The development of community-based service for older people in urban China: A case study in Guangzhou city

Abstract

In recent years, the Chinese government has been transforming from a direct service provider into a regulatory role in the provision of community services. This article aims to understand the recent development of community service provision for older people in urban China by using Guangzhou City as a case example. Through analysing documents, conducting fieldwork and interviewing municipal government officials and service agencies in Guangzhou, the author identifies several changes in the community service provision system in urban China and discusses implications of these changes.

Keywords

China community service contracting Guangzhou older people

Introduction

Under the 1996 Law of the People’s Republic of China regarding the Protection of the Rights and Interests of the Elderly,¹ the aged population in China was defined as citizens aged 60 years and above. According to the National Bureau of Statistics of China, the population aged 60 years and above accounted for 14.9 percent of the total population by the end of 2013 (China Statistical Bureau, 2014). In Western developed countries, older people are protected by a comprehensive social safety net which can more or less relieve the pressure of ageing (European Commission, 2009; The Economist, 2010; Wray, 2006). But in China, one of the most important challenges for ageing persons is the underdevelopment of long-term care systems for older people, which is becoming a pressing problem.

The new direction of long-term care policy in many developed countries is designed to reduce the use of institutional care and to promote the development of home and community-based care. This new direction partly reflects an increasing global preference for individual autonomy and personal control (Scharlach, 2011) and is also motivated by governments’ desire to cut down the expenditure of long-term care.

In China, the term community differs from the concept of community in English or German because the former is associated with a party-state-created entity and is used to serve state-building goals (Parris, 2012). On the one hand, the emergence of community care service was a result of the challenges to family care and institutional care. On the other hand, after the economic reforms in China, state-owned enterprises transferred their welfare responsibilities for employees to society from the 1980s. The community care services emerged in this context. The term community (shequ) materialised in 1986 when the Ministry of Civil Affairs of China came up with the idea of community service provision (shequfuwu) at the local level to respond to the needs of residents who were attached to work units but suffered considerably during the process of marketisation and state-owned enterprise reform (Parris, 2012).

Since the late 1980s, Chinese governments at different levels have applied the ideology of welfare socialisation² to the community service provision system by introducing multiple service agencies from the market and the third sector. These actions aimed to improve the efficiency and quality of community service. The Instruction on Speeding up the Development of Community Service issued in 1993 by 14 national ministries and committees (Zhang, 2002) provided the official definition of community services. In this policy document, community service referred to social welfare services provided by community organisations based in the Street Office (SO), Community Residents’ Committee (CRC) and township.³

In practice, SOs and CRCs play dominant roles in the administration, coordination and provision of community services in urban China. Both SOs and CRCs are responsible for social, political, economic, cultural and environmental-protection duties. Welfare service provision is only a small part of their assignments. Under this situation, in recent years the government policy has changed to emphasise the involvement of non-governmental organisations (NGOs) and professionals in terms of social workers in the provision of community service through the contracting mechanism.

Research objectives and methods

This article aims to understand the recent development of community service provision for older people in urban China through using Guangzhou City as a case example. Guangzhou City has been 1 of 13 demonstration sites for promoting welfare socialisation reform around China since 1998. Thus, its government’s experience of community services provision is relatively longer and more mature than other cities. Through analysing documents, conducting fieldwork and interviewing municipal government officials and service agencies in Guangzhou, the author identifies several changes in the community service provision system and discusses implications of these changes. Ethics approval for this study was obtained from the Research Committee of the City University of Hong Kong.

The fieldwork was conducted in 2011–2012. Interviews were arranged first with government officials with responsibilities for community service contracting out and community service provision for the elderly at the municipal, district and SO levels, with directors in service-providing agencies and with staff working in CRCs. Then, interviews with staff working in service-providing agencies were conducted in two pilot street communities recommended by the Bureau of Guangzhou Municipal Civil Affairs. The total number of formal interviews was 12. Besides these formal interviews, many informal interviews with government officials, people working in CRCs and social work agencies were conducted with the author making observations.

During the fieldwork in Guangzhou, the author acted as a positive and open observer engaged in community activities so as to achieve a profound understanding of the socio-cultural context in which the interviewees were embedded. By observing the physical environment and institutional setting of the various field sites as well as daily activities, the investigators gained valuable background knowledge about the culture of communities. Moreover, the observation was helpful to understand and interpret the meanings of interviewees’ responses and behaviour in their natural setting.

