Hospital to Home Care: The Potential for Acute Service Provision in the Home. Kings Fund Centre, London Filinson, R. (1997) ‘Legislating community care: the British experience, with U.S. comparisons’, The Gerontologist, 37,3: 333-140. Giddens, 2001. 4th ed. Sociology. Cambridge, Polity Press Graham, H. 1993 Hardship and Health in Women’s Lives Hemel Hempstead, Harvester Griffiths, R. (1988) Community Care: An Agenda for Action. A Report to the Secretary of State for Social Services, London: HMSO. Kirk, S. 1998 â€Å"Trends in community care and patient participation: Implications for the roles of informal carers and community nurses in the United Kingdom† Journal of Advanced Nursing Vol 28 August 1998 Issue 2 p.370 Lewis J. Glennerster H.1996Implementing the New Community Care. Open University Press, Milton Keynes. Manthorpe J.1994 The family and informal care. In Implementing Community Care (Malin N. ed.), Open University Press, Milton Keynes Millar, J. and Warman A. 1996 Family Obligations in Europe Family Policies Centre in association with Joseph Rowntree Foundation Moore, S. Scourfield, P. Sinclair, S. Burch, S. and Wendon, B. 3rd ed. 2002 Social Welfare Alive Cheltenham, Nelson Thornes. Phillips J. Bernard M.1995 Perspectives on caring. In Working Carers (Phillips J. ed.), Avebury, Aldershot. Twigg, J. (1993) ‘Integrating carers in to the service system: six strategic responses’, Ageing and Society, 13: 141-170. Unell, J. (1996) The Carers Impact Experiment, London: King’s Fund Publishing. . Walby,S. 1990. Theorising Patriarchy. Blackwell, Oxford. Walsh, I ed. 2000 Sociology: Making Sense of Society. Edinburgh, Prentice Hall. 1 [1] http://www.infosci.org/MS-UK-MSSoc/pubcca.html

Interpretive Essay on Edward Taylors Poem, Huswifery -- Edward Taylor

Interpretive Essay on Edward Taylor's Poem, Huswifery In the poem, Huswifery, by Edward Taylor, a very severe shift seems to take place. The poem begins with an analogy between the writer and a spinning wheel. However, at the end of the poem suddenly he is no longer the spinning wheel, he is now a man wearing the cloth that was spun by the spinning wheel. How could the main analogy of the poem shift so drastically? Actually, upon closer inspection, the shift does not seem so bizarre. The main idea of the poem is followed through from beginning to end. It is the story of a man who is truly devoted to the Lord and how his relationship with the Lord evolves from the point where he is seeking God in his life to the point where he has found him and become a changed man. As the man changes, the analogy within the poem must naturally evolve to keep up with his changes. In the first line, Edward Taylor asks that God be the master spinner behind his spinning wheel self which indicates his desire for the Lord to take control of his life and to use that life to create what He will. He then expounds upon this idea by incorporating many of the parts of a spinning wheel into the analogy. Taylor asks that all that he believes come from the Holy Word (his distaff) and that all that he longs for be kept in line with the Lord's wishes by His "swift flyers". He wants his conversation to spring forth from that which the Lord is creating in him, just as the thread, once spun, does not change in nature as it is wound around the reel. Essentially, in this stanza, he is saying: Lord, take me and mold my heart for I am Yours. The second stanza starts off saying much the same thing. It expands upon the idea of wanting the Lord to mold his heart an... ...to others and bringing others to devote their lives to God as well. And so, in the third stanza the spinning wheel is completely dropped out of the poem which makes sense, for once a machine's work is complete, there is no longer a need for that machine. In essence, he's saying that his life was just a machine for serving and creating hearts devoted to God. Now that this purpose is complete, it is time for him to pass on. But he asks one thing of the Lord. Though his earthly body and life may pass away, he wishes for his eternal soul, for all that truly makes up who he is to be clothed with the virtues the Lord has instilled in him. This is so that his "apparel shall display before [God]" that he is "clothed in holy robes for glory." In other words, he has done his best, followed the Lord all his life, and now he is ready to be taken to his eternal reward in Heaven.

