Understanding health and social care
International Journal of Integrated Care, 21 November 2007 - ISSN 1568-4156
Book review
Understanding health and social care
Jon Glasby
Bristol: The Policy Press, 2007, pp 216,
ISBN 978 1 86134 910 1
Lia Donkers, Physician Community Medicine, The Netherlands

This book provides a comprehensive analysis of both health and social care in the UK. With health and social care increasingly asked to work in partnership, there is a need for textbooks written in a not too ‘uni-professional’ way to be able to respond fully to the joined-up problems. This textbook presents some theoretical frameworks to bridge the gap between both services. Therefore, it is relevant for people involved in developing integrated care. The textbook is mainly aimed at students. It provides reflective exercises to populate the theoretical and conceptual knowledge to help understand the practical difficulties and possibilities of inter-agency working. Both author and publisher are university based. According to them, community care systems in the UK are the most fascinating aspects of British life next to the late Princess Lady Di.

Chapters 1 to 3 explore the gap between health and social care in the UK. By illuminating underlying notions and values the author seeks to explain why the current systems are the way they are. In medical care the professional power is very important in determining the content of work. Acute care is dominant. The care for daily life has been underestimated. Care for the mentally ill is still influenced by the historical point of view that people with mental problems commit crimes more often. In a similar way the public and media are stereotyping handicapped people as beggars: people pity them when they need care and blame them when they need cash. The way in which services have evolved over time has left the UK with a care system that is dominated by institutional responses to need. Understanding these diverging underlying notions is very important. Chapter 4 identifies the main topic of the book: partnership working in health and social care has to be a part of core business rather than an optional extra. Inter-agency working is best possible on common issues like: ‘How best to involve service users and patients in decisions about their own care?’ The following chapters discus four common issues: independent living, anti-discriminatory practice, user involvement and support for carers. Every chapter starts with a UK policy context on the issue, summarizes theoretical developing frameworks and presents practical dilemmas. Short textboxes provide a snapshot of the way similar issues have been dealt with in different settings, as in other countries. In the postscript the author remarks that partnership in the deeply divided UK care system will only succeed if progress can be made in building on these common issues as key concepts. Question is how long the current system can continue to contain such contradictions and tensions as it does now.

Firstly, the value of this book is its overview of the health and social care system in the UK. A summing up of key moments in the history of national care policy must be very useful for people involved in the UK system. For people who are not involved the outlines are far too comprehensive and difficult to compare with their own system, despite the short textboxes with international references. Secondly, the value of this book is its compilation of the most accepted theoretical frameworks regarding user involvement in services, anti-discriminatory practices, independent living and support for carers. This is very useful for people in and outside the UK. The book provides only ingredients to build up partnership or inter-agency care, not the final recipe. This is not thought out yet. From that point of view the book doesn't meet my expectations as a reader. But I'm not as desperate as the last sentences of the book suggest. The book provides me with interesting guidelines for building up partnership like: ban institutional responses to needs and promote joining-up in network configurations. This is probably a major key for change. The book is well written and easy to read. Some used metaphors made me laugh. This book, especially the second half, can be recommended to students and policy makers in health and social care to learn more about theoretical frameworks on the main topics in integrated care. I would give this book 3 stars out of 5.

Lia Donkers is the managing director of the Transmural Network Foundation at Gouda. This is a development cooperation of local care providers focused on integration of disease management, e-health, human resource management and health care prevention.