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The boundary between health and social care services has been an important focus of both social research and policy reform in many western and northern European countries. In the UK there is a history of particularly sharp divisions between the centrally funded NHS and locally run social services. A consequence for older people, especially those with less acute or "intermediate" needs, is that they may be rationed out, ignored, or treated inappropriately on either side of the boundary. This paper seeks to go beyond explanations in terms of financial, administrative and professional divisions by using now-available public records to show how the boundary between health and social care was set in stone in the immediate postwar years and resulted in a constant battle between the two services over the needs they would meet. The first part of the paper examines a largely hidden history of health and social care policy. The second part examines the new NHS Plan and the extent to which it is likely to resolve the problem of the boundary.

The starting point of this research was the concern that the circumstances, let alone quality of life, of those who migrated to England during the postwar period and who are now progressing into early old age and retirement, have only recently become an issue for research and policy. The study treats quality of life as a phenomenon (comprising the domains control, autonomy, pleasure, and self-realisation) distinct from its potential influences. Qualitative interviews with respondents from four ethnically homogeneous groups (Jamaican Caribbean, Gujarati Indian Hindu, Punjabi Pakistani, and white English) identified six factors that influenced their quality of life: having a role, support networks, income and wealth, health, having time, and independence. Findings suggest that while both the influences on quality of life and the domains of quality of life were consistent across the ethnic groups, it was the ways in which they played out in people's lives that revealed ethnic variations.

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