Document sans titre
Since 2002, the
National Board of Health and Welfare has been commissioned by the government
to provide annual reports on developments in the care for the elderly in Sweden.
In this article the development of needs, use of service and care, as well as
costs and resources required for the care of the elderly are discussed. To this
general overview a discussion on trends and policy developments in the care
of the elderly has been added.
Sweden has an ageing population,
and in 2007, from a total population of nearly 9.2 million inhabitants, 17.5
per cent were aged 65 years and above, and 5.4 per cent had reached the age
of 80 and above. In spite of the fact that ever greater numbers of elderly people
are living to an advanced age – or rather due to this fact – many
develop illnesses or disabilities and become dependent on others to receive
help in attending to their daily needs.
The aim of Swedish policies
towards the care of the elderly is for older persons “to be able to lead
active lives and to influence the conduct of social affairs and their own everyday
conditions, to be able to grow old in security and with their independence preserved,
to be met with respect and to have access to good health care services”.
Public help is intended to give patients freedom of choice and influence and
to maintain high standards. All elderly persons should have equal access to
these welfare services, regardless of age, sex, ethnicity, place of residence,
and purchasing power. In return for taxes people are provided with a broad spectrum
of welfare benefits that guarantee service and care, a minimum standard of living,
and the redistribution of income more evenly over a lifetime and between individuals.
Therefore, in general, no one has had to forgo service and care for financial
reasons.
According to the Social
Services Act (1982) the elderly have the right to receive public service and
help at all stages in life. All people who need help supporting themselves in
their day-to-day existence have the right to claim assistance “if their
needs cannot be met in any other way”. In 1983, the Health and Medical
Services Act came into effect. According to this Act, health care and medical
services aim to maintain a good health standard among the entire population
and to provide care on equal terms for all. In Sweden, responsibility for the
welfare of the elderly is divided between three government levels. At a national
level, the Parliament and Government have set out policy aims and directives
by means of legislation and economic steering measures. At a regional level,
the county councils or regions (21 in total) are responsible for the provision
of health and medical care. And finally, at a local level, the (290) municipalities
are legally obligated to meet the social service and housing needs of the elderly.
The county councils and the municipalities have a very high degree of autonomy
vis-à-vis central government. Both have elected assemblies and have the
right to levy taxes. The county councils and municipalities may, within the
limits prescribed by existing legislation, decide the degree of priority they
will give the elderly over other groups.
Public policies and programmes
providing health care and social services, as well as pensions and other forms
of social insurance, are comprehensive. The high percentage of women in the
labour market (72 per cent in 2007 according to OECD) necessitates a formal
system of care for the elderly, as does the fact that very few children (about
2-3 per cent) share their homes with their elderly parents. As care for the
elderly in Sweden is a public responsibility, there are no statutory requirements
for children to provide care (or financial security) for their elderly parents.
Care for the elderly is
almost entirely financed by taxes. The user only pays a fraction of the cost
(5-6 per cent). The largest percentage of the cost (about 82–85 per cent)
is covered by local taxes. National taxes cover the remaining cost of care for
the elderly (about 10 per cent). The fact that health care and social services
for the elderly are primarily funded by local taxes further confirms the independent
role of the local authorities, i.e. their independence from national government.
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