Under the direction of the English Department of Health, the University of York conducted a major review of the funding of and future strategy for adult social care in five countries – Germany, Netherlands, Denmark, Australia and Japan.

Goals of the study:

  • Describe the key features of social care funding and service delivery in the five countries
  • Examine current debates and reforms in arrangements for funding and service delivery in these countries
  • Discuss implications and lessons for reform in England

Some of the lessons learned include:

  • A single, integrated funding stream for long term care is easier to manage and sustain than multiple, fragmented funding streams.  Separate funding streams for health services and long term care also help the sustainability of both.
  • Central government has a major role to play in generating and managing resources for care.  Local government has important roles to play in conducting assessments and ensuring an appropriate range of services is available.
  • Income-related insurance contributions may be an acceptable, and progressive, way of raising revenue.
  • It is feasible to design systems in which older and younger disabled people enjoy the same entitlements and benefits.
  • Benefits in the form of cash payments are likely to encourage or support informal care-giving but additional social protection measures for carers are also required.
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