This paper considers activation policies in relation to older workers in a number of OECD countries. It explores four interpretations of ‘activation’ in respect of pension planning and retirement policies. However, activation policies need to be carefully evaluated. Labour market demands and a political language that stresses the ‘pension crisis’ and the ‘dependency ratio’ have to be considered in relation to established rights. Thus whilst governments may seek to promote a model of welfare based on the ‘consumer citizen’, in which retirement choices are made by reflexive individuals, the constraints on choice need to be highlighted. These constraints are likely to be unevenly distributed with some social groups experiencing longer working lives, less choice, with more compulsion and with conditions attached to any pension rights they may claim.

This paper examines the experiences of immigrants in Toronto as they pass through, and leave, Ontario Works (OW), a ‘Work First’ approach to social assistance that prioritizes rapid labour force attachment. We examine the Ontario Works activities of immigrants, compared to native born Canadians, and their respective post-OW job characteristics. We find that immigrants experience a significant relative wage disadvantage after participation, and substantially less wage growth when moving to the second post-welfare job. We conclude that Ontario Works, like most ‘work first’ employment programs, is ill-suited to addressing earnings disadvantage among immigrants. We suggest that programs ‘beyond work first’, though not targeted specifically towards immigrants, might nevertheless offer more assistance. The recurring wage disadvantage, however, would remain unaddressed and might require more direct intervention.

This article examines work-related stress and rehabilitation in the light of the introduction of Stress Management Standards in the UK in 2004. The Management Standards are outlined and the relevant literature on good practice in stress and rehabilitation is reviewed to provide a context for empirical research conducted with human resource practitioners in organisations. This view from the workplace provides insights on the issues faced, especially in the public services, when managing stress and rehabilitation. These include the role played by stress in people's personal life, the limitations of line management and the role of General Practitioners.

The last decade has witnessed a growing interest in the promotion and use of innovation as a means of improving public services. Rafts of central government initiatives exist to promote, support and learn from innovative activity. This paper examines the adoption of a new, innovative service in a social work setting in the UK, namely family group conferencing. It explores the rate and pattern of the adoption of this service innovation by Councils with Social Service Responsibilities (CSSRs). It examines the implementation process and identifies: resources, professional resistance, risk, the role of central government and champions amongst the factors that facilitated and inhibited its use in three case study sites.

This article explores the educational experiences of 93 young women who experienced pregnancy at school in England, in order to examine the relationship between dislike of school, teenage pregnancy and educational disengagement. The article argues that a strong dislike of school, pre-pregnancy, is often at the root of disengagement before pregnancy, a situation often exacerbated when the news of pregnancy is met with prevailing negative attitudes within school. However, once pregnant, educational alternatives to school frequently provide a route back into, and a changed perception of education. Tackling pre-pregnancy dislike of school may have important implications for both the support and prevention aspects of the Government's teenage pregnancy strategy.

Cost has long been a preoccupation in policy documents concerned with the care and support of older people (Means and Smith, 1998; Royal Commission, 1999). A history of moral panic about the ageing population coupled with a stereotype of older people as a dependent and ‘unproductive’ sector of society have combined to produce negatively focused debate, lacking in evidential support. Most recently, Wanless (2006) has highlighted the limitations of the evidence base and the narrowness of debate concerning the provision of social care services, arguing both for more informed debate and for consideration of the impact of developments in services and alternative funding models.

The future market costs of long-term care for older people will be affected by the extent of informal care. This paper reports on projections of receipt of informal care by disabled older people from their spouses and (adult) children to 2031 in England. The paper shows that, over the next 30 years, care by spouses is likely to increase substantially. However, if current patterns of care remain the same, care by children will also need to increase by nearly 60 per cent by 2031. It is not clear that the supply of care by children will rise to meet this demand.

The ageing of the population and increasing longevity result in predictions of sizeable increases in long-term care expenditures. Other analyses have shown significant decreases in disability prevalence among older people in the US. This study provides an empirical quantification of the net result of these two forces (increased expenditures due to ageing versus potential expenditure reductions due to reduced disability) using the Medicare Current Beneficiary Survey. The analyses show that the implications of ageing and increasing longevity for long-term care expenditures are modest relative to the effects of future increases or decreases in functional abilities of older people.

Using two linked simulation models, we examine the public expenditure costs and distributional effects of potential reforms to long-term care funding in the UK. Changes to the means tests for user contributions to care costs are compared with options for the abolition of these means tests (‘free’ personal care). The latter generally cost more than the former and benefit higher income groups more than those on lower incomes (measuring income in relation to the age-specific income distribution). Reforms to the means tests target benefits towards those on lower incomes. However, the highest income group are net losers if free personal care is financed by a higher tax rate on higher incomes and the effect on the whole population considered.

If we are to be able to reflect the cost implications of changes in the nature, quality and productivity of long-term care interventions in future projections, we need an approach to measurement that reflects the value and quality of care. This paper describes a theoretically based but pragmatic approach to identifying the welfare gain from government expenditure on social care and illustrates an application in projecting the costs of long-term care used in the Wanless review of future needs of social care for older people in England.

This paper argues for a transformation of arrangements for accessing and allocating public resources for long-term care in the UK. Currently these arrangements are fragmented, inequitable and not always well targeted. While not necessarily advocating a social insurance approach, the experience of Germany nevertheless shows how simplicity, transparency and equity of access can be combined with strong cost control levers and political sustainability. An opportunity to transform ways of accessing and distributing public resources for long-term care arises with the piloting of ‘individual budgets’ in 13 English local authorities from 2006. The paper argues that the principles underpinning individual budgets should be extended, with the UK government taking a strong national lead.

When Japan introduced a new public long-term care insurance in 2000, the eligibility criteria and benefits were designed so that those who had been receiving services would be able to continue to do so. Five years later, benefits were reduced by a partial levying of hotel costs in institutional care, and restricting the provision of instrumental activities of daily living support services in community care for those requiring only light care. Whether these revisions are effective in containing costs and whether a decision should be made to cover all ages and all disabilities are the issues for the future.

Drawing on recent quantitative and qualitative research, we consider lessons of the Scottish policy of free personal care for older people. The policy is embedded in political debates about devolution and interacts with various changing policies on care and support for older people. Evaluation is complicated by these interactions and by gaps in relevant data, especially concerning costs. Operationally, policy implementation has presented varying difficulties for local authorities. For clients and informal carers it remains popular, but is part of a service-led model of provision which does not reflect their own views of their care and support needs.

This review explores debates concerning the costs of long-term care for older people, and aims to give an overview of the recent and current research agenda in this area, referring primarily to work published 2000–2006. The focus of much work is on the identification of costs, their distribution and the contexts of policy and delivery of services in which these operate. Live debates concern future costs, their control and related issues of social justice and equity.

The websites listed here provide electronic resources relevant to different aspects of the costs of long-term care. Many include links to additional reports, research papers, reviews and other sources of information. They should be regarded as a representative sample rather than an exhaustive list of relevant information currently available on the Internet. Only English language sites have been included. All website addresses were available on 30 March 2007.