Policy and practice: fundamental contradictions in the conceptualization of community care for elderly people?

For more than two decades, community care has been proclaimed the answer to the 'social problem’ of the ageing of the population. Since the publication of the Community Care White Paper (Department of Health 1989), a plethora of discussion and guidance documents have followed. In this paper, critical examination is made of some of the assumptions that appear to underpin policy and debate about community care. It is argued that recent policy and community care reforms may be affected adversely by inherent conceptual contradictions and conflicting understandings and expectations about community care. It is suggested that the reassuring connotations of the phrase ‘community care’ may not be reflected in its reality and that the debate needs to be extended to acknowledge and address some of the underlying dynamics, contradictions and interactions that may have a bearing on the success of the reforms.