Brief introduction to Guangzhou and the aged population in Guangzhou

Guangzhou is the provincial capital of Guangdong Province, which is also the political, economic, technological, educational and cultural centre of South China. The city is 7434.4 km² in size and has a permanent population of 12.7 million as of 2011. The city has 10 districts, 2 counties, 131 SOs and 44 townships.

Since 1992, Guangzhou has been characterised by an ageing population, with people aged 60 years and above comprising 10.23 percent of the total population (Bartlett and Phillips, 1997). By the end of 2010, people aged 60 years and above comprised 14.48 percent of the total registered population (Yangcheng Wanbao, 2011). Most older people in Guangzhou could receive care services from relatives. Only 1.73 percent of the total aged population (60 and above) lived in nursing homes or social welfare institutions in 2010 (Yan, 2011).

Development of community service for older people in Guangzhou

Briefly, the development of community services for the elderly in Guangzhou can be divided into two stages since the introduction of the welfare socialisation policy in the 1980s: before community service contracting (from the 1980s to 2008) and after community service contracting (since 2009). The following two sections present the development of community services for older people in the two different stages.

Development of community service before contracting (from 1980 to 2008)

In the first stage, the Guangzhou government at the municipal, district and SO levels exerted much effort to establish community service facilities and to develop multiple community services for older people in the community.

Between the mid-1980s and the 1990s, Guangzhou municipal and district governments authorised SO and profit-making agencies to run community-based service programmes and organisations. Community services became more available to all residents and residents had to pay for the services when in use.

Although elderly community services were increasingly available for all the aged population who had lived in the community since the introduction of welfare socialisation in the 1980s, community services were mainly provided for ‘three nos’ (no relatives, no income source and no physical ability to work) elders by placing them in nursing homes run by the SO or profit-making agencies in the community. These community-based nursing homes provided food, clothing, housing, health care, rehabilitation services and cultural and social activities for ‘three nos’ elders (Zhang, 2002). The municipal and district governments offered funding to these nursing homes according to the number of ‘three nos’ elders under their care. These nursing homes had to cover the deficits through fee-charging services provided for other older people who paid out of pocket. Another type of service was health care services. Older people could receive basic medical care in community health care centres. For bedridden elders, medical consultation and care were provided at home (family beds). Regular medical check-ups for older people and their families were also available in some communities. However, the availability depended on the organisation of the SO. The doctors in the community health care centres were also invited to community service centres or stations to give lectures on elderly heath care.

In addition, ‘household responsibility contract services’ representing the spirit of mutual help had prevailed in the communities of Guangzhou since the 1990s (Zhang, 2002). CRCs divided volunteers into groups, and these volunteer groups signed contracts with the aged, the disabled and other residents in need. Thereafter, these volunteers assumed the responsibilities of providing house call services in terms of family mediation, rehabilitation and health care services, and home services for their service targets (Zhang, 2002). During the festivals and holidays, SOs and CRCs visited the single older people and sent several gifts to them.

In 2001, in response to the 2001 Starlight Programme promoted by the Ministry of Civil Affairs, the Guangzhou municipal government introduced the Suggestions on the Implementation of Starlight Programmes for the Aged.⁴ According to the suggestions, community facilities and community centres/stations for older people in the community should be constructed and reconstructed. These constructed and reconstructed facilities and centres/stations were called Starlight Family for the Aged. In urban areas, each SO was to have a community service centre with a size of approximately 300–350 m². Accordingly, each CRC would have a community service station with a size of approximately 100–200 m².

In light of the Suggestions, these facilities and centres/stations provided venues for elderly activities, a platform for elderly community care, and support for home-based care services. Home-based care services (e.g. housekeeping, daily life care, meal delivery, and escort), emergency call services, day care centre, health care and rehabilitation, and entertainment facilities (e.g. gyms, reading rooms and calligraphy studios) were to be provided for older people. Each district government could have their own design, service delivery model and fee-charging policies and regulations for home-based care services. At the end of 2010, 1391 service facilities and centres/stations had been established in urban areas of Guangzhou (Bureau of Guangzhou Municipal Statistics, 2011).

However, the Starlight Programme failed to reach its anticipated goals. In 2007, Xie (2008) undertook a study on the implementation of the Starlight Programme in Guangzhou. This study highlighted that the main reason for the underdevelopment of the Starlight Programme was the lack of financial support and full-time management staff (Xie, 2008). Most fitness equipment at Starlight Families for the Aged was old, and materials were outdated. A lack of administration and service provision was observed. Service records were unavailable, and the staff did not receive in-service training. The majority⁵ of older people did not know the functions of the Starlight Family for the Aged and regarded such facilities as mahjong rooms.

