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Where now for social care in England?

BMJ 2010; 340 doi: (Published 21 April 2010) Cite this as: BMJ 2010;340:c2017
  1. Christina R Victor, professor of gerontology and public health
  1. 1School of Health Sciences and Social Care, Brunel University, Uxbridge, Middlesex UB8 3PH
  1. christina.victor{at}

    The groundwork is done, but the election will determine the outcome

    On 30 March 2010 the white paper, Building the National Care Service, was published.1 This followed the green paper, Shaping the Future of Care Together, which was published in July 2009.2 Both of these policy documents have sought to tackle the perceived inequities in the current provision of social care to adults. Two key factors combine to create the current “postcode lottery” of social care provision. Firstly, the nature and level of services provided vary locally because social care was originally conceptualised as distinct from the universalist ideals of the NHS, and local championing of services reflected local needs. Secondly, social care has never been free at the point of delivery like the NHS, and the system of charging and means testing varies, with local authorities charging as much (or as little) as deemed appropriate.3

    To combat these established inequalities the white paper proposes the creation of a universal National Care Service (NCS) for adults that is based on integrating the diverse range …

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