Introduction

In many European countries, including some in the Mediterranean region, the first decade of the 2000s has witnessed an increase in state provision of social care services for older people, and this in spite of retrenchment policies in other areas of state welfare policies. This is certainly related to the pressing character of ageing in European societies, but also a response to the under-development of social care for older people in some countries.

Traditionally labelled as a classic example of a family-based welfare state and a member of the Southern European group, Portugal has undergone substantial reforms in its long-term care system in the last few years, namely, with the implementation of a new long-term care integrated system in 2006. Designated as Rede Nacional de Cuidados Continuados Integrados (National Network for Long-Term Integrated Care, RNCCI), it comprises an integrated network of health and social care services for those in need of long-term care, and it has opened a new path of policy design that departs quite substantially from what has been taking place in other countries in Southern Europe. It is an interesting solution to monitor how it articulates the existing formal and informal resources to expand long-term care provision without a significant increase in public social expenditure, and putting to good use the family-reliant inheritance of the welfare state model in place. It is based on a new approach to familism, with both positive and negative consequences that need to be carefully assessed but that ultimately may be of some interest in discussing the available paths for the development of long-term care solutions in familist social policy settings.

This chapter is organised into three main sections. The first section sets the background for the discussion of long-term care in Portugal within the broader debate about social policy design and welfare state development in South Europe. In the second section there is a more detailed presentation of the Portuguese long-term care system, with the introduction of some empirical material that forms the basis for the discussion, in the third section, about the implications of the Portuguese solution for the general debate about reforming long-term care in familist social policy settings. The chapter closes with some concluding remarks.