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King’s Fund looks at the highs and lows of 75 years of social care

The King’s Fund is reflecting on 75 years of the social care system in England, Wales and Scotland and the NHS, through a range of resources.

In a blog, King’s Fund senior fellow Simon Bottery takes the view that the 1948 National Assistance Act, which represents the foundation of modern social care, is both a cause for celebration and for regret.

He writes that the Act introduced the duty on local authorities to provide accommodation for older and ‘infirm’ people and a power to promote the welfare of disabled people. It also required residential care homes to be regulated and allowed local authorities to financially support voluntary organisations to, for example, provide meals to the elderly.  

On a positive note, the Act creates a public responsibility to provide services to people who, because of age, illness or disability, need support. Its focus was on decent accommodation for older people and on older age as a time of possibility rather than inevitable decline.

However, among the negatives of the Act, in his opinion, were the creation of a ‘fault line’ between today’s social care and the National Health Service: local authorities were allowed to charge for the accommodation and support they provide; the Act focuses on residential care, and provides only for problems that had not already been tackled, in other words local authorities were charged to ‘fill in the gaps’ between the support already provided by existing legislation. Bottery argues that this has probably contributed to the sense, still felt today, of social care as “a second-class citizen”.

Other resources provided by the King’s Fund include:

  • A history of social care funding
  • Key facts and figures about social care
  • Social care in a nutshell


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