Critical Review of Poor-Bashing: The Politics of Exclusion Essay

Social struggles and cultural crisis have been the subjects of various books over the years. They have resulted into an abundance of works done by social and theoretical experts as well as literary and media practitioners. One society crisis that these writers have discussed is the issue of poverty, the people involved in this situation, and the issue of poor-bashing they are faced with. However, only a few of these sources have really created their work using their own or personal experiences. The perspective coming from people who belong to the poverty block is significantly helpful and useful. This is because their personal experiences and battles ignite the search for truth and manifest the real issue that the poor people are the targets of a well-designed and orderly crusade of discrimination and exploitation. All it needs is a real presentation and argument of the issue for the public to realize that these poor people do not welcome being blamed for a condition that only society dictates.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Included in these first-hand writers is Jean Swanson (2001) who tackled the existing yet unfamiliar issue of poor-bashing in her book entitled â€Å"Poor Bashing: The Politics of Exclusion.† Swanson’s presentation of poverty, particularly poor-bashing, is a well-attested discussion that turned out to be a depiction of the real emotional expressions of the poor people and the author’s own cry from her heart.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The book is a passionate disclosure by anti-poverty activist Swanson of poor-bashing, a condition of the society that continuously fails to claim general information despite its existence and utilization as an anti-poverty tool for the past two decades. A seasoned anti-poverty activist, Swanson employed her personal experiences and various interactions with the rest of the poor people in her country to present the real issues brought about by poor-bashing.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   According to Swanson (2001), the term of poor-bashing hides the actual origins of poverty and the pain it inflicts to poor people. It degrades the employed people while taking away the pressure and responsibility from the rich members of the society. The Swanson book critically presents a new approach of writing poverty with the provision of the personal stories, ideas, and analysis of the poor about poverty. The book disputes the position that there is no one to be blamed for the condition of the poor people but themselves. The book serves as an expressive style of poor-bashing which was introduced in our terminology use and traditions. It is also an instrument for academic progress and direction (Swanson, 2001).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The term poor-bashing was defined by Swanson as a condition when poor people are pictured, neglected, accused, sponsored, sympathized, and wrongly blamed for being intoxicated, and contented of having big yet unmanageable families and settling as unemployed individuals depending on the welfare and financial assistance from the government. Aside from the said societal presentations, the poor people are likewise subjected to poor-bashing by the institution. A manifestation of low financial assistance rates for the promotion of social welfare is a type of poor-bashing by the establishment. Swanson added that having or allowing the existence of poverty when the society can possibly do away with it is also another poor-bashing kind.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   â€Å"Poor-Bashing: The Politics of Exclusion† critically looked into how low-income people and even those belonging to below poverty line are marginalized and maltreated by the state, media and the corporate world. However, Swanson pulled off some entertainment when she pictured how the term poor-bashing, which was used to represent people who are dependent on financial assistance and benefits, actually better fits to demonstrate the behavior of the sluggish rich members of the society. In presenting the many points of the book, Swanson featured several realistic voices and emotions of the poor, such as those of single mothers, a side that has not been focused on by other works. These single parents are made to experience poor-bashing when they are shown as people struggling to give food, clothes, and shelter to their kids because of an unforgiving and unacceptable financial condition. The structural and personal poor-bashing of single mothers denied them the chance to decide better for themselves and their children, thereby negatively affecting their way of living.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   An interview by Swanson with a single mother revealed that the latter did not prefer to be financially dependent and always on the welfare of other people. According to Swanson’s interpretation, the society where the single mother belongs and her partner in particular are the ones that actually put her life and that of her children where it is now. The poor-bashing applied to single mothers is just one of the pieces of evidence of the wide gap between the rich and the poor. Accordingly, in Swanson’s country (Canada) and in most parts of the world, statistics proves that the poor people tend to share only a small percentage of wealth while the rich people enjoy the biggest portion. It is generally perceived that people who have a share as that of the rich are assured of a dependable education and stable job. This is not because poor people are legally restricted to be a part of the majority, but it is because there are laws that are apparently in favor of the rich than the poor. This results in more options and opportunities available for the rich than for the poor.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Swanson’s book unveiled the orientation of poor-bashing in a clean, strong manner. One example is the author’s analysis of how the media, particularly the reporters, function when they cover and tell stories about poverty. Swanson called this as the media â€Å"poornography† where the media utilizes many attacks to get and present poverty stories. In the book, media â€Å"poornography† depicts poor people as sufferers. Swanson said that this is part of the journalistic approach to â€Å"putting a face on the problem.† However, this media portrayal does not change the problem. This is because the said media approach fails to determine the real causes of poverty. Charity, financial aid, and welfare dependency offered to poor people oftentimes do not offer a solution to the poverty problem.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Despite the strengths of the book and that of Swanson’s arguments, they did not allow readers to draw their own conclusions and realize for themselves the main points of the issue of poor-bashing. Instead, the author dwells and banks on rhetorics about the need to solve the problems of classism, racism and sexism. Although these issues are valid, they made the book feel and look out of focus. The non-stop utilization of poor-bashing term or affiliation, apparently to picture evident situations pertaining to the problem, actually created a feeling for the public to be subjected to reader-bashing. This is simply because the book is all but representation of the poverty problem and poor-bashing in particular but without drawing a definite solution on how to address the said condition.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     The book which depicts the poor as unworthy, lazy, possibly involved in criminal acts and a threat to stability of the society deviate attention away from the real problem of poverty. This is because it diverts the true reasons of poverty and unemployment into the poor people who are presented as victims of inequality. The book’s individualization of the causes to poverty and unemployment distracts focus on the actual solutions to the problem. These realities include legalities and corporate decisions that are designed to produce and promote the undermining of wages and employment conditions of the poor. The book turns out to be just an endless discussions of who are the poor yet deserving people. This eventually encourage self restriction instead of self-esteem among poor people. Even the book’s presentation of the creation and multiplication of profit and wealth among the undeserving rich is overdue and uncalled for.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In challenging poor-bashing, it should be understood by the poor that they are not to be blame for their conditions. There are factors to be considered such as an apprehension of the economic system that actually cause poverty and how treatment of poverty is supported by the government. One must learn and realize that there is enough profit and wealth to end poverty, for both the rich and the poor to share. People in turn, should benefit from poor-bashing and poverty. Poverty is a condition that entails government policy and the poor people that are subjected to poor-bashing actually benefits because they become cheaper in the labor market. Sometimes, the poor has to challenge bashing created not by poverty but by the condition resulting from the conditions of racism or sexism. The poor just have to dispute the depictions created by the term, myths, media, and the government.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Instead of stating proposals to address poor-bashing, the book should have encouraged the poor people to understand the underlying policies of the government, corporations, and media. These plans of action actually create confusion and exclusion and promote inequality and the feeling of blame. It is essential to unite crusades about poor-bashing with alliance against racism and other negative conditions of the society. It requires a lot of understanding and ultimately the need to build an organization of thoughts and actions. A concrete step is to end the kind of notion and feeling that group people into being poor or those on welfare dependency. This will not justify treating them badly and blaming them for poverty. There should be an end to blaming poverty to the poor or other oppressed people. In this manner, an adaptable and effective policies, laws, and economic system can be worked out that will allow poor people to productively compete against each other. Poverty should have a different and justifiable image. In the end, resolving poor-bashing requires addressing the issues of unequal distribution of wealth and income among all members of the society. With this, putting the blame of poverty on the poor would be stopped. Reference Swnson, J. (2001). Poor-Bashing: The Politics of Exclusion. Toronto: Between the Lines.   

