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Carers and Work-Care Reconciliation International Conference

University House, University of Leeds

Caring situations for a disabled child in Finland, Japan and Taiwan: Work-Care reconciliation

(Handout)

Presented by Yueh-Ching Chou, Toshiko Nakano & Antti Teittinen

Tuesday 13th August 2013, morning session, 11:00am workshop A

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Table 1: Basic data related to disabled child care in three countries

Age / type of disability Taiwan Japan Finland

Number and % of total

population

All with disabilities 1,080,000; 5% 7,443,000; 6% 303.000; 6%

All with IDs 96,565; 0.4% 547,000; 0.4% 40.000; 0.7%

% living either with family or

independently

All with disabilities 93% 93% 92%

All under age 18 with

disabilities*

97% (i) 94%

(ii) 98%

All with IDs 93% 77% 66%

% using residential services All with disabilities 7% 7% 4%

All under 18 with

disabilities*

3% (i) 6%

(ii) 2%

(iii)

All with IDs 7% 23% 25%

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Use of community services Less than 5% Less than 9%1

Use Personal Assistant services None2 None 4%

% employing a live-in migrant

care worker

All with disabilities 11% None-

All under 18 with

disabilities

1% None-

All with IDs 0.7% None-

Notes: IDs – intellectual disabilities

*For Japan, first figure is for persons under 18 with physical and intellectual disabilities; second figure is for persons under 20 with ‘mental

disorder’.

Sources: Figures for Taiwan: Chou et al, 2007, 2010; DSMI, 2007, 2011. Figures for Japan: Cabinet Office, 2010b; MHLW, 2005, 2006, 2009;

JILPT, 2011. Figures for Finland: Tossavainen, P. & Kuronen, R. (2012) Institutional Care and Housing Services in Social Care 201. THL; Social

Insurance Institution of Finland: Statistics on disability benefits 2012.

1 Includes persons using more than two service programmes.

2 In experimental stage-NGO; included in the Disability Act act since 2012.

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Table 2: Supporting parental care for disabled child in three countries

Finland Japan Taiwan

Support

from

workplace

Paid job alternation leave for 90-359

days; must take as min. 90 successive

days, employees with 12 months’

service and 10 yrs experience only, 70%

of unemployment benefit rate; costs

covered by state.

Unpaid care leave, max. 6 months per

request, available at employer’s

discretion.

Like all parents, childcare leave until the

child is 3 years old, paid flat-rate

allowance, with means-tested and

possible municipal supplements.

1995: employers recommended to offer family

care leave.

Paid family care leave, max. 93 days for each

family member (self-employed not eligible).

Paid or unpaid nursing leave for 5 days per

year (10 days per year if more than one

dependant).

Legal right to request flexible working:

employers must offer carers i) shortened

working hours; ii) flexible working time; iii)

limitation of extra working hours, up to one year

per application.

Paid parental leave (60% of salary)

parents (one at a time) with children

aged 6 mths-3 yrs, parents with

labour insurance; otherwise unpaid

Paid care leave, 5 days p.a. children

<12 yrs, civil servants only.

Flexible working or unpaid

one-hour early leave, employees

with children <3 yrs, companies

with 30+ employees only

Support

available

locally

1993: Decree on Support for Informal

Carers.

1995: Job Alternation Leave Experiment

Act allowed career breaks of 90-359

days.

1995:Childcare and Family Care Leave Act

(Revised) extended to care of ‘other family

members’ in addition to childcare

1999: Childcare and Family Care Leave Act

(Revised) obliged employers to offer family

care leave.

1993: Respite care initially

introduced (in Taipei City).

2002: Gender Equality in

Employment Act: unpaid leave to

care for relatives.

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1997: Social Welfare Act (revision): 1

free day per month for recipients of

carer’s allowance.

2001: Social Welfare Act (Revised): 2

free days per month for recipients of

carer’s allowance.

2002: Job Alternation Leave Act: 90-359

days’ financially supported leave made

permanent.

2005: Support for Informal Carers Act: 3

free days per month for recipients of

carer’s allowance.

2011: Support for Informal Carers Act

(Revised): LAs may contract with a

2000: LTCI Act: (in general, for persons over

65, not for persons with disabilities includes a

family carer support programme.)3

2001: Family Care Leave extended / amended.

2002: Family Care Leave extended / amended.

2004: Family Care Leave extended / amended.

2005: Family Care Leave extended / amended.

2009: Childcare and Family Care Leave Act

(Revised) obliged employers to establish a

system of short-time work for workers having

children aged 3 or younger, to extend the

maximum lengths for childcare leave when

both father and mother take the leave, to

establish a system of short-term family care

2004: 5 days per year paid care

leave (govt. officials only).

2007: Welfare of Disabled People

Act: included Special Care

Allowance to mid- or low-income

senior citizens.

2007: Welfare of People with

Disabilities Act: LAs to co-operate

with NGOs on respite/ carers’

services.

