Equity and efficiency in community care: supply and financing in an age of fiscal austerity

From the confrontation of fiscal austerity and growing needs in the United Kingdom has come a new ideology: ‘efficiency-focused mana-gerialism’. Common arguments and the adaptation of structures to reflect them can be seen in all areas of policy, but nowhere more clearly than in the long-term social care of the elderly, the subject of this paper. Perhaps the strand of policy analysis which most influences and epitomises the new managerialism is the work of the Audit Commission for Local Authorities in England and Wales, whose arguments and proposals have gained great and widespread influence. The commission's ‘three Es’ – economy, efficiency and effectiveness – have become among the most fashionable slogans of our time.