Enlarging the caring capacity of the community: informal support networks and the welfare state.

In common with most modern industrial societies, Great Britain is facing the unique late 20th century phenomenon of rapidly increasing numbers of people, especially very elderly people, requiring health and social care. The response in Britain has been to search for ways to enlarge the caring capacity of the "community" and, thereby, reduce the demands on public health and social services. Similar policy responses have been developed in other capitalist societies such as Canada, France, and the United States. Although a policy of "community care"--the provision of state services in people's own homes--was followed by governments of both major British political parties over the postwar period, under the right wing neo-monetarist regime of the present Thatcher administration the locus of policy has shifted toward encouraging greater reliance on the informal support networks of kin, friends, and neighbors. The reasons for this sea-change are explored and the assumptions that these networks are "natural" and necessarily the proper matrix of care are examined critically. This analysis draws on the results of recent research which indicates that informal support networks have significant limitations and that a policy based on withdrawing public services in the hope that these networks will fill the growing care gap is likely to be counterproductive. In conclusion, the author indicates the areas where further research is required to provide a sound basis for policy.