A、The lack of supervision by both the national and local governments. B、The impact of the current economic crisis at home and ab

Today’ s crisis in care for older people in England has two main causes. [22] First, people are living longer with a lot more complex needs. Second, they rely on a system that has long been marked by a poor relation between national health and social-care services.
    Current services originate in two key measures. They are the National Health Service and the 1948 National Assistance Act. This required local government to provide residential accommodation for older people and supervise care homes run by independent organizations. They also provided home and community services including meals, day centres and home helpers and other subsidized services. The National Health Service was free and wholly publicly provided. It delivered the best health-care for all. No such vision guided residential and community care though. [23] The care was substantially provided by voluntary services which worked together with local authorities as they long had with eligibility based on income.
    Today, life expectancy has risen from 66 for a male at birth in 1948 to around 80 now. In addition, there is better overall health and improved medical knowledge and care. This means an unprecedented number of people are surviving longer in conditions requiring expert support. Families provide at least as much care as they ever did. Even so, they can rarely without subsidized support address serious personal needs. Care for older people faced persistent criticism as these trends became apparent.
    From the early 1960s, local authorities were required to plan health and welfare services. The aim was to enable older people to remain in their own homes for as long as possible, but this increased concern about the lack of coordination between free health and paid-for social care. Through the 1970s, a number of measures sought to improve matters. However at a time of financial crisis, funding diminished and little changed. [24] In the 1980s, the government cut spending. Meanwhile, preference for private over public services made management even more difficult. Simultaneously, the number of sick older people grew. Governments emphasized the need to improve services. They did so though while doing little to stop the erosion of available aid. Services were irregular across authorities. Unless you were prepared to pay, they were increasingly difficult to obtain for any but the most severely disabled. Why has 60 years of criticism produced so little change? [25] Discrimination against older people has a long history. Additionally, those affected by inadequate health and social care are too vulnerable to launch the protests that have addressed other forms of discrimination.
Questions 22 to 25 are based on the recording you have just heard.
22. What is one cause of the current crisis in care for the elderly in England?
23. What does the speaker say about residential and community care?
24. What made management of care for the elderly more difficult in the 1980s?
25. What does the speaker say about older people in England?