How China’s social care providers are experimenting to meet the changing needs of citizens

Elderly man in doorway

Welfare provision in China, including social care for older people, is being stretched and challenged by economic, social and demographic changes in the country.  The rise in people’s expectations is creating pressure on government and service providers to deliver more and/or different services.

Meanwhile, the government’s role is shifting, as it attempts to find new ways to meet needs. Non-government channels, including private companies and a range of social organisations and social enterprises, are used. Given that responsibility for many welfare services is decentralised to low levels of government, it’s no surprise to find a wide range of experimentation underway, as local governments look for new ways to provide social care.

In late May and early June, researchers from the Institute of Development Studies and the London School of Economics, visited Taicang City in Jiangsu to see how these changes are taking place there. They went along with colleagues from the Chinese Academy of Social Sciences (CASS), to meet with officials from Taicang and from Shibei District of Qingdao City, and with a number of social organisations in Taicang at the forefront of the changes.

We had a very productive discussion meeting with officials from both Taicang and Qingdao on what local governments in both places are doing, as well as visits to several social organisations.

Highlights included:

  • Taicang is at the forefront of some of the changes that are taking place in redefining the role of the local state, including in provision of welfare services.

    Taicang is among the richest county level cities in Jiangsu and, at about an hour from northern Shanghai, is well networked. The pace of change is palpable, especially in newly-developed areas such as the Kejiao Xincheng. This area was farmland until recently, but is now shaping up as a high-end residential district, with manicured property developments, plenty of green space and a revamped riverside district. Even so, the pace of change seems destined to speed up, with plans to link the city even more closely to Shanghai via a high-speed rail link in the next two to three years.
  • The city government is trying out new approaches to service delivery, and experimenting with using social organisations to provide a range of services under contract to government.

    With a large elderly population, elderly day care centres are among the first types of services to be contracted to social organisations in this way. Of around eighty such day care centres in Taicang, more than ten have now been contracted to social organisations and the trend seems set to continue.We visited a centre run by Deyishan, a social organisation linked to researchers in the department of social work at Anhui University, and which is employing social workers to help attend to the needs of the elderly. The government provides premises for day care centres like Deyishan’s, and a voucher scheme run by the city gives each resident over the age of eighty 80 Renminbi per month to spend on services, including home care, day centre attendance, and so on. While it’s still early days, these are interesting shoots of change, as new actors start providing such services and changing the service offering.
  • Many of the initiatives being run by Taicang city government revolve around increasing social organisations’ role.

    For example, an incubator for social organisations run by the local Bureau of Civil Affairs provides office space to new social organisations, provides some subsidies for staff costs, links them with government and makes them aware of new service contracts they can bid for.
  • Government is clearly still feeling its way, and most service contracts remain small.

    It remains to be seen how this will evolve. While there appears to be substantial commitment to increasing the role of social organisations across a range of areas, there are clearly many issues to work through as local government agencies gain experience of contracting, overseeing these kinds of services, ensuring quality and accountability, and working out what should be core state functions and what can be contracted out.
  • ‘Ryan Social Work Centre’, run by a former CASS researcher, has just opened its doors.The Centre is funded by one of Taicang’s district governments to operate as a hub for social organisations, and foster the emergence of new social organisations capable of taking up government contracts. Again, it’s early days, but it will be interesting to see how the centre shapes up and finds a role combining building capacity and networks and linking government and potential new service providers.
  • Shebei District of Qingdao shows a somewhat different picture.

    Visiting officials discussed their initiatives for improving elderly service provision. There’s an Information & Communications Technology (ICT) flavour to many of these, including the development of an ICT platform in collaboration with a ‘social organisation’ to provide information on services for the elderly, and an online hub for consulting elderly residents’ views on services.

About the project

In 2015, the IDS and the Institute of Sociology of the Chinese Academy of Social Sciences received funding for a three year partnership from the Newton Fund, launched in 2014 to support collaborations that promote the economic development and social welfare of partner countries. The IDS-CASS partnership is looking at the changing role of state and non-government actors in providing social services in China’s rapidly evolving welfare regime and encouraging learning between researchers and officials in China, other rapidly developing countries, and the UK.

A core objective of the IDS-CASS collaboration is to promote mutual learning between officials and researchers in China and other countries experiencing similar challenges. Despite historical, social and institutional differences, there is a degree of similarity in strategies emerging.  Researchers from CASS visited IDS in July 2016 to interact with researchers from the UK and other countries, while a study visit by officials from Taicang and Qingdao is planned for 2017.

China, meanwhile, is pursuing its own learning agenda, and officials from a number of cities, including those involved in the IDS-CASS partnership, are starting to convene a network for mutual learning around shared issues. It will be interesting to see how mutual learning can help problem solving in dealing with the complex reforms that China’s local governments are dealing with, and how lessons from China can be of relevance elsewhere.

See the project page for more details.


Image: Old man smiling at his door in Tongli, Jiangsu province by Till Kuhn on Flickr (cc by 2.0)

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