2009: Employment Insurance Act:

unpaid care leave for carers of

family members.

2009: Welfare of Older People Act:

3 Persons with disabilities over 65 will be able to choose services based on LTCA instead of services based on the Comprehensive

Support Act for Persons with Disabilities Act.

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‘respite care’ worker to replace family

carer on ‘days off’.

2011: Employment Contracts Act

(Revised): right to request unpaid leave

to care for family member.

Health and social care:

Public universal healthcare (with

moderate user fees).

Home care and residential social care

services (with moderate user fees).

Variable, discretionary carers’ services

such as short-term respite care (with

moderate user fees).

State involvement:

Carer Allowance.

Job Alternation Leave Benefit.

Special Care Allowance (during

treatment of a child).

Disability Allowance (to parents of

leave.

Health and social care:

Healthcare system (with 30% user fees).

Early intervention support services.

Nursing care at home.

Short-term hospitalization.

Day service for disabled children.

After school care service

Specialist medical care.

State involvement:

Family Care Leave Supplement (through

unemployment insurance, for carers with prior

employment record only).

Special Child Rearing Allowance.

Welfare Allowance for Children with Severe

Disabilities.

Income tax allowance.

LAs to co-operate with NGOs on

respite/carers’ services.

Health and social care:

Variable, discretionary LA-funded

carer services (respite, training,

support groups, counselling,

information).

Universal insurance-funded

healthcare (NHI) system.

State involvement:

Income tax allowance.

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under 16-year-old disabled children to

support care at home).

families/c

ommuniti

es

involved

for

making

change

The Central Association of Carers in

Finland

exists to improve the status of

families in care situations

is for carers and their loved ones,

local associations and citizens

The Central Association of Carers in

Finland is an advocacy and support

association for carers and care receivers.

Japan’s 1998 Promotion of Specified

Non-profit Activities Act enabled eligible

non-profit organisations to become legal

entities. After LTCI system established in

2000, the Services and Supports for Persons

with Disabilities Act was enacted in 2006(the

Comprehensive Support Act for Persons with

Disabilities revised in 2012), many grassroots

voluntary organisations became non-profit

organisations (NPOs) and began to provide

services. Profit organisation also began to

provide services. NPOs and Profit

organisations growing rapidly. NPOs supply

employment support for employment for

persons with disabilities and day services for

children with disabilities.

NPO services share small – less than 16% –

role of private and quasi-public welfare

organizations); POs share over 57% for

In-home LTC (home help) and Home-visit care

for persons with severe disabilities (MHLW ,

1. TAFC-- Taiwan Association

of Family Caregivers established in

1996

-first voluntary group working for

the rights of carers;

-Campaigning on carers’ issues

began in 2010;

-by 2011, 10 branches;

- campaigns on 4 main issues: one

day a week respite for family

carers; paid family care leave;

inclusion of family carers in the

forthcoming LTC Services Act

(drafted in 2011); and economic

security for carers.

-TAFC and 26 other NGOs have

established a ‘LTC Coalition’ to

monitor the government’s design of

its planned LTC scheme: universal

LTC services to meet the needs of

care recipients and family carers;

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2011)

More recently, informal internet support network

groups managed by working mothers with disabled

children growing up, peer supporting or information

resources--Internet network groups will be much

more accessible than the support programmes for

carers organized by the national-wide and traditional

carers’ associations.

LTC inspection and ombudsman

systems; and family support

services; argued for domestic and

‘live-in’ migrant care workers, with

appropriate training, to be

integrated into Taiwan’s LTC

system

2. Woman groups involved

currently

future

challenge

s for

parental

carers of

disabled

children

1.Development of temporary care and

ensuring sufficient financial support for

formal and informal carers. It is also

important to develop peer support,

occupational health service for carers as

well as guidance and counseling.

2. A structural point is that it is

inexpensive to care disabled persons at

home. However, at the same time, family

carers’ situation is not so good, as they

often are displaced from labour markets

and their incomes are quite low.

3. Prolonged responsibilities of family

care when disabled children grow up.

1. To formulate new policies emphasising the

need for positive attitudes to flexibility in

the workplace and raising disabled children.

2. Policies need to support children’s

independent lives in the community, with

formal or informal resources available to

them and their families.

3. Parent-carers need the chance to choose a

working style which suits their caring

circumstances, which means providing a

special subsidy for children with disabilities

to ensure their financial security.

1. Aware of the needs and

well-being of parent-carers-- social

services available

2. Supporting parents/mothers--

paid work & reconcile paid work

and care—paid care leave available

for parents of disabled children

3. Reducing the cost of day care

4. Universal family subsidy

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Note: All data are based on the book, Chapter 1, 2, 8 and 12: T. Kroger & S. Yeandle (Eds.) Combining paid work and family care: Policies and

experiences in international perspective. Bristol: Policy Press.