Recent discussions of health and social care in the United Kingdom hav
e been dominated by the 1990 National Health Service and Community Car
e Act. A core dimension of the act was to encourage greater mixing of
the ''economy of care,'' specifically, greater pluralism in provision,
more systematic regulation of practice and assurance of quality, and
(in the longer term) greater variety of funding sources. The result ha
s been the development of social care markets. In this article, we des
cribe the mixed economy reforms and early evidence regarding success.
The main issues concern development of social care markets and the imp
lications for local authorities of their new purchasing roles.