ABSTRACT
Policies in relation to the care and treatment of very dependent people has been a dominant theme within the 'service' stream of policy in the NHS. By the early 1960s, it had become apparent that the care and treatment of the elderly, those with special needs (termed physically and mentally handicapped until the mid-1980s) and mentally ill people, whose requirements were for care rather than cure, posed special problems for an 'illness-based' NHS. In the 1970s, strategies were developed for each 'client' group through the preparation of reports. White Papers, and consultative documents. The policy documents had two common themes. First, that services should be provided in the community rather than in institutions, and second, that there should be cooperation between health authorities and local authority social service departments. The problems of achieving change form the theme of this chapter.
