The Social Construction of Public Care: From Community Care to Care by the State

Abstract

This chapter traces the shift in a set of discourses concerning the necessity for a publicly funded and state centralised system of provision of health and social care from a position of marginality in the nineteenth century to one of centrality and hegemony in 1945. This represented a paradigm change of massive cultural and political significance and set the scene for the development of policies we are presently addressing. How and why did it happen? In order to answer these questions we will be looking at the discourses surrounding the initial moves towards a state interventionist role in the nineteenth century when the first professionalisation of care by the community took place. This professionalisation was an answer to the existing system of care in and by the community which was operated by both charities and individual philathropy and performed by voluntary workers, and which was increasingly seen as inadequate. The inter-war years saw an increase in both the interventionist role by the state and also the debates and political discourses which sought to further this role. This was the period when Fordism both as a method of manufacturing and in the provision of care was initiated. The ideas which fermented during this period came to maturity and hegemony during the Second World War and formed the basis of thinking, policies and practices in the thirty years which followed.