Since 2005, as a response to the policy direction of developing home-based care service and improving community-based services proposed by China’s central government, some district governments in Guangzhou had experimented with home-based care and emergency call services. In 2008, the two service programmes were expanded to cover most districts of Guangzhou.

In August 2008, the municipal government commissioned the Guangzhou Community Service Centre, a public institution (quasi-government organisation), to launch an emergency call service programme (ping’an tong). Guangzhou Community Service Centre contracted out the service programme to a private enterprise called Guangzhou Sunshine People Care System Corporation for operation. It seems that the Guangzhou municipal government had involved the private sector in the provision of community services since 2008. However, the government agencies did not serve as direct service purchasers.

Six groups could receive free emergency call services: people aged 60 years and above receiving minimum living allowances (or having low income) and living alone (or living with spouse), people aged 70 years and above and receiving minimum living allowances (or having low income), older people receiving minimum living allowances (or having low income) and with disabilities at the fourth level and above, people aged 60 years and being model workers, soldiers with disabilities at the sixth level and above, and family members of revolutionary martyrs. In addition, for older people receiving minimum living allowances and older people with income lower than 500 yuan⁶ per month and living alone (or living with spouse), the government provided a subsidy for emergency call services, and this elderly group only had to pay 200.5 yuan for equipment installation and for the service fee for the first year. For the second year, they needed to pay 20 yuan per month for receiving the emergency call service. Other residents who needed emergency call services should pay 636 yuan for equipment installation and for the use of the service in the first year. Thereafter, they should pay 20 yuan per month for the use of the service.

By the end of March 2011, 8320 households received the emergency call service. Among these households, 6674 (80.22%) received subsidies from the government, whereas 1646 (19.78%) households paid out of pocket (Guangzhou Daily, 2011). The operation of the emergency call service programme, although not directly contracted by government agencies, indicates that government agencies might adopt other sectors in the provision of community services.

In December 2008, the Measure of Implementing Home-based Care Service for the Aged was issued by the Bureau of Guangzhou Municipal Civil Affairs and three other relevant bureaus. According to the measure, home-based care services including daily life care, housekeeping, counselling and other elderly care services based on needs assessment should be provided for people aged 60 years and above and living in the community.

Free services were provided for six types of elders: ‘three nos’ elders, elders who could not take care of themselves and who belonged to the key entitled groups (zhongdian youfu duixiang), elders who could take care of themselves and had an honorary title of model worker above the municipal level, elders aged 80 years and above and living alone, elders living alone and belonging to the key entitled groups (zhongdian youfu duixiang), and elders aged 100 years and above. The elders falling into the first category could receive services amounting to 300 yuan service time. The elders falling into the second to the fourth categories could receive services amounting to 200 yuan service time. The elders belonging to the fifth and sixth categories could receive services amounting to 100 yuan service time. Apart from the six groups eligible to receive free services, other elders who wanted to receive home-based care services pay for themselves. The service items, price and time were determined by the elderly and the administrator of the SO.

In early 2010, 575 service providers were supplying home-based care service for 9692 elders in 114 streets of Guangzhou (Yu, 2010). Compared with 1.119 million elders aged 60 years and above (by the end of 2009), the number of beneficiaries was limited, comprising approximately 0.87 percent of the total aged population.

In practice, the number of elders who paid for themselves was limited. For instance, by the end of 2007, only 341 out of 4239 elders receiving home-based care services paid out of their own pockets (Yan, 2008). In several communities, only 1 percent of the total aged population was receiving home-based care services (Xinkuai News, 2011). For elders who were receiving government-funded home-based care services, most were unaware of the service items they could receive. Li (2010) interviewed 26 elderly recipients in a district of Guangzhou and found that 9 of these 26 elders only used the cleaning service, and only 11 knew more about the offered service items. In addition, most residents were unaware of home-based care services. According to a survey conducted by Xie (2012), among 998 residents in 62 communities of Guangzhou, only 53 percent knew about home-based care services.

