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About this book

Part of Palgrave's Interagency Working in Health and Social Care series, this book explores the policy and practice which frames work with disabled people. Providing a critical review of the mainstream services available to disabled people, it assesses the successes and failures of interagency working, and offers a model for future practice.

Table of Contents

Introduction

Abstract
In this Introduction we would like to say a little about the what, the why and the how of this book. This book presents the academic field of disability studies, as it relates to health and social care policy and practice. Disability studies is concerned with the social, political and cultural analysis of disability. It has at its heart the social model of disability which views disability in terms of environmental, structural and attitudinal barriers that deny disabled people full participation in society and full citizenship rights. The book supports health and social care professionals, and students of these professions, in critical reflection on the provision of services to disabled people with the social model of disability as the underlying theoretical framework.
Sally French, John Swain

1. Modelling Disability and Impairment

Abstract
In this chapter we will examine two central models of disability, the individual model and the social model, to illustrate the ways in which underlying ideas and concepts can shape policy and practice in health and social care. We will also consider the tragedy model and the affirmative model, which are closely associated with the individual and social models of disability. Some consideration will also be given to the term ‘long term conditions’, which is frequently used alongside ‘disability’ in research and policy documents.
Sally French, John Swain

2. The Context: from Segregation to Equal Rights

Abstract
In this context chapter, we look back and look forward at the development of health and social care policy, provision and practice relating to disabled service users. We begin by critically considering some key concepts, such as professional and carer, formal and informal carer, to set the scene for an exploration of the historical context of the work of health and social care professionals with disabled people. This takes us first into the developing history as generated by disabled people themselves, challenging the official history as documented by non-disabled academics and service providers. We then briefly summarize the developments of policy, provision and practice, from the creation of the welfare state, through the NHS and Community Care Act, to the Disability Discrimination Act.
Sally French, John Swain

3. Disabled People: Health and Social Care

Abstract
This chapter looks across the board at services/provision, including education, employment services, transport and housing. In particular, we critically explore key concepts such as inclusion, exclusion, and mainstreaming of policy and practice. As throughout, our concentration is on UK services, though the discussion will draw, as appropriate, on international comparisons to inform the critique.
Sally French, John Swain

4. Residential Care

Abstract
This chapter examines the now extensive history of residential care as a discredited provision, whether within the local authority, health service or voluntary sector. We address the concept of autonomy in long-term care as a need and as a right. Within these discussions we shall revisit the continuing issues and controversies of residential/institutional living, including user involvement in controlling people’s lifestyles, the rights of disabled people in residential care and resources for residential/institutional living. We shall draw on our own research within a large-scale charity, which examined the views and experiences of disabled people in residential care.
Sally French, John Swain

5. Control of Health and Social Care Services by Disabled People

Abstract
In this chapter, we will be looking at innovative services that disabled people have developed themselves, or have brought about through prolonged campaigns and political pressure. We will also discuss how these services relate to, and integrate with, statutory and voluntary services. Although some disabled people have found the interventions of professionals and professional services helpful, others have been critical of the control professionals have over their lives and the restrictive nature of the services they provide (French, 2004a; French and Swain, 2008). This situation has led disabled people to create their own innovative services and to press for legislation that gives them greater control over the services they receive (Barnes and Mercer, 2006). We will start this chapter by discussing Centres for Independent (or integrated) Living (CILs) and will then go on to examine the policies of direct payment and individual budgets. We will end the chapter with a discussion of advocacy, with an emphasis on self-advocacy and peer advocacy.
Sally French, John Swain

6. Towards a Social Model of Inter-agency Working

Abstract
This chapter focuses specifically on the notion of inter-agency working and the possibility of this being grounded in a social model. So a starting question is the meaning of the notion of inter-agency working. There are closely related terms, particularly multidisciplinary working and inter-professional working, which you might like to follow up. These terms seem to us similar enough to focus on inter-agency working as an umbrella for the key issues.
Sally French, John Swain

7. User Involvement in Services for Disabled People

Abstract
Robson et al. define user involvement as ‘the participation of users of services in decisions that affect their lives’ (2003, p. 2) and Croft and Beresford believe that ‘speaking and acting for yourself and being part of mainstream society, lies at the heart of … service user involvement’ (2002, p. 389). The concept of ‘user involvement’ is now well established within professional and managerial practice, in both health and social care, and enshrined within legislation and policy such as the NHS and Community Care Act 1990 and the NHS Constitution (DH, 2009a). It is no longer the case that managers and professionals can or should make decisions on behalf of those they serve. When considering how disabled people can influence health and social services, the term ‘user’ is preferred to ‘patient’ or ‘client’ which both have connotations of passivity.
Sally French, John Swain

8. Disability and Diversity

Abstract
Social divisions within society underpin the notion of diversity. They include social class, ethnicity, age, gender, sexual orientation and disability. Social divisions help us to understand how society functions and our place within it at any particular time. They are associated with hierarchies of power and subsequent access to material and social goods. For instance, people of high socioeconomic status will usually have a high income which will give them access to private education and health care and enable them to go on expensive foreign holidays. These goods are, in contrast, unlikely to be available to people of low socioeconomic status who may struggle to obtain a basic standard of living. Social diversity is often viewed in positive terms, for instance job advertisements may state that diversity is welcomed or that a diverse workforce is needed. However, people who belong to certain social groups, for instance disabled people, old people and people from ethnic minorities, may experience prejudice (hostile attitudes) and discrimination (unfavourable treatment) in many areas of life.
Sally French, John Swain

9. Families and ‘Carers’

Abstract
We would like to begin this chapter by recognizing that to cover all the relevant issues would require another book and we have had to take a particular focus. The title of the chapter signals such a broad arena that it raises the realization that disability touches all our lives. There are numerous situations which we do not directly address here but which you may encounter and will need to follow up. These include the experiences of ageing parents of disabled adults, partner/spousal carers, and families caring for older disabled people. Life course transitions is also a major topic and we deal only with transition to adulthood in this chapter. If you have a particular interest in this topic, you will find Priestley (2001) useful. We focus here on the experiences of parents of disabled children, with the hope that the issues raised are generalizable to experiences of other groups signalled by the title of this chapter. We begin by considering the concept of ‘carer’.
Sarah Keyes

Conclusion

Abstract
In this book we have looked towards a social model for inter-agency working. As you will have seen, the social model has a foundation in critique. It is a direction of thinking that challenges the individual model of understanding disability, including the medical model and associated tragedy model. Within this, it takes a critical stance towards the provision, policy and practice of health and social care. This is not to deny the fact that disabled people require effective health and social care, as do non-disabled people. Nor is it about criticizing individual professionals, beyond the commonsense judgement that some do a better job than others. Within the social model, the analysis is directed towards society, lack of justice, and lack of equality built into society — or institutional discrimination. It is as a system, then, that the social model casts a critical eye upon health and social care services.
Sally French, John Swain
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