英國社區照顧之政策發展與實施之優缺分析－兼對台灣福利社區化之啟示

Community Care Policy Development in British: Lessons for Taiwan

賴兩陽(Leang-Yang Lai)

《臺大社會工作學刊》 3期 (2000/12) Pp. 151+153-212

https://doi.org/10.6171/ntuswr2000.03.05

摘要

英國是當前福利國家中社區照顧歷史最悠久的國家，迄今已逾五十年，與社區照顧相關法案多達二十二種之多。社區照顧的措施也隨著英國政治、經濟及社會變遷，而呈現不同風貌，其制度建構過程，深受福利意識型態的影響，包括自由主義、費邊社會主義、新右派與第三條路，這些意識型態主導了社區照顧政策的發展。其發展趨勢係從去機構教養化到解決福利國家危機、從政府為主體到福利混合經濟、從中央集權到地方分權、從照顧精神病患到以老人及身心障礙者為主、從「在社區中照顧」到「由社區照顧」、從個案工作者到個案管理者七大趨勢。台灣福利社區化係要落實社區照顧的主張，因此從美國社區照顧的發展歷程，台灣可資借鏡之處包括：尋求定位福利社區化政策的意識型態、結合專家學者以研訂政策、充實福利社區化的立法、加強政府機關協同合作、進行地方政府組織再造、推動照顧混合經濟、釐清政府角色定位、培養服務使用者參與、重視瞭解照顧者需求與強化照顧管理。

關鍵字

社區照顧 ； 福利社區化 ； 福利混合經濟

並列摘要

Britain have been developed their community care policy over fifty years. Their community care related act or legislation have 22 items. Approaches towards it have changed historically, according to their ideological underpinnings, that is, the predominating social values and institutional frameworks of the time. Britain's community care policy were influenced by the political ideology including Liberlism, Fabian socialism, Neo-liberlism or the New Right and The Third Way. Their developed tendency including: from de-institutionalization to solving the crisis of the welfare state, from state provision to mixed economies of welfare, from care for mental i1Iness people to learning difficulties people and elderly people, from ”care in the community” to ”care by the community” , from case worker to care manager. Lessons can be provided for Taiwan include: identify the ideology of community-oriented social service, associating professional to conclude policy, strengthen the legislation of community-oriented social service, enhancing cooperate between governments, progressing local governments restructure, implement mixed-economies of care, arranging the role of the government, encouraging services consumer participation, understanding carer's need and forcing care management.

並列關鍵字

community care ； community-oriented social services ； mixed economies of welfare