Market threatens variety in care policy

The Government's reorganisation of community care is threatening the survival of small care organisations and is based on an oversimplistic view of the public and private sectors, according to researchers at the University of Bristol.

Legislation designed to make greater use of independent organisations involved in community care is being hampered by lack of funding and support for small providers. Administration has risen at the cost of time spent on "hands-on" activities, researchers in Bristol's School for Advanced Urban Studies have found.

Current policies are designed to transfer much of the delivery of community care to private and voluntary agencies. But the Bristol study suggests that policy-makers and service purchasers lack understanding of how community care is evolving and the problems faced by providers and users.

The study, which focused on voluntary and private organisations in three localities, found a wide variety of organisations working in the service, suggesting that traditional distinctions between voluntary and private sectors which guide current policy are too simplistic.

Voluntary agencies may be set up by public sector workers and often draw people from the statutory and private sectors into their management groups or as volunteers. Private and voluntary organisations may receive public funds and employ people from a public or voluntary sector background.

The result is a healthy cross-fertilisation of management policies and values. But smaller community care providers are now in danger of being squeezed out of the market.

Joan Langham, a research fellow who worked on the study, said: "The pressures that we identified towards conformity, increasing managerialism and moves to diversity just in order to stay in the market could all lead to small organisations finding it much harder to survive. To lose them would be a significant loss because it is easier for service users to be involved with them."

The study, supported by the Joseph Rowntree Foundation, concludes that more networks and coalitions between different sizes and styles of organisation are needed to give smaller agencies access to economies of scale as well as maintain a user-friendly service.