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2012 Conference Presentation

Care models Portugal

7 September 2012

New approaches to familialism in LTC reforms: lessons from the Portuguese experience

Alexandra Lopes, University of Porto, Portugal


In many European countries, including some in the Mediterranean region, the last decade has witnessed an increase in state provision of social care services for the elderly, and this in spite of retrenchment policies in other areas of state welfare policies. This is certainly related to the pressing character of ageing in European societies, but also a response to the underdevelopment of social care for the elderly in these specific settings.

Traditionally labelled as a classic example of a familialist welfare state and a member of the Southern European group, Portugal has undergone substantial reforms in its social care system in the last years, namely with the implementation of a new Long-Term Care (LTC) integrated system in 2006. Designated as Rede Nacional de Cuidados Continuados Integrados (RNCCI), it comprises an integrated network of health and social care services for those in need of long-term care and it has opened a new path of policy design that departs quite substantially from what has been taking place in other countries in South Europe.

It is, we believe, an interesting solution to monitor for its implications in terms of how it articulates the existing formal and informal resources to expand long-term care provision, in a context of marked difficulties that do not leave any room for increases in public social expenditure and putting to good use the familialist inheritance of the welfare state model in place. It is based, as we will try to demonstrate, on a new approach to familialism, with both positive and negative consequences that need to be carefully assessed but that ultimately may be of some interest to discuss the available paths for the development of long-term care solutions in familialist social policy settings.


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