Published in 1998. Social provision in all European countries has faced increasing scrutiny during the 1990s. Focusing on gendered aspects of welfare state restructuring, each contributor examines the way in which the welfare state of his or her country has been restructed over the past decade, concentrating on services for elderly people and for children. Each chapter outlines the shifts in the mixed economy of welfare and describes the degree to which there has been greater decentralization moves towards a different style of public management or the introduction of market principles. The changes in the provision of services for elderly people and children is described for the same period. Finally, women's position as paid providers of services, as unpaid carers and as recipients of services is analyzed. This book investigates the idea that the move towards "marketization" in many countries is having a disproportionately detrimental effect on women whose leverage on the market tends to be weak.

Over the last two decades, many changes have happened to the social welfare policies of various industrial countries. Citizens have seen their pensions, unemployment benefits, and general healthcare policies shrink as “belt tightening” measures are enforced. But in contrast, long-term care has seen a general growth in public financing, an expansion of beneficiaries, and, more generally, an attempt to define larger social responsibilities and related social rights. The aim of this book is to describe and interpret the changes introduced in long-term care policies in Western Europe. The volume argues that recent reforms have brought about an increasing convergence in LTC policies. Most of the new programs have developed a new general approach to long-term care, based on a better integration of social care and health care. The book explores increasing public support given to family care work (in the past, the family would take care of the elderly or infirm) and increasing growth and recognition of a extended social care market (by which care has shifted from a moral obligation based on family reciprocity to a paid, professional activity). A new social care arrangement has therefore been developing in Western countries, based on a new mix of family obligations, market provision, and public support. In order to understand such changes, this analysis will take into account the social and economical impact of these reforms.

A comparative study of social care provision in the member states of the European Union. After sections on definitions and the context for social care in these countries, the authors look in more detail at the institutional framework provided by the European Union itself.

What are public health services? Countries across Europe understand what they are or what they should include differently. This study describes the experiences of nine countries detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England France Germany Italy the Netherlands Slovenia Sweden Poland and the Republic of Moldova and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services. Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications. This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance (both forthcoming).

OF 'SOLIDARITY' IN UK SOCIAL WELFARE Here then, perhaps, is a British version of solidarity in social welfare, but early there are strong tensions between the powerfully liberal individualistic strands of the British understanding of the functions of the state and the socialistic or communitarian tendency of a commitment to universal welfare provision. In the search for the roots of this understanding of welfare we shall survey, fitst, the historical background to these tensions in some early British political philosophers, starting with Hobbes and ending with Mill. We then consider the philosophical and social influences on the Beveridge Report itself, and we will trace the emergence of the philosophy of the welfare state in the era following the Second World War. Finally we consider the contemporary debate, as it relates to the 'Third Way' thinking of New Labour. 2. A mSTORICAL SKETCH In the previous section we observed that the philosophy underlying the Beveridge Report could be described as 'liberal collectivism'. What are the historical antecedents of this strange amalgam of individualism and collectivism? Within the short scope of this chapter, any account of the philosophical history must be little more than a sketch, but we can perhaps understand most debates in British socio-political thought as a continuing dialogue with the well known claim of Thomas Hobbes in Leviathan that all political institutions are founded on egoistic motives.

Drawing on research across a wide range of European countries, this book analyzes the key issues at stake in developing long-term care systems for older people in Europe with a focus on progression and improvement for policy and practice.

Demographic, epidemiological, social and cultural trends in European countries are changing the traditional patterns of care. The next decades will see rising numbers of care-dependent older people and noncommunicable diseases as the leading cause of chronic illness and disability. Further, urbanization and the break-up of the traditional large family group will lead to gaps in the care of older or disabled family members. These changes in needs and social structure require a different approach to policy and services in the health and social sectors; a disease-oriented approach alone is no longer appropriate. Home care could be an answer to these issues: a sustainable approach to prevent the need for unnecessary acute or long-term institutionalization and to maintain people in their homes and communities as long as possible. Along with new forms of service delivery organization, technological innovation can represent a viable solution to developing home care in Europe, provided that health care systems can further enhance integration and coordination. This publication is part of the work of the WHO Regional Office for Europe to present evidence for health policy- and decision-makers in a clear and understandable form. It explains why health and social services should provide high-quality and targeted home care for disabled and older people. It provides evidence for the effectiveness of home care, shows how it can be improved, and explains the need to ensure equitable access. The publication also explores the varied cultural and care contexts in different countries, and reveals how to educate professionals and the public about these issues. This booklet seeks to broaden awareness, stimulate debate and promote action.