ABSTRACT
This chapter explores some of the challenges that occur when delivering care to so-called vulnerable and marginalised groups and explores some of the risks and consequences to risk-management and deficit-focussed perspectives. Vulnerability and marginality categories are replicated from the top down throughout the human services sectors in health, mental health, social work and social services, disability, and criminal justice. The top-down service delivery model – is reproduced throughout these sectors; for instance, a physician remains in charge of a patient's care, whether in the community, in a mental health facility, or in residential aged care. While maintaining the appearance of fairness and economic accountability, the modern neoliberal state effectively replicates the three groups codified by the Elizabethan Poor Law in 1601. Equity is generally understood as the quality of fairness, both in Hobbes' sense of reason and as a set of values that guide policy and resource allocation.
