Reforming long-term care: lessons from other countries

Document type
Glendinning, Caroline; Moran, Nicola
Date of publication
1 June 2009
Working paper; no DHP 2318
Social Work, Social Care and Social Services, Disabled people, Older Adults
Social welfare
Material type

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Valuable lessons, both positive and negative, can be learned from the experiences of funding and delivery of long-term care for older and disabled people in other countries. Evidence from other countries can, amongst other things:
  • Open up for examination a range of different principles and assumptions on which funding and delivery arrangements could be based.
  • Shed light on potential political and social factors that might constrain implementation.
  • Identify additional measures that may be required to achieve desired policy objectives.

This paper reports on the experiences of a selected number of other countries in reforming their arrangements for funding and delivering long-term care. Of course it is not always easy - or indeed possible - to transfer arrangements from one country or jurisdiction to another. Arrangements for social and long-term care, in particular, are often embedded in the distinctive historical, cultural and legal traditions of particular countries; reforms tend to be incremental rather than transformational. However, comparisons with other countries can help in identifying underlying principles and trajectories of change. Moreover, radical reforms that break with traditional institutional and cultural arrangements are also sometimes possible.

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