The hardest hit, as everywhere, are those who have no choice.
Theodor Adorno

Letting us have a choice will drive quality in long term care, or at least that is what a number of countries are pining their hopes on. This is seen as necessary because regulating and policing alone are insufficient measures to guarantee quality services.

Who would have thought that focussing on what elderly health consumers want would prove a strategy for improving the quality of care!

A recent paper released by OECD ‘A good life in old age‘ suggests that in long term care, or nursing homes, that consumer choice is a key driver for quality improvement.

Countries On Board

Countries such as Portugal, Spain, US, Australia and a number of European countries are well advanced down a strategy and policy pathway that aims to have consumer choice drive quality and competition in long term care. In some of these countries the idea of competition through public comparison of services, i.e. naming and shaming also forms part of the change strategy.

Who knows best?

It might seem strange that the concepts of choice and competition are only now coming into the spotlight in long term care of the elderly. In all other areas of our adult life these ideas flourish through the ‘free market’. Perhaps this delay is related to the discord between the medical and the free market model.

On the one hand the medical model which ‘knows what is best for you’ and is slightly paternalistic has been preeminent while now the free market model,which puts you as sort of equal number one (with profit), is seeking ascendancy.

The challenge of choice

The challenge in putting choice into the long term care equation is that the funding exists to enable the expectations of consumers to be met. Without adequate funding consumers choice is just rhetoric.