ABSTRACT
The consideration of any prominent policy or legislative trends may also shed some light on the issues facing specialist provision. Integral to the reforms has been the emphasis on moving away from hospital and residential/institutional care towards primary level and community based forms of provision. There has been encouragement to the private and voluntary sectors to be the 'providers' of care, and for health and social service agencies to undertake a largely gate-keeping role of assessing the need for, and the purchasing of, required services. The prominence of community care and the wish to develop primary health care, also have an international dimension. The diversification of health and welfare services provided amongst a greater variety of agencies has served to make the form and function of many professions less uniform. In the health sphere of the Western industrialised world, the overall pattern of disease has progressed from the acute and curable towards the chronic and incurable.