Through participant observation and interviews in four districts of Guangzhou, Chen (2011) identified four challenges in developing home-based care services. First, financing channels and funds were insufficient. Government funding in terms of revenues from the welfare lottery was the sole funding source for the development of home-based care services. The municipal government had to set stringent criteria for the elderly to receive free home-based care services because of limited funds. Thus, the coverage of home-based care services was low. Second, the direct service providers did not have professional quality. Most service providers were unemployed females who had received little training for service provision. In addition, the job of a direct service provider did not pay well (approximately 1500 yuan per month) and required intensive labour, the recruitment was difficult and the turnover rates were high. Therefore, service quality was unsatisfactory. Services provided merely met the basic demands of daily life for the elderly; psychological and emotional support was lacking. Third, the coordination among different agencies was insufficient. Civil affairs departments assumed the major responsibility of implementing a home-based care service programme. However, the programme needed the coordination of other agencies, such as health departments, culture departments and enterprises in the community. The coordination mechanism had not been established. Thus, the degree of resource integration was low. Fourth, the majority of residents were unaware of the home-based care services. The SO and CRC did not promote a home-based care service programme in the community. Thus, most elders did not know about the items, price or application procedures of home-based care services.

Some SOs have recently attempted to contract out the home-based care service programme to private enterprises or NGOs. According to the 2008 Measure of Implementing Home-based Care Service for the Aged, registered NGOs and private organisations were encouraged to undertake home-based care service programmes with grants from the municipal government. Moreover, the service-providing organisations were encouraged to set up social work posts.

To summarise, although the government at different levels had built community facilities and developed several service programmes since the 1980s, the coverage of service programmes remained small. For instance, home-based care services only covered 0.36 percent of the total aged population in Guangzhou in 2008 (Xie, 2009, as cited in Zhang and Zhang, 2012) and approximately 0.87 percent of the total aged population in early 2010. A study conducted among 2261 elders in Guangzhou in 2008 showed that only 516 (22.82%) elders received different types of community services (Wang, 2012). Moreover, the quality is not good; service monitoring and evaluation are not highlighted and are unavailable. Only 33.5 percent of 2261 elders thought that the community services provided had the function of taking care of the elderly in the community (Wang, 2012). The government at different levels gradually recognised its limitations in providing community services and considered involving the private agencies and NGOs in the community service provision system.

Community service contracting (since 2009)

Since 2009, as a response to the nation’s call to promote the development of social work, on the one hand, and aiming to enlarge service coverage and improve service quality, on the other, Guangzhou municipal government has begun to pilot contract management in delivering community service in the form of contracting out community service programmes to registered service-providing NGOs. These service-providing organisations are usually called social work agencies, most staff members of which are registered social workers. Social work agencies are introduced in the community service provision system to improve service efficiency and service quality. The government agencies contract out community service programmes to these social work agencies through non-competitive contracting or competitive contracting models. Since the introduction of community service contracting, Guangzhou government agencies have retreated from directly delivering some community service programmes and have shouldered more roles in regulation, funding, coordination, monitoring and inspection.

From 2009 to 2010, the Guangzhou municipal government proposed 10 official documents covering several aspects: cultivating professional social workers, establishing a salary system for social work positions, evaluating social service contracting, supporting the development of social work agencies, building Community or Family Comprehensive Service Centres in streets and so on, to institutionalise community service contracting.

According to the Provisional Measures of Promoting Social Management Service Reform and Establishing Community Comprehensive Service Centre at the Street Office Level published in 2010, Community or Family Comprehensive Service Centres were to be established in pilot streets between September 2010 and September 2012. From 2013 to 2015, 50 percent of SOs in Guangzhou were to set up Family Comprehensive Service Centres that should be expanded to all streets between 2016 and 2020. The Provisional Measures were updated in the 2011 Measures of Accelerating the Establishment of Family Comprehensive Service Centre at Street Office Level. According to the latest measures, each SO in Guangzhou was to set up at least one Community/Family Comprehensive Service Centre before June 2012.

By the end of 2011, 20 SOs in 12 districts of Guangzhou had started experimenting with the contracting out of community services. Family Comprehensive Service Centres were established in these 20 streets. The government at the municipal and district levels offered 2 million yuan to each contracted social work agency to run the Comprehensive Service Centre and to provide various community service programmes for community residents.

Family, elderly and youth services are the three main types of services that should be provided for community residents. Aside from providing these services, other service programmes such as services for the disabled, community development programmes, community correction programmes, coordination of labour relations and employment training for laid-off workers and the unemployed are offered. To some degree, the community services provided by social work agencies are needs-oriented because social agencies needed to conduct a residents’ needs survey before service provision.

With respect to elderly care service, the municipal government aimed to establish a comprehensive platform and a 10-minute service circle for elderly care by integrating community organisations and resources, improving community service facilities and launching diversified community service programmes for the elderly, with an emphasis on providing door-to-door and one-stop comprehensive home-based care services.

Contracting models

Considering the absence of service-providing NGOs, particularly social work agencies, the municipal government deregulated the registration threshold for NGOs, enabling NGOs who could not find government agencies or business units as professional supervisory units to be under the supervision of SOs.

