Book reviews

The debate about the current and future provision of long‐term care for older people is ubiquitous throughout Europe, North America and Australasia. Countries share the challenges of changing demographic profiles and increasing proportions of people aged 80 or over; political pressures to contain government funding on health and welfare services; and rising consumer expectations. The way that each society has responded to these challenges highlight both similarities and differences in their nature, the historical and cultural contexts, and the contested character of the debate. The development of quasi‐markets and the mixed economy of health and welfare provision, privatization, selectivity and ‘targeting’ of services and increasing managerialism are shared experiences but the approaches taken within different countries has been quite diverse. A comparative social policy analysis potentially offers a rich source of ideas for developing policies in any one country based on the experiences of others. This edited book provides such an analysis and focuses on the shifting boundaries between health and social services, between public and private provision, and between the provision of services and income transfers.

As the editor comments comparative social policy provides many challenges to the analyst. One is the choice of comparison. The book contains chapters about the UK, Germany, the Netherlands, Finland, Denmark and Australia. There appears little rationale for the inclusion of these countries and exclusion of others. But perhaps more critically it lacks a common comparative framework which makes it hard going for the reader to undertake their own analysis of the material presented. The editor makes a laudable if somewhat belated attempt in a conclusion to draw out the important differences and similarities between the selected countries and provides insights for the UK which might be helpful at a time when the long‐term care debate is likely to become highly contested with the appearance of the Report of the Royal Commission on Long‐Term Care.

This book adds to the ideological debate on long‐term care but offers little which is new and not reported elsewhere. For the student of social policy the descriptions of the different countries will provide useful information but the chapters are not comprehensive and are unbalanced. Chapter 2 assumes knowledge of the UK welfare system and focuses on contested areas of current policy. Chapter 3 is a good but focused account of the introduction to long‐term care insurance in Germany. Chapter 4 provides a good overview of the Netherlands and a focused discussion of personal budgets for older citizens. Chapter 5 assumes knowledge about the structure of the Finnish system and focuses on the reforms to health and social care over the last decade. Chapter 6 provides an excellent overview of health and social care for older people in Denmark whilst Chapter 7 gives a similar quality introduction to the emergence of community care in Australia. For those students expecting a more mechanistic and broader view of the structure and organization of long‐term care, this is not the book to read. Neither is it my choice for a comparative analysis of the politics of long‐term care at the end of the millennium.