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Innovations and Care of the Elderly: The Cutting-edge of Change for Social Welfare Systems. Examples from Sweden, the Netherlands and the United Kingdom

Published online by Cambridge University Press:  14 November 2008

John baldock
Affiliation:
Faculty of Social Sciences, University of Kent, Canterbury.
Adalbert everst
Affiliation:
European Centre for Social Welfare Policy and Research, Vienna.

Abstract

This article is based on an international study which investigated innovations in home care for the elderly in three European countries:Sweden, the Netherlands and the United Kingdom. It is argued that the particular changes taking place in services for the elderly may be indicative of what will happen more generally throughout welfare systems. This is because patterns observed in an area of acute pressure are often precursors of further developments. Welfare systems change first at points of pressure where established policies and solutions are no longer working or cannot be sustained. Innovation and reform become necessary. This is certainly true of social care policies for the elderly in industrial countries. It is no coincidence that in each of the three countries we studied government has commissioned major inquiries into the operation of the care system and that the early 39905 will see the introduction of substantial reforms. We argue that the changes that are taking place, although mediated by particular national traditions and politics, have much in common. They are part of a shift away from the state-dominated post-war welfare settlements towards more diffuse and pturalist forms of social care. The frail elderly, for demographic and etonomic reasons, are in tne front line of this shift to new patterns.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1992

