從「全控機構」到「最佳價值」--英國社區照顧發展的脈絡與省思_

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題名：	從「全控機構」到「最佳價值」--英國社區照顧發展的脈絡與省思
書刊名：	社區發展季刊
作者：	黃源協
作者(外文)：	Hwang, Yuan Shie
出版日期：	2004
卷期：	106
頁次：	頁308-330
主題關鍵詞：	新右派；福利多元主義；在社區照顧；由社區照顧；照顧管理；社會工作才能；The new right；Welfare pluralism；Care in the community；Care by the community；Care management；Social work competence
原始連結：	連回原系統網址
相關次數：	被引用次數:期刊(9) 博士論文(1) 專書(1) 專書論文(1) 排除自我引用:9 共同引用:0 點閱:43

本文旨在分析社區照顧如何在「全控機構」與「福利國家危機」的脈絡中，發展並結合成90年代之準市場的由社區照顧模式，並在90年代末期進入到最佳價值的模式。17世紀濟貧法案的機構照顧，因發展成缺乏人性關懷的全控機構，而有去機構化和生活正常化的倡導，進而發展成「在社區照顧」。另一方面，1970年代中期的福利國家的危機，提供了新右派意識型態浮出政治檯面的契機，由新右派所倡導的新管理主義以及福利多元主義，在強調分散化與民營化的服務模式下，彈性、參與以及需求或消費者導向的服務，已逐漸地取代傳統福利科層之僵化、無效率以及供給導向的服務。這股脈絡匯集了「在社區照顧」，而朝向「由社區照顧」，再到準市場的由社區照顧，並藉由照顧管理的引進，和社工才能的倡導，以實踐準市場的在社區照顧理念；此外，為回應具市場導向的新服務模式，社會工作的訓練也朝向社會工作才能的培養。唯這股潮流並未能有效舒緩全控機構和政府失靈的問題，而飽受質疑，為此，新工黨政府期能藉由最佳價值原則的運用，去營造一個真正具有績效的新社區照顧。

以文找文

The paper aims to analyse how the quasi-market ‘care by the community care’ was created under the developmental contexts of total institution and welfare state crisis. The institutional care under the Poor Law was developed into a total institution without human concern. This resulted in an advocacy of de-institutionalization of life normalization, and further developed into policy of ‘care in the community’. On the other hand, the crisis of welfare state in the mid-1970s provided a turning point for the upsurge of the ideology of the New Right. The idea of the new managerialism and welfare pluralism derived from the New Right ideology stress the strategies of decentralization and privatization of welfare services in care provision. Under which, the care model which emphasizes flexibility, participation, and need-led /consumer–led services has increasingly replaced with traditional bureaucratic model which has been condemned because of its inflexibility, inefficiency and supply-led services. The quasi-market ‘care by the community’ had therefore become the mainstream of welfare service delivery under two trends. To carry out the ideal of community care, care management has been introduced as a necessary technique. Furthermore, to response the new market-driven service model, the social work training has toward the way of so called ‘social work competence’. However, the quasi-market ‘care in the community’ has suffered condemns and challenges as a result of incapability in coping with problems caused buy the total institution and government failure. The current New Labour Government is intended to introduce and use the principle of the Best Value to build up a new community care with real performance.

以文找文

期刊論文
1.	Bowl, R.(1996)。Legislating for user involvement in the United Kingdom:mental health services and the NHS and Community Care Act 1990。International Journal of Social Psychiatry，42(3)，165-180。
2.	Filinson, R.(1997)。Legislating community care--The British experience, With U.S. Comparisons。The Gerontologist，37(3)，333-340。
3.	Forder, J.、Knapp, M. R. J.(1993)。Social care market:the voluntary sector and residential care for elderly people in England。Researching the Voluntary Sector，1。
4.	Henwood, M.、Wistow, G.、Robinson, J.(1996)。Halfway there? Policy, Politics and Outcomes in Community Care。Social Policy and Administration，30(1)，39-53。
5.	Higgins, J.(1989)。Defining community Care:realities and myths。Social Policy and Administration，23(1)，3-16。
6.	Knapp, M.、Wistow, G.(1996)。Social care market in England:Early Postreforin Experiences。Social Service Review，355-377。
7.	Lewis, J.、Bernstock, P.、Bovell, V.、Wookey, F(1997)。Implementing Care Management:Issues in Relation to the New Community Care。British Journal of Social Work，27，5-24。
8.	Macdonald, G.、Sheldon, B.(1997)。Community Care Services for the Mentally ill:Consumers' Views。International Journal of Social Psychiatry，43(1)，35-55。
9.	Stoker, G.(1987)。Decentralisation and Local Government。Social Policy and Administration，21(2)，157-170。
10.	Kendall, J.、Knapp, M.(2001)。Providers of Care for Older People: The Experience of Community Care。Voluntary Organisations and Social Policy in Britain \\ Rochester, C. ; Harris, M. (eds)，108-123。

