Long-term care and austerity in the UK: a growing crisis
The chapter begins by outlining the funding and governance arrangements for long-term care in the UK. The fragmentation of these arrangements – in particular the separate funding and governance arrangements for the health and social care elements – is important in understanding the impacts of austerity and austerityrelated policies on the levels and quality of care for older people. The chapter then summarises recent policy and practice developments that reflect aspirations to improve the quality, efficiency and effectiveness of long-term care. These developments include the introduction and extension of personalised approaches to allocating funding and delivering care; the widespread development of rehabilitation and reablement services; the twin pressures to integrate services while at the same time devolving responsibilities from central to local government; and reforms to individual rights and funding arrangements contained in the 2014 Care and Support Act. These developments provide the contexts within which increasingly stringent austerity-related measures have been introduced. The next section of the chapter details the austerity-related policies introduced by the 2010-2015
coalition government and the more radical proposals of the conservative government that came to power in May 2015. The last section discusses the impacts of these measures with particular focus on the extensiveness, quality and equity of services for older people and family carers and on the providers of care services. The main focus will be on developments in England, with reference to measures elsewhere in the UK where possible.