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References

Abel-Smith, B. 1984. Cost-containment in Health Care: The Experience of Twelve European Countries from 1977 to 1983. Luxembourg.Google Scholar
Alber, J. 1988. Die Gesundsheitssysteme der OECD – Länder im Vergleich. In PVS Sonderheft, 19, Opladen.Google Scholar
Balbo, L. (1987). Crazy quilts: rethinking the welfare state from a woman's point of view. In Sassoon, A. Showstack (ed.) Women and the State. Hutchinson, London.Google Scholar
Baldock, J. C. (1989). Social work services in the United Kingdom: a perpetual crisis of marginality. In Munday, B. (ed.) The Crisis in the Welfare State: An International Perspective on Social Services and Social Work. Harvester&Wheatsheaf, London.Google Scholar
Baldock, J. C. and Ungerson, C. 1990. What d'ya want if you don' want money? In M., McLean and G., Groves (eds) Women's Issues in Social Policy. Routledge, London.Google Scholar
Brody, E. M. 1981. Women in the middle and family help to older people. The Gerontologist, 25, 1929CrossRefGoogle Scholar
Buckingham, L. 1990. Insurers poised to offer a free enterprise alternative. The Guardian, 05 26, 16.Google Scholar
Bulmer, M. 1987. The Social Basis of Community Care. Allen and Unwin, London.Google Scholar
Challis, D.J. and Davies, B. P. 1986. Case Management in Community Care. Gower, Aldershot.Google Scholar
Challis, D., Darton, R., Johnson, L., Stone, M., Traske, K. and Wall, B. 1989. Supporting the Elderly at Home: The Darlington Community Care Project. PSSRU Monograph, University of Kent, Canterbury.Google Scholar
Challis, D., Chessum, R., Chesterman, J., Luckett, R. and Traske, K. 1990. Case Management in Social and Health Care: the Gateshead Community Care Experiment. PSSRU Monograph, University of Kent, Canterbury.Google Scholar
Cm 849. 1989. Command Paper, Caring for People: Community Care in the Wext Decade and Beyond. HMSO, London.Google Scholar
Evers, A. and Wintersberger, H. 1990. Shifts in the Welfare Mix: Their Impact on Work, Social Services and Welfare Policies, 2nd ed.Campus/Westview, Frankfurt and New York.Google Scholar
Flora, P. (ed.) 1986. Growth to Limits: The Western European Welfare States since World War II, vol. 2. Walter de Gruyter, Berlin.Google Scholar
Goffman, E. (1961)79. Asylums: Essys on the Social Situation of Mental Patients and Other Inmates. Anchor Books, Doubleday and Co., New York.Google Scholar
Gough, I. (1979). The Political Economy of the Welfare State. Macmillan, London.CrossRefGoogle Scholar
Griffiths, Sir Roy. 1988. Community Care: Agenda for Action – A Report to the Secretary of State for Social Services. HMSO, London.Google Scholar
Hokenstad, M. C. & Johansson, L. (1990). Caregiving for the elderly in Sweden: program challenges and policy initiatives. In Biegel, D. E. and Blum, A. (eds) Aging and Caregiving: Theory, Research and Practice. Sage, San Francisco.Google Scholar
House of Commons. 1990. Community Care: Choice for Service Users, Sixth Report of the Social Services Committee, No. session 1989–1990. HMSO, London.Google Scholar
Johansson, L. 1985. Informell kontra offentlig äldreomsorg – n˙gra data fron ULF-studien 1980/1981. Nordiska hälsovadshögskolan, Göteborg.Google Scholar
Johnson, N. 1987. The Welfare State in Transition; The Theory and Practice of Welfare Pluralism. Wheatsheaf Books, Brighton.Google Scholar
King, J. 1990. A Helping Hand – Care management in Kent. Community Care, no. 802, pp. 2325.Google Scholar
Knapp, M. 1989. Private and voluntary welfare. In McCarthy, M. (ed.) The New Politics of Welfare: An Agenda for the 1990s? Macmillan, London, 225252.CrossRefGoogle Scholar
Kraan, R., Baldock, J. C., Davies, B. D., Evers, A., Johansson, L, Knapen, M., Thorsiund, M. and Tunissen, C. 1992. Care for the Elderly: Signficant Innovations in Three European Countries. Campus Westview, Frankfurt and New York.Google Scholar
Lagergren, M., Lundh, L., Orkam, M. and Sanne, C. 1984. Time to Care. Pergamon Press, London.Google Scholar
Land, H. 1988. Social security and community care: creating perverse incentives. In Baldwin, S., Parker, G. and Walker, R. (eds) Social Security and Community Care. Gower, Aldershot.Google Scholar
Lewis, J. & Meredith, B. 1989. Daughters Who Care: Daughters Caring for Mothers at Home. Routledge, London.Google Scholar
Ministry of Health and Social Affairs (MHS). 1988. The Government's Carefor the Elderly Bill. Press Release, Stockholm.Google Scholar
Ministry of Health and Social Affairs (MHS). 1989. Recommendations of the Advisory Committee on Caring Services for the Elderly. Press Release, Stockholm.Google Scholar
Ministry of Welfare, Health and Cultural Affairs (MWHCA), 1988. Changing Health Care in the Netherlands. The Hague.Google Scholar
&Connor, J.The Fiscal Crisis of the State. St Martin's Press, London.Google Scholar
Organisation for Economic Co-operation and Development (OECD). 1988. Ageing Populations: The Social Policy Implications. Paris.Google Scholar
Poullier, J.-P. 1986. Levels and trends in the public-private mix of the industrialised countries' health systems. In Culyer, A. and Jönsson, B. (eds) Public and Private Health Services: Complimentarities and Conflicts. OUP, Oxford.Google Scholar
Qureshi, H. and Walker, A. 1989. The Caring Relationship: Elderly People and Their Families. Macmillan, London.CrossRefGoogle Scholar
Shanas, E., Townsend, P., Wedderburn, D., Friis, H., Milhoj, P. and Stehouwer, J. 1968. Old People in Three Industrial Societies. Routledge and Kegan Paul, London.Google Scholar
Social and Cultural Planning Office (SCPA). 1986. Social and Cultural Report 1986. Rijswijk, Netherlands.Google Scholar
Social and Cultural Planning Office (SCPA). 1988. Social and Cultural Report 1988. Rijswijk, Netherlands.Google Scholar
Swedish Office of Statistics (SOS). 1986. Den Framlida Befolkningen. SCB, Stockholm.Google Scholar
Taylor-Gooby, P. 1985. Public Opinion, Ideology and State Welfare. Routledge and Kegan Paul, London.Google Scholar
Thorslund, M. 1990. The increasing number of very old people will change the Swedish model of the welfare state. Social Science and Medicine, forthcoming.CrossRefGoogle Scholar
Twigg, J. (1989). Models of carers: how do social care agencies conceptualise their relationships with informal carers? Journal of Social Policy, 18 (1), 5366.CrossRefGoogle ScholarPubMed
Ungerson, C. (1987). Policy is Personal: Sex, Gender and Informal Care. Tavistock, London.Google Scholar
Waerness, K. (1990). Informal and formal care in old age: what is wrong with the new ideology in Scandinavia today? In Ungerson, C. (ed.) Gender and Caring; Work and Welfare in Britain and Scandinavia. Harvester/Wheatsheaf, Hemel Hempstead.Google Scholar
Walker, A. 1985. The Care Gap. The Local Government Information Unit, London.Google Scholar
Wenger, G. C. (1984). The Supportive Network: Coping with Old Age. Allen and Unwin, London.Google Scholar