Two models for contracting community services have been formed. Model 1 is theoretically defined as non-competitive contracting model. Under this model, the SO or the semi-government organisation establishes a social work agency registered with the local Civil Affairs departments. The social work agency recruits staff to deliver community service to community residents. The director of the social work agency is usually appointed by the SO. Thus, these social work agencies have a close relationship with government agencies. Model 2 is identified as a competitive contracting model. Under Model 2, the government contracts out community service to certain registered social work agencies through a competitive tendering system.

Initially, the municipal government attempted to adopt a competitive contracting model in all pilot streets. After recognising the insufficiency of eligible service-providing organisations, the pilot SOs were given the autonomy to employ either the non-competitive contracting model or the competitive contracting model. In addition, the SOs were given the autonomy to establish a legal service-providing NGO to implement contracted service programmes. Since 2012, after the researcher had finished fieldwork in Guangzhou, the Guangzhou municipal government required that all streets adopt the competitive contracting model for community service contracting.

According to the Guangzhou municipal government work plan of Promoting Social Administration Service Reform and Establishing Community Comprehensive Service Centre in Pilot Street Communities, all contracted social work agencies should sign a formal contract with purchasing authorities that specifies the duration of the contract relationship, service requirements, quality standards, amount of subsidies and payment method, rights and obligations, as well as penalties for non-performance. The duration of all contracts is usually one year. After one service year, the contract can be renewed based on the evaluation of service performance. According to the evaluation report (2010–2011)⁷ regarding the performance of Guangzhou’s 20 pilot street communities experimenting on community service contracting, all social work agencies passed the final evaluation and their contracts were renewed. It seems that the actual contract duration is long-term and developmental.

To ensure the quality of service, the 2010 Provisional Measurements of Guangzhou Social Work Position Arrangements and Social Worker’s Remuneration Guidance stipulated that the number of social workers in each NGO having a contract relationship with government agencies should not be less than 25 percent of the total number of employees. To become a social worker, college students majoring in social work or staff engaged in careers relevant to social work should pass the National Social Work Professional Qualification Examination and then register with Civil Affairs departments or their authorised agencies and regularly attend continuing education training courses.

In practice, given that the number of eligible NGOs was limited, most pilot SOs adopted the non-competitive contracting model to provide community services. Among the 20 pilot SOs experimenting with community service contracting in 2011, 11 adopted Model 1, whereas the other 9 introduced Model 2. Although Model 2 required a competitive tendering mechanism in selecting qualified social work agencies, few social work agencies competed for the bid in reality because the number of available social work agencies was limited.

Moreover, fault and contingency handling and dispute procedures written in the contracts were negotiated between government agencies and service-providing agencies in the real world. Government agencies need the involvement of social work agencies in providing community services for two reasons: first, this contracting with NGOs represents an innovation for social management, which is highlighted by upper-level governments; second, collaboration could increase service coverage and improve service quality. In this situation, the role of written contracts is merely a record of what has been agreed upon between the parties involved in the contracts.

Financing

According to the Provisional Measures of Guangzhou Financial Support for Developing Social Work issued by the Bureau of Municipal Finance and the Bureau of Municipal Civil Affairs, funding sources for social work agencies consist of financial budget from the district/county government, payment transfers from the municipal government, welfare lottery revenue, social funds and payments from service users.

A government official from the Bureau of Municipal Civil Affairs emphasised that the government funds comprise more than 90 percent of total funding of most social work agencies in Guangzhou.⁸ The municipal government and the district/county government offered a lump sum grant to eligible social work agencies yearly for service provisioning and capacity building. In total, the two levels of government provided 2 million yuan as purchase funds for each social work agency that signed a contract with pilot SOs.

Roles of different actors within the contracting mechanism

Under the circumstance of community service contracting in Guangzhou, social work agencies are generally the service providers, whereas SOs serve as the service purchaser, and the municipal and district governments mainly serve as the service supervisor and inspector. In other words, government agencies play the regulator role, while NGOs assume the role of service provider.

In particular, the Civil Affairs departments take the major responsibility for drawing up service contracts and budgets for community service contracting, regulating the procedures of service contracting, assessing the feasibility of service programmes for contracting, managing the inspection, establishing the service programme database and prioritising service programmes, determining the funding level and service quality criteria, and monitoring service quality and performance. The finance departments are responsible for approving the service programme budgets, allocating funds, monitoring the use of funds and evaluating the performance of funds. The SO determines the service contracting model and selects the social work agencies for contracting. As community service providers, social work agencies apply for funding from the government, design service programmes, deliver community services and report service performance to the government agencies.

