In September, 1994, the National Advisory Council to the Prime Minister on Social Security disclosed the Second Report on the"Future Image of the Social Security System." Among other things, the Report stressed the pressing need for the construction of a comprehensive public care service system as an integral part of our Social Security System and proposed establishing a public long-term care insurance program as soon as possible.
In response to growing concern on the construction of a public care service system, the National Government took two important actions. One was the revision of the goals of 1990 Ten-year Gold Plan, now called the New Gold Plan. The other was the setup of the special task force for the development of a comprehensive public care service within the Ministry of Health and Welfare.
The New Gold Plan was made public in December, 1994. Below, let me briefly explain the contents of the New Ten-year Gold Plan. Its goals are to be reached before the end of fiscal year 1999 (Table 1, 2).
●The number of homehelpers will be increased from 31,405 (1989) to 170,000 (the former goal was 100,000.) When the goal is reached, the ratio between homehelpers and the population aged 65 and over will be 1 ： 127.6. It is said that in Sweden this ratio is roughly 1 ： 50. This means that Japan's level will be still far below the levels of other advanced countries of Western Europe.
｡?he number of Day Service Centers will be increased from 1,080 (1989) to 17,000 (the former goal was 10,000.) When the goal is reached, Japan will have one such center for every 1,300 older persons aged 65 and over, or a typical medium-sized city of 100,000 will have approximately 13 such centers.
｡?he number of beds for Short-term Stay Service (respite care service) will be increased from 4,274 (1989) to 60,000. (the former goal was 50,000.)
｡?he development of visiting nurse services for the elderly will be accelerated. The goal set by the New Ten-year Gold Plan is 5,000 Visiting Nurse Stations throughout Japan. This goal was newly added in the New Gold Plan. (In 1989, the number of such centers was negligible.)
｡?he number of beds for long-term institutional care will be increased from 189,830 (1989) to 570,000. This means that when the goal is attained in 1999, the proportion of institutionalized older persons among those aged 65 and over will be 2.6 percent. This figure is far less compared with those of countries in Western Europe and North America. It is said that the average proportion among these countries is approximately 5 percent. Parenthetically speaking, however, the average length of stay of older persons in hospital in Japan is much longer than in other advanced countries. Thus, the actual gap between the needs and the available resources in the year 1999 will be considerably narrower than pure numerical comparison would indicate.
