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Reforming care and support in England – what can we learn from other countries?

Posted on 4 August 2009

Like other developed countries, England faces the challenge of meeting the needs of a growing elderly population.

A new Government Green Paper, seeking views on the future funding and delivery of care and support services for older and disabled people, draws on research by the Social Policy Research Unit (SPRU) at the University of York.

Unsupported family care can adversely affect health and paid work

Professor Caroline Glendinning

In two reports, SPRU researchers set out what can be learned from the experiences of other countries grappling with the same issues.

Recent reforms in countries as diverse as Australia, Germany, Netherlands, Japan and Denmark show widespread commitments to universal provision for everyone with similar levels of disability, regardless of age or income. They also show that modest increases in contributions to long-term care insurance schemes are politically feasible, as people are aware of the future benefits. 

In all the countries examined, central governments play a major role in ensuring fairness. These countries have also often built policies for supporting family carers into reforms of services for older and disabled people.

Indeed, across Europe, family carers provide much more help to older and disabled people than formal health services, but in many EU countries both information about the numbers of carers and services to support them are scarce.

Professor Caroline Glendinning, who led the SPRU research, said: “Unsupported family care can adversely affect health and paid work, so employment and long-term care policies alike need to take account of the work of family carers. 

“Across Europe, more research is needed into the contributions made by family carers – and the opportunity costs of those contributions. On the other hand, important principles – universal entitlements to help; equal treatment for those with similar levels of need; and contributions from working age as well as older people – underpin the policies of other countries and could be adopted in England.”

The reports, as well as research summaries and a European Union Policy Briefing are available to download at the SPRU website:


Notes to editors:

  • Department of Health (2009) Shaping the Future of Care Together, Cm 7673, Stationery Office, London
  • C. Glendinning and N. Moran (2009) Reforming Long-Term Care: Recent Lessons from Other Countries, Social Policy Research Unit,  University of York, York
  • C. Glendinning, H. Arksey, F. Tjadens, M. Morée, N. Moran, H. Nies (2009) Care Provision within Families and its Socio-Economic Impact on Care Providers across the European Union, Social Policy Research Unit, University of York, York
  • More information on the Social Policy Research Unit at the University of York is available at

Contact details

Rachel Pitman
Tel: +44 (0)1904 321981