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Learning from afar: how Japan transformed Social Care for the elderly

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Learning from afar: how Japan transformed Social Care for the elderly

Social Care in England is coming under increasing strain. An ageing society is placing ever-more complex demands upon Social Workers, whilst successive budget cuts have made it much more difficult for millions of elderly people to access the support they need to live a healthy and fulfilling life.

With the government’s forthcoming Green Paper on Social Care having been delayed for launch until sometime later this year, many Social Care experts and Social Carers are understandably worried about what the future holds for Britain’s care system. However, perhaps the answer to these problems lie somewhere unexpected: Japan.

Japan boasts the oldest population in the world, and it’s getting older: in fact, the number of people aged 65 or older is expected to reach seven million by 2025. In any other nation, this strain upon Carers- especially given the decreasing numbers of young, active workers- would be a matter for serious concern.

However, Japan has managed to transform the way in which they provide for the elderly. Up until 2000, there was no publicly-funded Social Care in Japan; instead, caring for the elderly was looked upon as a familial responsibility. This resulted in overflowing care homes, Carers struggling to fulfil their responsibilities, and even neglect of the elderly.

However, they now enjoy a better standard of Care than almost any other country in the world. How? And what can we learn from them?

Transforming the Social Care system

Amid a slew of reforms, the Japanese government introduced Long-Term Care Insurance in 2000, with the intention of reducing the burden of Care on families, and meeting the needs of everybody over the age of 65. 
When they reach retirement, the current system requires elderly Japanese to apply to their local government and undergo a test designed to assess their needs. Following this, a Care Manager gets in touch to advise them on how the system can best help them meet those needs, depending on their budget and on the private and not-for-profit local service providers that operate in the area.

The new regulations aim to make elderly Japanese as self-sufficient as possible: the idea of community care has been championed at the expense of residential homes, many of which have adopted complicated entry requirements designed to reduce applications.  

Instead, providing Care is seen as a social, rather than a familial, duty. The system relies heavily on local volunteers to support the needs of their ageing population, and many of them are themselves over the age of 65. The boundaries between Carer and the person being cared for are dissolving: in fact, many elderly Japanese consider it an important part of their social responsibility to volunteer in this way, and it’s an attitude that goes a considerable way to meeting the demand for the 2.5m caregivers who will be needed by 2025. 

Though the system undergoes regular three-year reviews, the principle behind it has stayed the same, and so have sources of funding: taxation, insurance premiums that everybody above 40 must pay, and a 10% co-payment taken from people accessing the service. This new way of providing Care is now widely accepted across Japan, and one that’s seeing great results: there are fewer barriers to access than ever before, and elderly people can make the most of a huge support system designed to make their old age as comfortable and enjoyable as possible. 

How can the UK adapt?

Though the UK’s situation is not precisely the same as Japan’s, there are still important lessons that we can learn from them. Indeed, the Nuffield Trust published a recent report that illustrates some basic lessons that the government could implement to meet the needs of its straining care system. 

These include getting greater buy-in at the public level, most notably by reimagining the role of the Social Care system as a long-term project rather than as a short-term fix to any social problems. Fairness and transparency should also be encouraged at all levels, especially for patients. To ensure that the system continues to meet the needs of its patients, it should be periodically reviewed, in much the same way that Japan’s is, allowing Social Carers to deliver a more flexible service which can adapt to cope with demand. 

To help streamline the service, the Nuffield Trust also recommends that the government create a new role: that of Care Manager. Though similar positions exist in the UK, many of them have differing responsibilities. Creating a standardised role that would help people understand what they can get out of their local care service would be a huge step towards empowering the elderly; indeed, they should also be given the power to play a more active role in the care system, either through volunteering or providing support to their fellows. 

Stepping towards the future

Though Japan’s Social Care system has its own share of failings, its willingness to embrace change and create a community that cares for its elderly is a bold, progressive vision that the UK should aspire to emulate. 

With the government’s Green Paper not far away, we at Charles Hunter Associates are excited to see what the future will bring for the country’s Social Care system, and for the Social Care workers who work within it. Be a part of it: browse our jobs in Social Care here.