Care has been a popular topic of study and research for many decades and, as Judith Phillips comprehensively demonstrates, it remains infinitely researchable. The book reviews the wide range of perspectives that have been adopted over the years and sets out clearly the various schools of thought that have engaged with the subject – from feminism to postmodernism, from geography and ecology to culture and ethnicity. While adopting a lifecourse approach, it is mostly written with a focus on older age although in certain sections, such as those on risk and abuse, the position of children predominates. Given the author's professional background, it is not surprising that most of the discussion is situated in the context of health- and social-care although she acknowledges that care can also be played out in other arenas. Much of her concern is to examine the old but constant questions of family roles and responsibilities in caring for dependent members. Is the modern family too dysfunctional or too dispersed to care? Can women balance caring and working responsibilities successfully? Is caring a gendered role?

In an examination of the ethnic and cultural aspects of care, Phillips is careful to note both the diversity of experience and response that characterises different ethnic communities and the changing global context. In doing so, she challenges some of the myths often associated with the study of care and ethnicity. She also acknowledges the profound social change that increasing migration is causing both for the home countries which are losing people who would otherwise be there to care for their elders and for the host countries that are ‘contracting out’ the care of their older people to incoming migrants. At the heart of the book, however, is an examination of care today in the British health- and social care system. The author outlines the development of the system during the second half of the 20th century, particularly the development of community care and the associated antipathetic attitudes towards institutional care. She points out that there has been very little debate about the growth of the private sector in the provision of residential and nursing-home care (as well as domiciliary care), and few opportunities for the public to express their views. There has indeed been a transfer of responsibility from the public to the private sector with huge implications (especially financial) for many people. It is estimated that one-third of the residents of care homes are self-funders and that many local authority supported residents are pressurised into ‘top ups’ being paid for them by their relatives. Substantial numbers of people have to pay for some or all of their domiciliary care. Such is the transformation by stealth of modern social care.

The picture that is drawn of the increasingly bureaucratised and formalised structure and practice of care is not appealing, even though elements are cloaked in the rhetoric of empowerment and participation. In particular, Phillips criticises care management as being ‘inconsistent with the key essentials of an ethic of care’ (p. 124). She also looks at attempts to integrate health- and social-care, and catalogues a long list of difficulties that inhibit its accomplishment, including institutional and professional boundaries and rivalries, philosophical differences, budgetary separation and poor communication. On reflection, it seems extraordinary that we still employ the same concept – ‘care’ – to cover what goes on at one end of the spectrum (the affective relationships within families) as well as what we resolutely refer to as care at the other end (the formal, mean-spirited world of eligibility criteria and risk averseness). As Phillips says, ‘such a resource-driven system fails to see caring as a moral obligation guiding human agency’ (p. 124). Perhaps it is time to end attempts to yoke them together in a single unified concept. Perhaps we should talk instead about ‘care’ (the affective and the morally driven) and ‘social care’ (the official system of managing dependent people).

There is a useful and challenging chapter on risk and abuse. The author describes the way in which care has become redefined as ‘risk aversion and protection’ (p. 144) and how the overwhelming urge to avoid scandals (as were rife in the past, as in the old mental hospitals, or as prominent today, such as child abuse) has conditioned the way in which social-care services now operate. It would have been useful if Phillips had extended this line of thinking when considering current policy developments. It could be argued that the Green Paper on adult social care, Independence, Wellbeing and Choice (Department of Health Reference Department2005), and the White Paper Our Health, Our Care, Our Say that followed, take risk aversion one step further by transferring risk-taking responsibility from statutory agencies onto the shoulders of dependent people and their families themselves (through direct payments and managing one's own personal assistance). These documents, however, are not mentioned. The book will be useful for all students and researchers of social policy and social gerontology. It summarises the main debates succinctly, cites the key research comprehensively and raises some interesting and challenging questions about the current social-care system as well as presenting some of the moral issues associated with care in the modern world.