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England could learn from Japan’s social care system, report claims

The government could learn important lessons from the Japanese social care system, experts have claimed.

According to the Nuffield Trust report, ‘What can England learn from the long-term care system in Japan?’, the Japanese system offers some important lessons for England.

Its key success has been to gain public support though a commitment to transparency, fairness and consistency - something that the Trust says England has repeatedly failed at.

National criteria ensures that access to care is the same regardless of where a person lives and that the system is reviewed every three years. Reforms are then made where needed, enabling the Japanese government to respond to public concerns and address concerns over expenditure.

The Long Term Care Insurance (LTCI) system - which is partly funded by a national insurance fund paid into by all those aged over 40 and partly out of general and local taxation - emerged out of a national debate about how to support an ageing population.

It is reportedly easy for service users to navigate due to a ‘care manager’ that is responsible for supporting individuals to make a care plan, identify suitable providers, coordinate between careers, the individual and the family and oversee the care plan in the long term.

A similar role exists in some parts of England, but provision is patchy and there is no single definition of the role.

The think tank says that the system’s commitment to long term prevention of loneliness and ill health is a “stark contrast” to England’s short term approach, which is “driven by budget constraints” and increasingly focused only on those with the highest needs.

However, the report warns that the Japanese system is not without problems, which England can also learn from.

The Japanese government underestimated demand for long term care and has adjusted the system to reduce eligibility, increase co-payments and change insurance premiums as a result.

The authors of the report say that there are similar risks in England if the full extent of informal and unpaid care are not recognised.

Japan also faces the threat of a growing shortfall in care workers over the next 10 years - a problem that is mirrored in England and could be exacerbated by Brexit.

Lead author of the report, Natasha Curry, senior fellow in health policy at the Nuffield Trust, said that cultural differences between the two countries mean that the Japanese system is not a ‘silver bullet’ to solving England’s social care crisis.

“But as the Government begins to ask difficult questions about the future of social care, the Japanese experience in reforming long-term care for the elderly offers some important lessons for policymakers as they seek to bring about much-needed reform in England.

“In particular, the Japanese experience suggests there is real value in embedding transparency and flexibility in the system, helping people navigate their way around it, and promoting healthy living,” she added.

The Citizens’ Assembly on Social Care, the first citizens’ assembly, was recently commissioned by Parliament to consider the best way to fund adult social care.

Top image: Nayomiee


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