Social care markets in England: early postreform experiences

Recent discussions of health and social care in the United Kingdom have been dominated by the 1990 National Health Service and Community Care Act. A core dimension of the act was to encourage greater mixing of the ''economy of care,'' specifically, greater pluralism in provision, more systematic regulation of practice and assurance of quality, and (in the longer term) greater variety of funding sources. The result has been the development of social care markets. In this article, we describe the mixed economy reforms and early evidence regarding success. The main issues concern development of social care markets and the implications for local authorities of their new purchasing roles.