Monitoring and evaluation

In 2010, the Provisional Evaluation Measures of Guangzhou Government Purchasing Social Services was promulgated. According to the measures, the Bureau of Municipal Civil Affairs sets different criteria to monitor and evaluate service performance for each type of community service for contracting.

For a specific service programme, such as home-based care, evaluation indicators and measures were issued in late 2011 and late 2012, separately. In the 2011 Guangzhou Home-based Care Service Evaluation Index (Abbreviated List), the evaluation covers seven dimensions in terms of venues and facilities (16 points in total), rules and regulations (16 points in total), management of service target files (12 points), implementation of service programmes (20 points in total), monitoring and evaluation of service programme (12 points in total), service items (16 points in total) and service development (8 points in total).

According to the 2012 Evaluation and Financing Provisional Measures for Guangzhou Home-based Care Service Providing Organizations, the municipal government provides 30,000 yuan for service-providing organisations that achieve excellent points (90 points and above) annually, 20,000 yuan for those that achieve good points (80–89 points) and 10,000 yuan for those that pass the evaluation (60–79 points). For those that do not pass the evaluation (60 points and below), the municipal government will not provide subsidies in the coming year.

Meanwhile, the administration of community facilities is underlined at the municipal level. In August 2010, the Measures of Managing Guangzhou Starlight Family for the Aged was introduced to improve the poor administration of the Starlight Family for the Aged. Evaluation measures focus on five dimensions: venues and facilities (15 points in total), management (45 points in total), service performance (15 points in total), social appraisal (15 points in total) and service development (10 points in total). After the evaluation, all Starlight Families for the Aged are divided into three categories, and the government at the municipal and district/county levels together offered 70,000, 50,000 and 30,000 yuan for Starlight Families for the Aged falling into different categories.

Evaluation and funding incentives are two important methods used to improve service quality under the context of contracting out community service. When the researcher conducted fieldwork in two street communities of Guangzhou, leaders of SOs and directors of service-providing organisations always highlighted that evaluation measures should be followed. The leaders always stated the importance of attracting more residents to participate in community affairs, given that most evaluation indicators were related to the number of participants. Otherwise, the agencies might not be able to pass the evaluation. After the introduction of quality assurance measures, agencies felt more pressure than before. However, NGOs could obtain more financial support from upper-level governments if the service evaluation was satisfactory.

In practice, service evaluation was mainly based on the number of services provided, the social worker’s workload and the frequency of service participation. Interviewed government officials cited quantitative indicators as more objective bases for assessing service performance. Thus, the existing problems in the service delivery process could not be identified by adopting quantified performance assessments (Jing and Gong, 2012). Contract management in delivering community services is a relatively new local initiative in China. The government at different levels is unskilled in gauging performance measurements under the context of contract management processing (Yip and Hanson, 2009). Therefore, the government relies more on quantitative instead of qualitative indicators. However, to what extent these qualitative indicators could measure the service outcomes is questionable.

Discussion

Before the introduction of the community service contracting mechanism, SOs were required to be established in urban areas of China in accordance with the Regulations on the Formation of Street Offices in Urban Area promulgated in 1954. The CRCs served as self-management, self-education and self-service mass organisations at the grassroots level (Chan, 1993). The SOs assumed leadership in planning and coordinating community services, whereas the CRCs organised a series of supplementary mutual support and services for the community residents (Chan, 1993).

The major problem caused by the traditional community service provision network is the availability of community service. As observed by Zhang (2002), SOs and CRCs dealt with many administrative affairs assigned by their top-level government authorities, that is, ‘the grassroots administrative structure is overwhelmed by regulatory, managerial, organisational and economic tasks’ (p. 346). Therefore, SOs and CRCs did not have time to promote and provide community services. In some circumstances, community services were non-existent except in name (Zhang, 2002).

In recent years, the Chinese government has emphasised professionalisation and improvement of the quality of services provided to the community. To achieve these goals, relevant rules and regulations have been promulgated at the national, provincial and municipal levels. Local initiatives establishing new service delivery models have been promoted in several developed cities. By learning from the experiences of other countries in improving the efficiency and quality of public and social services, most developed cities and areas in China initiate measures to provide efficient social services, such as adopting contract management and recruiting professional staff whose backgrounds are in social work. From this viewpoint, the government plays an important role in developing contracting mechanism and professionalism in delivering community services.