會議論文
1.	DoH、SSI(2002)。Modern Social Services – A Commitment to Reform。London。

研究報告
1.	Netten, A.、Ryan, M.、Smith, P.、Skatun, D.、Healey, A.、Knapp, M.、Wykes, T.(1690)。The Development of a Measure of Social Care Outcome for Older People。

圖書
1.	Payne M。Social Work and Community Care。London：Macmillan。
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13.	Johnson, N.(1999)。Mixed Economy of Welfare--A Comparative of Welfare。London：Prentice Hall Europe。
14.	Lewis, J.、Glennerster, H.(1996)。Implementing the New Community Care。Buckingham：Open University Press。
15.	Means, R.、Smith, R.(1998)。From Poor to Community Care: The development of welfare services for the elderly 1939-1971。The Policy Press。
16.	Skidmore, D.(1994)。The Ideology of Community Care。London：Chapman and Hall。
17.	Victor, Christina R.(1997)。Community Care and Older People。Stanley Thornes。
18.	Sullivan, M.(1994)。Modern Social Policy。London：Harvester Wheatsheaf。
19.	Gamble, A.(1988)。The Free Economy and the Strong State:The Politics of Thatcherism。Basingstoke and London：Macmillan。
20.	Cowen, Harry(1999)。Community care, ideology, and social policy。Hertfordshire：London：Prentice Hall Europe。
21.	Hughes, O. E.(1998)。Public Management & Administration。New York：ST. Martin's Press。
22.	Johnson, N.(1992)。Reconstructing the Welfare State--A Decade of Change 1980-1990。London：Harvest Wheatsheaf。
23.	Pierson, Paul(1994)。Dismantling the welfare state? Reagan, Thatcher, and the politics of retrenchment。Cambridge University Press。
24.	Bryson, L.(1992)。Welfare & The State。Macmillan。
25.	Mishra, R.(1990)。The Welfare State in Capitalist Society。Harvester Wheatsheaf。
26.	Johnson, N.(1987)。The welfare state in transition: The theory and practice of welfare pluralism。Amherst, Massachusetts：University of Massachusetts Press。
27.	Adams, R.(1998)。Quality Social Work。London：Macmillan。
28.	Butcher, T.(1995)。Delivering Welfare Services。Buckingham：Open University Press。
29.	Rao, N.(1996)。Towards Welfare Pluralism--Public Service in a Time of Change。Aldershot：Dartmouth。
30.	Means, R.、Morbey, H.、Smith, R.(2002)。From community care to market care? The development of welfare services for older people。The Policy Press。
31.	Wistow, Gerald、Knapp, Martin R. J.、Hardy, Brian、Allen, Caroline(1994)。Social care in a mixed economy。Buckingham：Open University Press。
32.	Wistow, G.、Knapp, M. R. J.、Hardy, B.、Forder, J.、Kendall, J.、Manning, R.(1996)。Social Care Markets: Progress and Prospects。Open University Press。
33.	Department of Health(1989)。Caring for people: Community care in the next decade and beyond。HMSO。
34.	Means, R.、Smith, R.(1998)。Community Care: Policy and Practice。Macmillan。
35.	Busfield, J.(1997)。anaging Madness: Changing Ideas and Practice。Community Care: A Reader \\ Bornat, J. (et. al. ; eds)。London。
36.	Davies, B.、Fernandez, J.、Nomer, B.(2000)。Equity and Efficiency Policy in Community Care – Needs, Services, Productivities, Efficiencies and Their Implications。Aldershot。
37.	Easterbrook, L.(2003)。Moving On From Community Care – The treatment, care and support of older people in England。London。
38.	Hill, M.J.(1994)。Understanding Social Policy。Oxford。
39.	Ministry of Health(1963)。Health & Welfare: The Development of Community Care。London：HMSO。
40.	Philps, I.(1995)。Institutional Care。Social Policy and Elderly People – the Role of Community Care \\ Laczko, F. ; Victor, C.R. (eds)。Aldershot。
41.	Scott, D.W.、Russell, L.(2001)。Contracting: The Experience of Service Delivery Agencies。Voluntary Organisations and Social Policy in Britain \\ Rochester, C. ; Harris, M. (eds)。Basingstoke。
42.	Swann, D.(1993)。Privitisation, deregulation and the New Right。Public Policy and the Impact of the New Right \\ Jordan, G. ; Ashford, N.(eds)。London。

