Breaking the Mould: New Trajectories in the Domiciliary Care of Older People in Ireland

Abstract

This article reviews the development of domiciliary care services for older people in Ireland over the last decade. It reveals three central developments, namely (i) the first steps, in the Irish context, towards a quasi-market; (ii) the introduction of cash-for-care and the subsequent notable segmentation of care tasks among three provider groups; and (iii) a rapidly increasing reliance on for-profit private home care providers. The authors conclude that while the Irish social care regime is still anchored in important ways in the primacy of informal (family) care and the subsidiarity principle, it has broken path-dependency by evolving towards an increasingly complex mix of public, not-for-profit and for-profit provision and financing. The most policy-relevant aspect of this new constellation is the lack of a regulatory framework that would enable the State to monitor the multiple and diverse providers with the view to ensuring the quality of home care services.