The Chinese government is transforming from provider into a regulatory role in the provision of community services. Regulation emerges at different stages of service provision. At the input stage, potential service-providing organisations undergo a registration process, during which they should meet the minimum requirements (e.g. organisations’ experience and knowledge in service provision and employment of a sufficient number of registered social workers). For instance, the municipal government requires that the bidding organisation should fulfil certain conditions when applying for social service bidding projects. The bidding organisation should be legally registered as a social organisation, a civil non-enterprise unit or a public institution and should have a certain proportion of social workers or assistant social workers. Regulation also covers the procedures and processes of service delivery, such as conducting a service demand survey and setting procedures for handling complaints. Output regulation in terms of measuring and evaluating the quality of service is also available.

Before the 2000s, professional services, particularly social work services, were not available in the community (Zhang, 2002). Volunteer services or activities were spontaneous or called for by work units and mass organisations (Zhang, 2002). These volunteer services were characterised as symbolic activities because they were not regular businesses and were provided only on a number of special days of the year (Zhang, 2002). In addition, volunteers in the community were usually old people with little formal education.

Under the context of contracting, social work agencies are autonomous in running service programmes in accordance with actual community situations. These service programmes attract more residents to participate in community activities and consequently expand services and improve community participation. After the community service contracting, the community services for the elderly have generally become more available. The goals of expanding service coverage and improving service quality have been also achieved to some degree.

Conclusion

The contracting mechanism and the emergence of the social work agency are identified as two new institutional settings in the community service provision system in urban China. The case of Guangzhou indicates the adoption of community service contracting is a top-down approach wherein Guangzhou municipal government selects several pilot communities as experimental sites for implementing community service contacting programmes. The social work agencies running government-funded community service programmes receive funds from municipal-level governments and district as well as Street Office-level governments.

Community service contracting increases manpower and financial resources in the provision of community service, thereby expanding the coverage of community services. Therefore, community service contracting makes community services more available and accessible to community residents and enhances the level of the residents’ participation.

That said, it is still too early to evaluate the effects of contracting out community service to social work agencies. The community service contracting model may confront new challenges in the further development, including the insufficiency of social workers and the immaturity of NGOs in China. The markets of both professional provision and community service provision are underdeveloped in China. The government should provide supportive policies, such as taxation, preferential policy and financial support, so that the third and private sectors can penetrate into the social service market. The government should also regulate the development of the social service market and preserve the image of social service in terms of welfare and justice.

Footnotes

Funding

The work described in this article was supported and funded by the Fundamental Research Funds for the Central Universities, Guangdong Univeristy Youth Innovation Talent Project (2015WQNCX002), and the City University of Hong Kong.

Notes

Author biography

Wenyi Lin is a lecturer in the School of Public Administration, JiNan University. She obtained her PhD degree from the City University of Hong Kong.

References

Bartlett

Phillips

D.R.

(1997) ‘Ageing and aged care in the People’s Republic of China: national and local issues and perspectives’, Health & Place 3(3): 149–159.

Bureau of Guangzhou Municipal Statistics (2011) Guangzhou Statistical Yearbook. Guangzhou, China: Bureau of Guangzhou Municipal Statistics (in Chinese).

Chan

C.L.W.

(1993) The Myth of Neighbourhood Mutual Help: The Contemporary Chinese Community-based Welfare System in Guangzhou. Hong Kong: Hong Kong University Press.

Chen

Y.L.

(2011) ‘Exploring Home-based Care Model – A Case Study in Guangzhou’, Social Sciences Review 26(6): 51–4 (in Chinese).

China Statistical Bureau (2014) China Statistical Yearbook. Beijing, China: China Statistics Press.

European Commission (2009) ‘The World in 2025: Rising Asia and Socio-ecological Transition’, Directorate-General for Research Socio-economic Sciences and Humanities. Available online at: https://ec.europa.eu/research/social-sciences/pdf/policy_reviews/the-world-in-2025-report_en.pdf

Guangzhou Daily (2011) ‘Guangzhou Elders Aged 80 and above Could Use Free Emergency Call Service’, Guangzhou Daily, 31 March. Available online at: http://gd.news.sina.com.cn/news/2011/08/09/1167534.html (accessed 26 May 2013) (in Chinese).

Jing

Y.J.

Gong

(2012) ‘Managed Social Innovation: The Case of Government-sponsored Venture Philanthropy in Shanghai’, Australian Journal of Public Administration 71(2): 233–45.

Lei

Walker

(2013) ‘The Big Society in China: A Failed Experiment’, Social Policy and Society 12(1): 17–30.

10.

Y.Y.

