If you want to know why adult social care is in crisis this is the book for you. Wide ranging in its themes and historical trajectory, it sets out the path of social care through the height of state planning ambition in the late 1960s to the almost accidental privatisation of care home provision in the 1980s. It locates the fragility of the current system in the missed opportunity of 1948. Social care was left out of the Beveridge settlement. Whilst the NHS has been subsequently venerated and protected, it has never been possible to muster a similar amount of public or political will to bring in an equivalent system for people requiring long-term care.

The book diagnoses the current issues facing social care in England from a range of directions including the fragile role of local government in a highly centralised state and the lack of an ethical framework for care commissioning. It sets out the dilemmas facing commissioners and the pressures which an inadequate system pushes down onto poorly paid care workers and the people that they support. People have gone from being clients of the state to consumers in markets, missing the opportunities for the social rights of citizenship in the T.H. Marshall tradition.

Going beyond critique, the book highlights the potential drivers of change: new models of commissioning; improved policy capacity in local government; a reframing of the care debate. There is a lot here that students, academics and general readers will find of interest. The changing role of social work is explored more extensively than in many books on social care. The chapter on Covid-19 is helpful and uptodate, describing the pandemic as ‘a colossal stress test of everything previously taken for granted’. The strain and tragedy is well captured but also the resourcefulness of communities and the activism of the state, suggesting that Covid-19 created conditions for transformation which are in danger of being lost.

The book has the sub-title ‘the Privatisation of Adult Social Care in England’, and this was somewhat jarring. At several points the renationalisation of care is mooted. However, care was never nationalised in the way that this language suggests. It always was and remains mostly private in the sense of being undertaken by families in homes. In this sense it is completely different to the NHS or a nationalised industry, and the language of ‘renationalisation’ feels descriptively inaccurate. There is also a normative point here: do we want to go back to a point where more provision was by the state? To do so would require a more thorough acknowledgement than is offered here of the failings of state care: the institutional abuse and neglect, the limited vision of life that was offered for people with disabilities or age-related frailty. Whatever comes next in the sector has to acknowledge that history—and its enduring legacy in the present—more explicitly than happens in this book.

Given the book's suggestion that social care missed out in the postwar settlement, I would have liked more discussion of the concept of a National Care Service (NCS), which is mentioned only in passing. An NCS has been proposed by Labour in a series of Westminster elections, and is currently being developed in Scotland and Wales. Inherent in this language is the idea that care would benefit from being treated like another NHS. This is attractive in terms of investment and public support, but offers a centralised and professionally-dominated model which sits awkwardly with many accounts of social care as ‘a life not a service’.

I agree with where the book ends up: social care's future must be one of diverse, local, mixed economies of small and responsive providers based on ethical and coproduced commissioning. It is clear that some localities are having a go at this. There is also change coming from central government with the introduction of a cap on care costs and a requirement that local government pays a ‘fair cost’ for care. However, without greater investment and the new approaches to commissioning that Hudson proposes, we will be stuck with the problems he so deftly identifies: bargain basement services, profiteering multinationals and a system teetering on brink of collapse.

如果您想知道成人社会关怀为何陷入危机，这本书适合您。它涵盖了广泛的主题和历史轨迹，从 1960 年代后期国家计划的雄心壮志到 1980 年代几乎偶然的养老院私有化，阐述了社会护理的道路。它将现行制度的脆弱性归咎于 1948 年错失的机会。社会关怀被排除在贝弗里奇定居点之外。虽然 NHS 随后受到了崇敬和保护，但从未有过类似的公众或政治意愿，为需要长期护理的人引入同等系统。

这本书从一系列方向诊断英格兰社会护理当前面临的问题，包括地方政府在高度集中的国家中的脆弱作用以及缺乏护理委托的道德框架。它列出了专员面临的困境以及不完善的制度给低薪护理人员和他们所支持的人带来的压力。人们已经从国家的客户变成了市场的消费者，失去了马歇尔传统中公民社会权利的机会。

除了批评之外，这本书还强调了变革的潜在驱动力：新的委托模式；提高地方政府的政策能力；重新构建护理辩论。这里有很多学生、学者和普通读者会感兴趣的内容。社会工作角色变化的探讨比许多关于社会关怀的书籍更广泛。关于 Covid-19 的章节很有帮助，而且是最新的，将大流行描述为“对以前认为理所当然的一切的巨大压力测试”。压力和悲剧得到了很好的体现，但社区的机智和国家的积极性也得到了很好的体现，这表明 Covid-19 为转型创造了条件，而这些条件有失去的危险。

这本书的副标题是“英国成人社会关怀的私有化”，这有点刺耳。在几个方面，护理的重新国有化正在讨论中。然而，护理从未像这种语言所暗示的那样被国有化。从家庭在家里承担的意义上说，它一直是并且仍然主要是私人的。从这个意义上说，它与 NHS 或国有化行业完全不同，“再国有化”的语言在描述上感觉不准确。这里还有一个规范点：我们想回到国家提供更多规定的点吗？要做到这一点，需要比这里提供的更彻底的承认国家护理的失败：机构虐待和忽视，为残疾人或与年龄相关的脆弱者提供的有限的生活视野。

鉴于该书建议在战后解决方案中遗漏了社会关怀，我希望更多地讨论国家关怀服务 (NCS) 的概念，这只是顺便提及的。工党在威斯敏斯特的一系列选举中提出了 NCS，目前正在苏格兰和威尔士发展。这种语言固有的想法是，护理将受益于像另一个 NHS 一样对待。这在投资和公共支持方面很有吸引力，但提供了一个集中的和专业主导的模式，这与许多将社会关怀视为“生活而不是服务”的说法尴尬地坐在一起。

我同意这本书的结尾：社会关怀的未来必须是多样化的、本地的、混合经济的小型和响应迅速的提供者，基于合乎道德和共同生产的委托。很明显，一些地方正在尝试这样做。中央政府也发生了变化，引入了护理费用上限，并要求地方政府为护理支付“公平成本”。然而，如果没有 Hudson 提出的更多投资和新的调试方法，我们将被他如此巧妙地识别的问题所困扰：廉价的地下室服务、暴利的跨国公司以及在崩溃边缘摇摇欲坠的系统。