Japan's government wants a national qualification for housework support services, a self-pay field that care managers fear could expand as public nursing care insurance contracts, shifting more of the cost onto families.
The government's Japan Growth Strategy Council proposed the qualification in April, and the first exam is to be held next autumn. The stated aim is to keep people from leaving jobs to provide care or raise children, and to raise the quality and reliability of the services.
Services that support elderly people fall into two kinds. Nursing care insurance services can be used with a copayment of 10% to 30% depending on income. Services outside the insurance are paid for in full by the user. Housework support belongs to the second kind.
Visiting care under the insurance is delivered by helpers with professional qualifications. Providers outside the insurance need no care qualification at all.
A question of quality, and of scale
Freelance nonfiction writer Mayumi Nakazawa, who writes a series on home medical care and support, said she welcomes efforts to secure service quality. Her concern is what the word "growth" is being used to justify.
“If the expansion of services outside the insurance leads to a shrinking of nursing care insurance services, it defeats the purpose — not only for care workers but for the people who use the services.”Mayumi Nakazawa, nonfiction writer
She said she wants to consider what care services should look like by hearing from the care managers who draw up care plans about the situation on the ground.
Built to share the burden
Nursing care insurance was created in 2000. It set out to socialize care — to have society as a whole support what families had until then carried alone.
Insurance services are now an indispensable part of daily life for elderly people. Nakazawa writes that many people notice something when they first start using them.