Adult social care was the first major social policy domain in England to be transferred from the state to the market. There is now a forty-year period to look back at to consider the thinking behind the strategy, the impacts on commissioners and providers of care, on the care workforce and on those who use care and support services. In this book, Bob Hudson meticulously charts these shifts. He challenges the dominant market paradigm, explores alternative models for a post-Covid-19 future and locates the debate within the wider literature on political thinking and policy change.