其他
1.	DETR(1998)。Modernising Local Government – Improving Local Services through Best Value，London。
2.	DoH(1998)。Moderning Social Services – Promoting Independence, Improving Projection, Raising Standards，London。

圖書論文
1.	Barry, N.(1999)。Neoclassicism, the New Right and British Welfare。British Social Welfare in the Twentieth Century。London：Macmillan。
2.	Beecham, F.、Hallam, A.、Knapp, M.、Baines, B.、Feyno, A.、Asbury, M.(1997)。Costing care in hospital and in the community。Care in the Community: Illusion or Reality?。John Wiley and Sons。
3.	Browning, D.(1992)。Purchaser/Provider Split:Passing Fashion or Permanent Fiture。Purchasing and Providing Social Services in the 1990s:Drawing the Line。London：PSI。
4.	Clarke, J.、Langan, M.(1993)。Restructuring welfare:the British welfare regime in the 1980s。Comparing Welfare State:Britain in International Contexth。London：SAGE。
5.	Graham, H.(1997)。Feminist Perspectives on Caring。Community Care--A Reader。London：OUP。
6.	Jones, K.、Fovvles, A. J.(1998)。Total Institution。Understanding Health and Social Care: An Introductory Reader。London：SAGE。
7.	Jordan, G.(1993)。New Right and public policy:a preliminary overview。Policy and the Impact of the New Right。London：Pinter Publishers。
8.	Judg, K.、Knap, M.(1985)。Efficiency in the Production of Welfare:The Public and the Private Sectors Compared?。The Future of Welfare。Oxford：Basil Blackwell。
9.	Lc Grand, J.、Robbinson, R.(1984)。Privitisation and the Welfare State:An Introduction。Privitisation and the Welfare Stste。London：Unwin Hyman。
10.	Morgan, B.(1996)。Community care and social work with adults。Social work competence: Care Knowledge, Values and Skills。London：SAGE。
11.	Pirie, M.(1995)。Reasons for Privitization。Privitization and the Welfare State。Aldershot：Dartmouth。
12.	Ramon, S.(1991)。Principle and conceptual knowledge。Beyond Community Care: Normalisation and Integration Work。London：Macmillan。
13.	Ryan, J.、Thomas, F.(1993)。Concepts of normalisation。Community Care--A Reader。Basingstoke：Macmillan。
14.	Webb, A.(1985)。Alternative futures for social policy and state welfare。Challenges to Social Policy。Aldershot：Gower。
15.	Walker, A.(1997)。Community care policy:from consensus to conflict。Community Care: A Reader。London：Macmillan。
16.	Victor, C. R.(1995)。Do we need institutional care?。Social Policy and Elderly People--the Role of Community Care。Aldershot：Avebury。
17.	Symonds, A.(1998)。The social reconstruction of care:from the state to the community。The Social Construction of Community Care。London：Macmillan。
18.	Jack, R.(1998)。Institutions in Community Care。Residential versus Community Care: The role institutions in welfare provision。London：Macmillan。
19.	Hochschild, A. R.(1993)。[Emotion in organization] Preface。Emotion in organization。London：Sage。
20.	Mooney, Gerry(1997)。Quasi-markets and the Mixed Economy of Welfare。Social Policy--A Conceptual and Theoretical Introduction。London：SAGE。
21.	Ashford, Nigel(1993)。The Ideas of the New Right。Public Policy and the Impact of the New Right。New York：Pinter Publishers。
22.	Hoyes, L.、Means, R.(1997)。The impact of quasi-markets on community care。Community care: A reader。London：Macmillan。
23.	Johnson, N.(1999)。Personal Social Services and Community Care。New Labour, New Welfare State?--The "Third Way" in British Social Policy。Policy Press。

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