In this chapter we explore two of Peter Townsend's pioneering studies: first, The family life of old people (1957), an ethnography of Bethnal Green, and second, The last refuge (1962), a nationwide study of old people living in residential homes. We suggest that these key texts laid the foundations of his entire opus.

The financial Dunkirk

Before describing these studies in more detail, and discussing their relevance for contemporary research and policy agendas, it is important to place them in context, opening with the immense challenge Britain faced in 1945. John Maynard Keynes had laid a paper before the Cabinet titled The financial Dunkirk, the title all too clearly setting out the scale of the problem (Toye, 2004). The national coffers were empty and an ill-fed, ill-clothed and ill-housed people believed that the hard-won victory would now bring prosperity or at least a job and a roof over their heads. Recovery, despite huge loans from the US, was desperately slow. David Kynaston calls the period from 1945 to 1951 Austerity Britain (2007). But while everyday life was indeed austere, his title underplays the achievement of the Attlee government in laying, however unevenly, the foundations of the welfare state. Its policy of redistribution of wealth and income was for Old Labour the beginning of the long march to a more just society.

Nonetheless the Labour government fell in 1951, punished for their failure to build enough council housing. When the Conservative manifesto pledged to build 300,000 homes a year, and achieved its target, Prime Minister Macmillan was able to declare triumphantly, ‘You’ve never had it so good’. However, Labour's redistributive policies were sufficiently well entrenched and popular that the Conservative government could only begin to reverse this in the mid-1950s. Despite the struggle, with Peter among the leaders in the defence of the poor from the 1950s to his death in 2009, it has taken a combination of Conservative and New Labour governments to turn Britain into a massively unequal society in which the difference in expectation of life between the poor and the rich is now a full 10 years.

The importance that William Beveridge attached to the maintenance of full employment is not surprising. Unemployment had been a major focus of his work both as an academic economist and as a policy adviser since the beginning of the 20th century (see, for example, Beveridge, 1909). The labour exchanges together with unemployment insurance, which, along with other economists, he advocated to facilitate the matching of jobs with those seeking employment, were introduced before the First World War. He was heavily involved in the work of the Unemployment Assistance Board in the 1930s and was all too aware of the problems created by a wages system that took no account of family size and a benefit system that did. (Eleanor Rathbone had converted him to the need for family allowances in the 1920s.) By the 1940s, he had been much influenced by Keynes and governments’ crucial role in managing demand to avoid mass unemployment (see Harris, 1977). The experience of two world wars demonstrated that governments did have the capacity to support mass employment. While few argued for continuing such a high level of government intervention in the economy in peace time, there was greater acceptance that governments should and could plan the economy in order to minimise unemployment levels. The coalition government's White Paper Employment Policy published in 1944 stated: ‘The government accept as one of their primary aims and responsibilities the maintenance of a high and stable level of employment after the war’ (White Paper, 1944).

Over the following decades, the balance of responsibility for both the problem and the solution to unemployment shifted between the government and the individual, with more emphasis placed on the actions of unemployed individuals themselves. In this chapter, first, the resulting changes in the meanings of ‘idleness’ and ‘unemployment’ will be briefly described. Second, the huge shift in the responsibilities of wives and mothers in relation to the labour market, both ideologically and in practice, will be discussed.

Policy proposals published in England during 2005 emphasise the importance of ensuring that older people and adults needing care achieve ‘independence’ and are given ‘choices’ consistent with their own well-being. Indeed, the Green Paper on social care is entitled Independence, well-being and choice: Our vision for the future of social care for adults in England (DH, 2005). This chapter will first explore how far the interpretation of the complex and fluid concepts of ‘independence’ and ‘choice’ reflected in current policies is adequate ‘to secure the dignity and quality of life of older citizens, and to ensure that they receive the support they need in the place, and manner they prefer’ (Baldwin, 1995, p 138). This exploration will be placed within the contexts of the growing emphasis on individuals as consumers rather than as citizens; the increasing identification of ‘active citizenship’ with being in paid employment; and the increasing commodification and marketisation of care services. In particular, current policy developments in domiciliary and residential care services will be examined to illustrate some of the contradictions and dilemmas that arise in these contexts, which are very different from those of the post-war British welfare state.

