Reforms in long-term care policies in European Union countries

SPRU research team

• Caroline Glendinning
• Alison Wilde
  
  

External collaborators

• Costanzo Ranci, Polytechnic of Milan, Italy (co-convenor)
• Emmanuele Pavolini, University of Macerata, Italy (co-convenor)
• August Österle, Institute for Social Policy, Vienna University of Economics, Austria
• Viola Burau, University of Aarhus, Denmark
• Claude Martin, French School of Public Health and University of Rennes, France
• Blanche LeBihan, French School of Public Health and University of Rennes, France
• Hanne Marlene Dahl, University of Roskilde, Denmark
• Hildegard Theobald, University of Vechta, Germany
• Marta Szebehely, Department of Social Work, University of Stockholm, Sweden
• Barbara daRoit, University of Utrecht, Netherlands
• Gregorio RodrÃguez-Cabrero, University de Alcalá de Henares, Spain

Project summary

Aims

In response to increasing pressures of demographic ageing and changes in the availability of family care, many EU countries have reformed their long-term care services over the past 15 years. The aims of this study were to:

• Describe changes in long-term care policies in nine Western European countries over the past two decades.
• Examine the extent to which reforms illustrated a convergence between models that were originally developed in very diverse institutional and economic contexts.

Specific features of reform that were examined included:

• Pressures and drivers for change
• Forms of change and evidence of convergence
• Regulatory reforms and evidence of convergence
• Impacts and outcomes of reforms for users and for institutions 
• Decentralisation and its impacts.

Methodology

Each participating researcher contributed a report on reforms in her/his own country, written to a common structure, but emphasising particular unique national features where relevant. All participating researchers contributed to the concluding comparative chapter.

Policy and practice aims

Developing appropriate and sustainable long-term care arrangements is an important area of welfare state development; many welfare systems have to date not provided adequate coverage for the new risk of dependency. These developments involved redefinitions of social rights and the respective roles of families and market mechanisms; and the emergence of new regulatory regimes. The study analysed these changes and examined them for evidence of convergence. It contributed to the development of theoretical approaches to different welfare regimes and to the understanding of the changes within these regimes, in the contexts of common demographic, social and economic pressures.