Introduction: social care anniversaries

Although NHS anniversaries have been widely celebrated and form the basis of a number of detailed histories, adult social care has tended not to receive the same attention and focus. The National Assistance Act – the piece of legislation which many see as leading to the creation of the modern adult social care system – received Royal Assent on 13 May 1948, just weeks before the launch of the new National Health Service. In one sense, therefore, all the anniversaries set out in the opening chapter to this book could also be seen as joint anniversaries of both health and social care. This is very fitting, as health and social care have been so inextricably linked ever since – with a series of attempts to break people’s lives down into separate ‘health’ and ‘social care’ needs proving increasingly meaningless over time. However, the vast majority of previous accounts have focused solely on the NHS, and adult social care is rarely mentioned, even in passing. As a result, the history of adult social care is largely overlooked – and even people working in adult social care may know little about the origins and evolution of their current services and roles.

In many ways, the current adult social care system is based on the legacy of the Poor Law, with frail older people, disabled people and people with learning disabilities or with mental health problems initially supported within local communities, and then – as problems of poverty and rapid industrialisation and urbanisation increased – in infamous institutions known as ‘workhouses’ (see Payne, 2005; Means, Richards and Smith, 2008; Pierson, 2011; Glasby, 2017; Humphries, 2022; for an overview of the history and development of adult social care and of the social work profession). Faced with more need that they could ever possibly meet, workhouses were deliberately designed to be as a harsh as possible so that only people who were absolutely desperate would seek support, with everyone else doing all they could to remain as independent as possible (a principle known as ‘less eligibility’). After the Second World War, an attempt was made to distance modern adult social care from this controversial and unfortunate legacy, with a clear separation between national financial support for those on low incomes or unable to work (‘social security’) and practical care and support for people who are frail or disabled (‘adult social care’).