Spatial and Structural Change in Institutional Care for the Elderly in South East England, 1987–90

In Great Britain, the 1980s were marked by an increasing involvement of the independent sector in the provision of long-term institutional care resources for the elderly. In this paper, spatial and structural changes in the provision of all categories of residential and nursing beds in the South East region of England between 1987 and 1990 are investigated. The data were obtained from a variety of sources including directories of private institutional care facilities, the Department of Health, and the Office of Population Censuses and Surveys. Separate analyses of change were conducted for (a) the public and private residential care sectors, and (b) all categories of independent care (that is, residential and nursing) resources, at both regional and local scales. The results disclose that the 1987–90 period witnessed continued rapid growth of institutional care resources in the South East region, although public-sector involvement in the provision of residential care beds declined. An analysis of spatial shifts of independent residential and nursing beds at the county level of resolution does not reveal appreciable changes in their overall levels of geographical concentration in the region. However, the provision of independent care beds may be approaching saturation level in some coastal retirement communities, with part of the relatively rapid growth shifting locally to surrounding, mainly inland, areas that have recently experienced notable gains in their elderly population. Analysis of structural growth components indicates that disclosed changes in the spatial distribution of independent care beds are attributable to both the opening of new homes and the expansion of existing premises.