Table 4.

Carers' experiences of the rationing of social care support services

Type of rationing (Klein et al. 1996, Arksey 2002)	Findings
Rationing by deterrence – access to care is made difficult	We needed to [make adaptations around the home] and again I tried to phone social services and I just couldn't get an appointment so I gave up. [CR15]
	Well it was my experience of being in this caring business if you're not forceful they'll just walk over you, especially now with the money like it is … If you look like you're not going to make an effort or if you don't appeal, they're of the opinion if you don't appeal you didn't want it anyway. [CR31]
Rationing by denial – services are denied to specific individuals or client groups	[Sighs] I have rung the carers' group but I didn't get any support … I rang regarding something in the newsletter but it didn't apply to us because we didn't qualify. [CR14]
Rationing by delay – access to services is discouraged by delaying tactics	There are the promises, but – November and we're now July? How much longer do I have to wait? [CR22]
	They don't do reviews unless something radically changes … I've been in touch to get a reassessment and they said, ‘Is there any change?’ only that he's got worse, but they don't do reassessments. [CR25]
Rationing by deflection – agencies protect resources by channelling clients to other services	I was given lots of phone numbers and lots of avenues to go down … I couldn't understand why. [CR10]
Rationing by charging – the service user contributes towards the costs of the services they receive	And because the government have cut so much they're charging each individual more and more money for the care they're getting. And whether you can afford it or not, and we can't afford it anymore. [CR19]
Rationing by termination or dilution – services are withdrawn or the quality or quantity of services is reduced	One carer had recently received notice of the withdrawal of a day care (college placement) provided for the care recipient over a number of days per week and spoke of the uncertainty and anxiety that this had caused:
	Because when the rug gets pulled, the rug gets pulled. And they're doing it all the time and they shouldn't be. [CR13]
	Another carer [CR29] spoke of how the care recipient's day care centre had closed and then reopened, but with a more limited range of activities available to clients.