Challenges and reforms in Long‐Term Care policy in Spain

Abstract

Over the last decades most Western European countries developed  social protection schemes aimed at responding to the disability and long term care (LTC) needs of its populations. Nevertheless, it is only in recent years that the increasing social and political visibility of dependency related issues has led to the discussion, design and implementation of LTC policies in Southern European countries, where public policies designed to deal with situations of dependency remained generally fragmented and poorly developed until very recently. This paper aims at reviewing the initiatives adopted by Spanish authorities to respond to the LTC needs of its population, analysing how these policies have evolved in terms of the organization, structure and governance of care provision systems in recent years. In order to account for the evolution of these policies we shall briefly review their historical evolution, linking this analysis to the basic typology of welfare regimes models previously described. From a neo-institutionalist perspective, taking into consideration the importance of “path dependencies” should allow us to understand the determinants of the programs introduced in Spain in relation to LTC. As a matter of conclusion we will review the main implication of these developments for the evolution of LTC policies in Spain, and how these may respond to the NSR of dependency in a context of accelerated socio-demographic transformation.