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Funding long-term care for older people: lessons from other countries
- Authors:
- GLENDINNING Caroline, et al
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2004
- Pagination:
- 35p., bibliog.
- Place of publication:
- York
An evaluation of how other countries are devising fair and sustainable ways of funding long-term care for older people. Like the UK, many other countries are facing challenges in devising fair and sustainable ways of funding the long-term care needed by new generations of older people. While the challenges are similar, their responses are sometimes very different from our own. Nevertheless, their experiences can provide valuable lessons for the UK. This report draws on the experiences of long-term care funding – both the raising of revenue and the mechanisms by which it is allocated to services and allowances – in Australia, Austria, Denmark, France, Germany, Japan, Netherlands, Scotland and the United States.
Improving equity and sustainability in UK funding for long-term care: lessons from Germany
- Author:
- GLENDINNING Caroline
- Journal article citation:
- Social Policy and Society, 6(3), July 2007, pp.411-422.
- Publisher:
- Cambridge University Press
This paper argues for a transformation of arrangements for accessing and allocating public resources for long-term care in the UK. Currently these arrangements are fragmented, inequitable and not always well targeted. Different arrangements exist in Scotland and England; Wales has also debated the introduction of free personal care. While not necessarily advocating a social insurance approach, the experience of Germany nevertheless shows how simplicity, transparency and equity of access can be combined with strong cost control levers and political sustainability. An opportunity to transform ways of accessing and distributing public resources for long-term care arises with the piloting of ‘individual budgets’ in 13 English local authorities from 2006. The paper argues that the principles underpinning individual budgets should be extended, with the UK government taking a strong national lead.
Choice, competition and care: developments in English social care and the impacts on providers and older users of home care services
- Authors:
- RODRIGUES Ricardo, GLENDINNING Caroline
- Journal article citation:
- Social Policy and Administration, 49(5), 2015, p.649–664.
- Publisher:
- Wiley
This article critically examines recent changes in markets for home (domiciliary) care services in England. During the 1990s, the introduction of competition between private (for-profit and charitable) organisations and local authority providers of long-term care services aimed to create a ‘mixed economy’ of supply. More recently, care markets have undergone further reforms through the introduction of direct payments and personal budgets. Underpinned by discourses of user choice, these mechanisms aim to offer older people increased control over the public resources for their care, thereby introducing further competitive pressures within local care markets. The article presents early evidence of these changes on: a) The commissioning and contracting of home care services by local authorities and individual older people; b) The experiences and outcomes for individual older people using home care services.. Drawing on evidence from two recent empirical studies, the article describes how the new emphasis on choice and competition is being operationalised within six local care markets. There are suggestions of small increases in user agency and in opportunities for older people to receive more personalised home care, in which the quality of care-giving relationships can also be optimised. However, the article also presents early evidence of increases in risk and costs associated with the expansion of competition and choice, both for organisations providing home care services and for individual older service users. (Edited publisher abstract)
Reforming long-term care: recent lessons from other countries
- Authors:
- GLENDINNING Caroline, MORAN Nicola
- Publisher:
- University of York. Social Policy Research Unit
- Publication year:
- 2009
- Pagination:
- 51p., bibliog.
- Place of publication:
- York
This paper reports on a review that explored the experiences of a number of countries in reforming their arrangements for funding and delivering long term care. It aimed to: describe the key features of social care funding and service delivery in a number of countries; examine the current debates and reforms in arrangements for funding and delivery in these countries; discuss the implications and lessons for reform in England. In doing so, three issues were of particular interest: the promotion of choice through individual budgets; sustainability of current arrangements; the extent to which funding and delivery arrangements apply equally to older and younger people with care and support needs. The paper concludes with a number of lessons for the reform of care and support in England.
Paying for long-term domiciliary care: a comparative perspective
- Authors:
- GLENDINNING Caroline, et al
- Journal article citation:
- Ageing and Society, 17(2), March 1997, pp.123-140.
- Publisher:
- Cambridge University Press
Concerns over growing numbers and proportions of older people in industrialised societies have prompted interest in the development of cheaper ways of providing long-term care for older people. While debate in the UK is currently focused on the costs of residential and nursing care, other European and Nordic countries have introduced schemes designed to encourage or sustain the provision of 'social' care by family members, friends and 'volunteers', on the assumption that this can be provided a lower net public expense that either residential care or formally-organised domiciliary services. This article describes four different models on which such payments are currently based. These models are discussed and evaluated, taking into account factors which include the eligibility criteria for payments; maximising the autonomy of older people and family care-givers; and the relationships between financial payments and access to services.
Rearranging the deckchairs on the Titanic of long-term care: is organizational integration the answer?
- Authors:
- GLENDINNING Caroline, MEANS Robin
- Journal article citation:
- Critical Social Policy, 24(4), November 2004, pp.435-457.
- Publisher:
- Sage
Since 1997 the British government has actively promoted collaboration between health and social care services, culminating in proposals for fully integrated health and social care organizations -called Care Trusts - to address problems in co-ordinating services for older people. This paper draws on historical evidence to examine the origins and development of these difficulties. A consistent theme over the past 50 years has been the changing role of health services in the provision of long-term support for older people and the consequent redefinition of the boundaries between health and social services. However, these changes have largely not been matched by corresponding transfers of resources that might enable social services to meet their increased responsibilities. Moreover, the demands of the acute hospital sector risk marginalizing the social support valued by older people themselves. The paper argues that organizational restructuring will therefore fail to improve coordination between health and social services for older people unless these underlying issues are also addressed.
Rights and realities: comparing new developments in long-term care for older people
- Editor:
- GLENDINNING Caroline
- Publisher:
- Policy Press
- Publication year:
- 1998
- Pagination:
- 179p.,bibliog.
- Place of publication:
- Bristol
Focuses on the shifting boundaries between health and social care, between services and money, and between public and private provision of care. Explores the experiences of a number of countries which have recently made changes in the organisation, funding or delivery of long term care services for frail older people.