Today adult social care refers to a broad range of services and providers including residential care homes, nursing homes and supported living. Adult social care in England includes all forms of personal care and practical assistance provided for people in need aged 18 and over. This timeline charts the emergence of formal social care services and explains how we have ended up with the split between health and social care that we have today.
The concept of social care was relatively late in developing. Its origins lie in the 1601 Poor Law Act which sought to consolidate all previous legislative provisions for the relief of ‘the poor’ and the Poor Law Amendment Act of 1834 which introduced a new, more punitive approach to receiving state support.
As the 19th century progressed, there was an increasing focus on improving public health, and the state had a growing role in improving the health of the population as well as investigating concerns about poor conditions in workhouses. While health and healthcare became gradually separated from the provisions under the Poor Law, it wasn’t until 1948 that other forms of public assistance were completely detached from the Poor Laws.
The decision to nationalise hospitals as part of the NHS rather than giving the administration of hospitals to local government marked the start of a perennial debate over the boundaries between NHS organisations and local authorities and the separation between health and social care services. A debate that is still very much alive today.