Policy Paradigms and Long-Term Care: Convergence or Continuing Difference?
This chapter analyses policy paradigms in the area of long-term care for older people in France, Spain, England, Sweden and Germany2 since the mid-1990s. The chapter identifies three paradigms that do not have much in common and that have not converged in any essential respects. While the statist paradigm (to which Sweden continues to adhere) and the familialist/individualist paradigm (to which care policies in England and Spain belong) have experienced only minor changes, the ‘state pays, others provide’ paradigm to which France and Germany adhere has undergone extensive changes. Contrary to some other recent accounts of the development of social care systems, this chapter argues that there are no signs of significant convergence towards universalisation, individualisation and formalisation in the long-term care policy paradigms in the five countries analysed here. Despite the absence of significant convergence between the paradigms, there are two common themes that the long-term care policies in all five countries share, namely the emphasis on homecare (domiciliary or ‘community’ care) and the increased inclination to turn to the market as a source of care (marketisation).
KeywordsInformal Care Social Assistance Senior Official Social Care Service Statist Paradigm
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