The three workshops in this research project were key to understanding how actors related to each other in the different countries. Each workshop brought together three participants from two countries, representing: a financer (in most cases a municipality), a provider organisation (a mixture of for-profit and non-profit organisations) and a country expert.

Germany and UK (England) - 3 November 2009, Brighton

Similarly to the previous workshop, the role of local authorities is markedly different: in Germany, the Sozialamt of the local authority is a network-facilitator and works with local residents who are not entitled to care insurance. Before the 1995 introduction of care insurance it had the resources and powers to shape and fund care provision for its citizens. In England, local authorities are able to shape the market, especially for home-care, where they contribute something to the cost of care for most recipients. The incentives given to private providers for different care packages differ to a great extent from one local authority to the other.

Local authority social workers in England assess and advise people on their care needs; in Germany this role is played by the Medical Services of the Health insurance funds (MDK), whose doctors and nurses assess people’s entitlement to benefits. The Sozialämter play a subsidiary role: many offer advisory offices in conjunction with non-profit organisations to support vulnerable citizens in managing their care.

The Sozialamt has a residual role post-1995 reform in inspecting nursing homes and also advises developers on sites. In residential care, UK local authorities’ influence is less than in home-care because over half of the market is made up of people who pay the full costs of their care from private means. But England may be moving towards additional insurance coverage for its citizens – a government Green Paper is currently looking at options.

Read about the other workshops:  Belgium (Flanders) & Sweden and Czech Republic & Spain

To find out more about our work on Contracting for Quality please email Stephen Barnett in the ESN Secretariat using firstname.lastname@esn-eu.org