Abstract
The final sections of the National Health Service & Community Care Act, 1990 will be implemented from 1 April 1993. The legislation does not change social policy in relation to clients, nor does it increase the investment of resources into social or health care. Improvements will be achieved by competition and marketplace discipline creating greater efficiency and effectiveness in the delivery of social care. There is a requirement for better assessment of need, and the delivery of needs-led services through a care management system which is new to the UK. To do this satisfactorily, social service agencies must delegate decision taking to care managers, and devolve budgets to that level. The changes involved present an immense challenge to the culture of local government and threaten the tradition of local authority service provision. Local authorities are committed to making a success of the change and there is already evidence of this. The article addresses the issues as seen from the perspective of a D...
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