Creating a service system from scratch: Community old age care services in China

Abstract

Broadly speaking, China's current old age care service system has two pillars: community services (including home services and community-based services) and institutional care homes. While the need for services is still far from being fully met, this service structure has only emerged recently after years of development, including some U-turns, involving different roles for the market, the family, the state and the community. This chapter analyses the policies and practices for community old age services and examines the current situation and the key governing issues. It shows that old age care in communities has multiple components. It is hard for each individual sector or service provider to initiate an all-rounded service system organically. The initial development of a community old age care system that covers all people in need requires the state to function as the initiator, stimulator and the coordinator. The case in China shows that that market actors did not initially see 'business' in community old age care services and were reluctant to operate in this field. The state therefore was involved in identifying what roles can be played by the market and figuring DILEMMAS IN PUBLIC MANAGEMENT IN GREATER CHINA AND AUSTRALIA 474out the conditions and supports needed for providers from non-government sectors. In this sense, the government had to introduce policies to 'bring the market' into or 'create the market' in the community service sector.