Cash-for-care programmes in four European countries: A Comparison of Ireland, the Netherlands, Finland and the UK

This project analysed cash-for-care programmes for older people in four European countries. The homecare grants in Ireland, direct payments in the United Kingdom (England), service vouchers in Finland and personal budgets in the Netherlands were studied with a view to gaining an understanding of the background and reasons for the introduction of cash-for-care programmes and the impact that these programmes have had on the care regimes and care recipients in the four countries.

While the motives for introducing cash-for-care programmes were fairly similar in all four cases (choice, autonomy, compensation for gaps in existing provision, employment creation, efficiency and cost savings, shifting preferences towards domiciliary care), the schemes differ with respect to their impacts on the care regimes in question. The cash-for-care programmes currently have modest coverage as compared with direct service provision and provide no more than an optional supplementary source of care in three of the studied countries. Cash-for-care schemes have not therefore radically transformed the care regimes in Finland, The Netherlands or the United Kingdom. In Ireland, however, the restricted availability of alternative forms of formal service provision means that the expansion of cash-for-care might shift care provision significantly towards private provision and financing.

This research was funded by IRCHSS (Irish Research Council for the Humanities and Social Sciences). PI was Virpi Timonen, Co-Investigators Janet Convery and Suzanne Cahill. The results of this study were published in 2006 in Ageing & Society.