The ‘active’ and ‘independent’ citizen

As Lewis argues in Chapter Two, by the end of the 20th century the solutions to poverty, welfare dependency and the rising costs of pensions being advocated in many advanced industrialised societies were for more adults to become and remain active in the labour market. In 1999, the Organisation for Economic Co-operation and Development (OECD) published a report A caring world: The new social policy agenda. As well as advocating the combination of employment-oriented social policies with family-friendly policies so that parents could more easily combine care and employment, the authors of the report argued that countries should develop ‘an active ageing policy’. This would include:

Introduction

The Conservative government elected in the summer of 1979 openly challenged the fundamental assumptions upon which the British postwar welfare state had been founded. The relationship between social and economic policies changed, calling into question the commitment to full employment that both Keynes and Beveridge believed was an essential underpinning of a social democratic welfare state. As Jessop (2002, p 61) much later wrote, reflecting on what he called the “Keynesian national welfare state”:

In this model, public expenditure and the growth of the public sector is desirable because the ‘social wage’, funded by progressive taxation, guaranteed all citizens access to the health, education and welfare services when needed, irrespective of their capacity to pay at the time of their use. Thus inequalities in money income are less important, money wage increases can be restrained and inflation kept within bounds. The risks that individuals face over their lifetime, such as unemployment, sickness and old age are collectivised.

This chapter will follow the transformation over the past quarter of a century from a ‘Keynesian national welfare state’ to one based on supply side economics and a fundamental distrust of public and collective provision, that is, a residual liberal welfare model in Esping-Andersen’s typology (Esping-Andersen, 1990) or a Schumpeterian competitive welfare model in Jessop’s terms. I will look, in particular, at how privatisation shaped not only the development of social policies but also their very function and meaning. Privatisation can mean returning collective responsibilities to the family – ‘re-commodification’ (O’Connor et al, 1999; Jessop, 2002) as well as moving activities from the public sector to the market – ‘marketisation’ (see, for example, Ungerson, 1997; Knijn, 2000).

Introduction

Richard Titmuss, the first professor of social administration in Britain, was also the first to set out a comprehensive research agenda for social policy (Titmuss, 1958). He was strongly committed to an infrastructure of universal services because it “provides a general system of values and a sense of community” (Titmuss, 1968, p 135). However, he was well aware that “universalism was not by itself alone, enough” (1968, p 135). His own work, along with that of Peter Townsend, Brian Abel-Smith, and Tony Lynes, had revealed that poverty among pensioners, as well as sick and disabled people, low-wage earners and their families, and lone parents, had not been eradicated despite full employment and the general growth in affluence in the 1950s and 1960s. Moreover, inequalities in the distribution of income and wealth remained, despite being tempered by the tax and benefit systems. In practice there was unequal access to – and effective use of – the social services. In particular, the middle classes made fuller use of the education and health care systems. As universalism has been watered down, particularly since 1980, the challenge today is how to re-establish universality in the context of growing reliance on the private for-profit sector heavily subsidised by the taxpayer. Or, perhaps, the challenge in fact is to find an alternative way to sustain a sense of community and social solidarity. This chapter explores some of the key issues involved, looking first at some of the main changes which have occurred since the 1950s.

During the 1960s, Beveridge's principle of flat-rate benefits in return for flat-rate contributions had been abandoned, and both National Insurance (NI) contributions and benefits had become earnings related (up to a ceiling set at one and a half times average male earnings). A tax credit scheme to tackle the problem of the inadequacy of the basic state pension had been considered in the mid-1960s and abandoned (for a detailed account, see Webb, 1975). Instead,attention focussed in the short term on making means-tested supplementary benefits (now Income Support) more acceptable to pensioners, and in the longer run developing a ‘partnership’ between public and private providers which would form the basis of reforming state pensions. In this partnership (which took until 1975 to reach the statute book because of two intervening general elections), employers, with their occupational pension schemes, had a significant role to play.

Stephen Byers, the Secretary of State for Trade and Industry was launching a consultation paper Work and parents: Competitiveness and choice (DTI, 2000). He made it very clear that ‘parents’ includes both fathers and mothers. However, it is also clear from reading the paper that any measures to help parents ‘to balance work and family life’ so that they ‘may contribute fully to the competitiveness and productivity of the modern economy’ must be based on giving families ‘reasonable choices’ taking ‘the needs of business into account’.

In the past, the ‘reasonable’ choices facing mothers in the UK were constructed differently. The big increase in economic activity rates, which had occurred among married women in the UK since the Second World War, was almost entirely accounted for by an increase in part-time employment. Very few (5%) of married women had full-time employment while they had a pre-school child. Until 1980, lone mothers irrespective of the age of their child(ren) were more likely to be economically active than married mothers in the UK. There was little difference in the level of qualifications of married and lone mothers – neither were well qualified (see Land et al, 2000). Social assistance was there for those without earnings. As the Supplementary Benefit Commission, responsible until 1980 for the means-tested supplementary benefit system (now called Income Support) wrote in their last annual report: