Multilevel governance and its effects on long-term care support
Multilevel governance and its effects on long-term care support
The chapter discusses the changes occurred in multi-level governance in recent decades, with the introduction of more universal LTC policies. These changes have resulted in a greater involvement by central tiers of government, in contrast to previous policies which were generally administered at local or regional government levels. This means that LTC policies have experienced a shift towards greater national uniformity. The central government has set up common rules that – to various degrees and in different forms – apply to the whole country, including rules on eligibility, levels of care, funding, assessment procedures, and quality regulation. This process has positively increased the territorial equity of LTC systems. The chapter shows that introduction of more territorial uniformity was generally part of broader policies aimed at developing and enlarging LTC systems, but over time has changed. In several countries, the recent trend is for greater national uniformity to be accompanied by decreasing public support for LTC provision. A challenge for the future, therefore, will be to monitor the effects of this combination of greater national uniformity with reduced public expenditure on LTC.
Keywords: multi level governance, central government, regional governments, local governments
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