One of the most important themes in the play Macbeth by...

One of the most important themes in the play Macbeth by William Shakespeare comes from one of the last lines in Act 1, Scene 1 of the play. The three witches speak this line Fair is foul, and foul is fair (1:1:12), shortly before they disperse and it becomes a prophecy and an secret warning throughout the rest of the play. This one line becomes more and more important as the play unfolds beginning even with Macbeth’s opinions at the beginning of the story and lasting throughout the play with the constant themes of deception and doing evil in the name of good. We see that even from the beginning the unfolding events and themes can all be predicted through these first few lines in Act 1 Scene 1, events and themes that surround†¦show more content†¦All of Macbeths titles of Thane of Glamis, Thane of Cawdor and King of Scotland came by foul means just for the witches benefits. Macbeth became King of Scotland after murdering King Duncan which the witches first put in his mind that he will be king. Macbeth has a ruthless way of advancing in life. You notice this more in King Duncans statement Theres no art/ to find the minds construction in the face (1:4:11-12). Fair is foul and foul is fair is also, found in the actions of Lady Macbeth and Macbeth after the murder of king Duncan. Although Macbeth has the appearance of a good and generous host (fair), he was secretly plotting king Duncans death (foul). Which was very foul. Also, Lady Macbeths plan of the murder shows the twisted atmosphere they have created and how twisted she is. Both a woman and a host, she should be the model of grace and poise. She is described, however, as a fiendlike queen (5:6:69) and exhibits a cold, scheming mentality. In addition, there porter or door man likens the place to the house of the devil. Which also shows a foul and evil environment. 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