(2010) ‘Concept and Behavior of Providing for the Aged and Intervention of Social Work – A Study Based on a District of Guangzhou’, Journal of South-Central University for Nationalities (Humanities and Social Sciences) 30(3): 109–12 (in Chinese).

11.

Parris

(2012) ‘Transforming State and Citizen through Community Building: A View from Zhejiang’, in Yu

J.X.

Guo

S.J.

(eds) Civil Society and Governance in China, pp. 190–214. New York: Palgrave Macmillan.

12.

Scharlach

(2011) ‘Chapter 6: Aging, Family and the Welfare State’, in Chen

S.Y.

Powell

J.L.

(eds) Aging in Perspective and the Case of China: Issues and Approaches, pp. 87–102. New York: Nova Science Publishers, Inc.

13.

Shang

X.Y.

X.M.

(2011) ‘The Care Regime in China: Elder and Child Care’, Journal of Comparative Social Welfare 27: 123–31.

14.

The Economist (2010) ‘“Into the Unknown”: Special Report on Japan’s Ageing Society’, The Economist, 18 November, 1–15.

15.

Wang

(2012) ‘Supply and Demand Analysis of Home-based Care Service in Guangzhou’, Productivity Research 7: 93–5.

16.

Wong

Y.C.

Leung

(2012) ‘Long-term care in China: Issues and prospects’, Journal of gerontological social work 55: 570–586.

17.

Wray

L.R.

(2006) ‘Social Security in an Aging Society’, Review of Political Economy 18(3): 301–15.

18.

et al . (2005) ‘Emerging services for community-based long-term care in urban China: A systematic analysis of Shanghai’s community-based agencies’, Journal of aging & social policy 17(4): 37–60.

19.

Xie

J.S.

(2012) ‘Exploring into City Residents’ Community Work Service Demand and Its Mode – with Guangzhou as an Example’, Journal of Guangdong University of Technology 12(2): 13–8 (in Chinese).

20.

Xie

Z.X.

(2008) ‘Dilemmas of and Suggestions on Starlight Program: An investigation in Guangzhou’, Journal of social work 9: 29–389 (in Chinese).

21.

Xie

Z.X.

(2009) ‘Community welfare service model in urban China since the 1980s: Using older adult’s community welfare service system as an example’, Proceedings of China Social Welfare Conference, Shaanxi, China (in Chinese).

22.

Xinkuai News (2011) ‘Guangzhou Home-based Care Service Faced Dilemmas, since the Elderly Are Not Willing to Pay for the Service’, Xinkuai News, 26 November. Available online at: http://news.xkb.com.cn/guangzhou/2011/1126/172025.html (accessed 26 May 2013) (in Chinese).

23.

Q.W.

Chow

J.C.

(2011) ‘Exploring the Community-based Service Delivery Model: Elderly Care in China’, International Social Work 54: 374–87.

24.

Yan

(2008) ‘Guangzhou Model of the Elderly-care Patterns’, Journal of Social Work 10: 47–9.

25.

Yan

Z.Q.

(2011) ‘An Analysis of the Organizations Supporting the Old at the Ageing of Population in Guangzhou’, South China Population 26(6): 1–7 (in Chinese).

26.

Yangcheng Wanbao (2011) ‘The Aging Rate in Guangzhou is Lower than that of Guangdong Province and the Whole Country’, Yangcheng Wanbao, 17 May. Available online at: http://news.21cn.com/guangdong/guangzhou/2011/05/17/8306257.shtml (accessed 10 October 2012) (in Chinese).

27.

Yip

Hanson

(2009) ‘Purchasing Health Care in China: Experiences, Opportunities and Challenges’, in Chernichovsky

Hanson

(eds) Innovations in Health System Finance in Developing and Transitional Economies (Advances in Health Economics and Health Services Research, vol 21), pp. 197–218. Bingley: Emerald Group Publishing Limited.

28.

(2010) ‘Population Ageing and Issues of Care for Elderly in Guangzhou’, Academic Search for Truth and Reality 2: 15–8 (in Chinese).

29.

Zhang

X.T.

(2002) ‘Community-based Care for the Frail Elderly in Urban China (A Dissertation Submitted to the University of Hong Kong in Partial Fulfillment of the Requirements for the Degree of Philosophy at the University of Hong Kong)’, PhD Thesis, University of Hong Kong, Hong Kong.

30.

Zhang

X.T.

Zhang

X.S.

(2012) ‘The Structural Troubles and Their Solutions of Home Care Services for the Aged’, Zhejiang Social Sciences 8: 81–6 (in Chinese).