Health care reform in the UK: Unrealistic or broken promises to older citizens?

For 50 years the National Health Service (NHS) in the UK has been changing in response to economic, political and social pressures. In 1980 the pace of change increased, culminating in fundamental reforms to the provision of health and social care in the 1990 NHS and Community Care Act. Cost containment underpinned the rationale for the changes but inefficiency and bureaucratic waste was blamed by the New Right political elite. The reforms represented an attack on medical power which was curtailed by the introduction of the internal market and the cloning of business methods. This article explores the context in which these reforms were engineered and reports the implications for older people who were led to believe that the Welfare State would support them in later life.