For the past two decades the vast majority of social care services paid for by the state (care homes, home care and other support services) are provided by the private sector in England. As a result there is a substantial evidence base of the effects of the marketisation of social care services on the quality of care which is provided to older people and other people with disabilities. The way in which the market in social care services has developed provides important lessons for the new markets which will be created in the NHS.
1. Stewart Player and Allyson Pollock: “Long Term Care; from public responsibility to private good.” Critical Social Policy Critical Social Policy May 2001 vol. 21 no. 2 231-255.
View document
This article charts the trajectory and structure of the market in long-term care provision.
2. Peter Scourfield “Caretelization revisited and the lessons of Southern Cross” Critical Social Policy December 6, 2011
View document
This commentary reflects on the perils of relying on a privatized and marketized system of care homes for vulnerable older people.
3. Allyson Pollock et al NHS Plc – The Privatisation of our healthcare Chapter 6 Long Term Care.
This chapter sets out the development of the market of long term care in England in the post war period and under New Labour and looks at the consequences of marketisation for older people.
4. Rosenau, P. V. and S. H. Linder (2003). “Two Decades of Research Comparing For-Profit and Nonprofit Health Provider Performance in the United States.” Social Science Quarterly 84(219-241).
This article reports on a systematic review of data-based, peer-reviewed scientific assessments of performance differences between private for-profit and private nonprofitU.S. health care providers published since 1980.
5. O’Neill, C., C. Harrington, et al. (2003). “Quality of care in nursing homes – An analysis of relationships among profit, quality and ownership.” Medical Care Research and Review Vol. 41(no.12 ): pp1318-1330.
This report examine the relationship between profit levels and quality in proprietary and nonproprietary nursing homes WHO, accounting for resident and market characteristics.
6. Kitchener, M., J. O’Meara, et al. (2008). “Shareholder Value and the Performance of a Large Nursing Home Chain.” Health Services Research 43(3): 1062-1084.
This report analyzes corporate governance arrangements and quality and financial performance outcomes among large multi-facility nursing home corporations (chains) that pursue stakeholder value (profit maximization) strategies.
7. Comondore, V. R., P. J. Devereaux, et al. (2009). “Quality of care in for-profit and not-for-profit nursing homes: systematic review and meta-analysis.” BMJ: 339:b2732 doi:2710.1136/bmj.b2732.
View document
This systematic review and meta-analysis of the evidence suggests that, on average, not-for-profit nursing homes deliver higher quality care than do for-profit nursing homes.
8. Stephen Allen and Julian Forder and “Markets in Social Care – Lessons from Research” PSSRU 2011
View document
This report provides a very useful overview of all the research on markets in social care (primarily residential and nursing home care).
9. Stephen Allen and Julian Forder “Competition in the English Nursing Homes Market” PSSRU 2011
View document
This original study of nursing home quality in England finds that competition drives down both quality and price.
10. Domiciliary care providers in the Independent Sector, 2001
View document
This reports provides an interesting overview of the motivations of those involved in delivering home care services as well as the quality of the service delivered.
11. Understanding Public Services and Markets: Summary Paper of the Report Commissioned by the King’s Fund for the Care Services Inquiry June 2005.
View document
This report from PSSRU provides a useful overview of the operation of the market for social care services in England.
12. Care Home Closures:The Provider Perspective Jacquetta Williams, Ann Netten,Brian Hardy, Tihana Matosevic and Patricia Ware Discussion Paper 1753/2 February 2002.
View document
This report contains one of the very few studies on the reasons behind care home closures over the past decades and the reasons behind this from a provider perspective.
13. Melanie Henwood “Lost to the System? The Impact of Fair Access to Care” 2007.
View document
This is a report about those who have been denied access to adult social care as a result of the fact that they don’t meet local authority eligibility criteria.
14. Commission for Social Care Inspection 2006 ‘Time to Care’
View document
An overview of the home care sector in England from the national regulator. This report establishes the fact that large amounts of home care services for older people take place in 15 minute time slots. Has a significant amount of data on the home care market inEngland.
15. Robin Means and Randall Smith:Book: From Poor Law to Community Care: The Development of Welfare Services for Elderly People 1939-1971
One of the very few historical accounts of how the current system of community care services for older people has developed and how this aspect of care provision has been subject to different principles from those underpinning the NHS, leading to greater marketisation, rationing and locally determined eligibility criteria.
16. Robin Means, Hazel Morbey, Randall Smith Book: From Community Care to Market Care?: The Development of Welfare Services for Older People
The second part of this historical account of social care which brings the account up to the introduction of the community care market reforms in 1993.
17. Hilary Land and Susan Himmelweit “Who cares who pays” Unison report on personalisation.
View document
A useful introduction to the personalisation debate in social care
18. Alan Roulstone, Hannah Morgan “Neo-Liberal individualism or self-directed support : are we all speaking the same language on modernising adult social care.” Social Policy and Society 2009
This article argues that in the absence of adequate funding and exposure to organisations of disabled people, day service recipients risk moving from a position of enforced collectivism to an enforced individualism characteristic of neo-liberal constructions of economic life.
19. Catherine Needham Book: Personalising Public Services – Understanding the personalisation narrative. Policy Press 2011.
This book provides an excellent insight into the debate about personalisation in adult social care focusing on how the notion of personalisation became central to policy makers thinking on social care as well as how as a concept both embodies notions of consumerism as well as empowerment and liberation.
Support Our Work
CHPI is the only truly independent health think-tank dedicated to the founding principles of the NHS. To continue our work keeping the public interest at the centre of health and social care policy, we need your help.
Please support CHPI so we can continue to impact the health policy debate.
About the author
