Research On The Implementation Deviation Of Neighborhood Care Policy For The Elderly In Rural Areas

In recent years,the rural elderly service problem is increasingly serious.In the case of insufficient supply of formal care services,the use of rural relatives and friends,neighbors and other informal care resources to carry out care for the elderly has become the model choice of China’s rural care services.How to promote the long-term operation of this model under the circumstance of limited policy resources has become an important issue in personal social service policy.After reviewing relevant literature,it is found that foreign neighborhood care policy studies are mainly carried out in the field of informal care policy studies from the aspects of background,existing resource structure and relationship with formal care.Domestic academic research on neighborhood care policy mainly focuses on policy advocacy,policy pilot analysis and other aspects,but has not provided in-depth analysis on the formulation and implementation of neighborhood care policy.It is a reliable policy analysis path to trace the problems existing in policy making by obtaining relevant information after policy implementation.On this analysis path,T.B.Smith proposed that there are four main factors affecting policy implementation:idealized policy,implementing agency,target group and environmental factors.The tension among the factors,especially the destructive tension,may lead to policy implementation deviation.Based on Smith’s policy model,this paper constructs an analytical framework according to the tension between different elements.At the same time,the author explains the causes of tension from the perspective of policy knowledge.The attitude,speech and action of relevant subjects in the policy process are important reference factors for policy formulation and implementation research.The correlation method of qualitative research is an effective way to obtain humanistic information.In this paper,in-depth interview,participatory observation,questionnaire survey and policy text analysis were used in qualitative research to obtain relevant information on policy formulation and implementation of neighborhood care policies in C City.By comparing the policy text and policy implementation,it is found that the implementation of neighborhood care policy in C city has three implementation deviations: "limited implementation","replacement implementation" and "innovative implementation".These three implementation deviations have negative,neutral and positive impacts on policy implementation respectively.Under the guidance of Smith’s model,this paper finds that policy implementation bias is the result of the tension between idealized policy and implementation subjects,target groups and environmental factors.In terms of the implementation deviation caused by the tension between the neighborhood care policy and the subject of policy implementation,this paper first finds that the neighborhood care policy and the subject of policy implementation follow different values and ethics.The neighborhood care policy follows the policy ethics,which is embodied in the welfare,protection and foundation of the policy.The executive subject follows the ethics of personal communication,which is mainly embodied in reciprocity,relationship and expediency of interpersonal communication.The different values and ethics lead to the difference between the neighborhood care policy and the corresponding choice of the implementers.In other words,on the one hand,the policy design takes the most urgent needs as the service object,the most basic long-term care needs as the service content,and the professional development as the service quality.The neighborhood volunteers prefer to choose the elderly who have a specific type of relationship with them,and prefer to provide non-private care services with life wisdom as the service means.On the other hand,the service time demand of the elderly recipients is characterized by continuity and timeliness,which is different from the service supply preference of the neighborhood volunteers,such as emergency and short period.These differences lead to limited implementation of neighbourhood care policies.In terms of the implementation deviation caused by the tension between the neighborhood care policy and the target group,this paper first finds that the neighborhood care policy and the target group follow different practical logic.The neighborhood care policy follows the logic of welfare governance,and shows the characteristics of simple,typified and determined service needs.The target group follows the action logic to meet the needs,and shows the action characteristics of X multi-field practice,multi-objective orientation and multi-directional participation.Different practical logics lead to differences between neighborhood care policies and target groups.In other words,on the one hand,the service design of the neighborhood care policy shows the characteristics of classification and service simplification,while the needs of the elderly recipients show the characteristics of joint and complex needs.On the other hand,the policy design assumes that assisted older persons are passive recipients of care services,when in fact assisted older persons appear as active care partners.The above tension between policy design and target group leads to the implementation bias such as limited implementation and innovative implementation.In terms of the implementation deviation of the tension between neighborhood care policy and environmental factors,this paper first finds that neighborhood care policy and environmental factors have different intellectual justifications.The neighborhood care policy absorbs official knowledge and expert knowledge,so that the policy text shows the characteristics of ideal,universality and intervention.Environmental factors activate local knowledge,which is characterized by reality,situation and constraint.Different intellectual motivations make the neighborhood care policy and environmental factors differ.That is,on the one hand,the neighborhood care policy of C City assumes that the cultural tradition of neighborhood mutual assistance in rural society is an effective cultural capital to solve the shortage of elderly care,and this premise is quite different from the practical neighborhood helping habits in rural areas.In fact,the forms and types of interaction between neighbors still exist,but the amount of mutual assistance has been greatly reduced;On the other hand,the standardized design of the neighborhood care policy in C City presents the characteristics of consistency and high quality,while the factors such as the natural environment,economic development level and public service supply of rural society show the characteristics of heterogeneity and limitations.The contradiction between policy design and environmental factors leads to the implementation deviation of neighborhood care policy,such as limited implementation and replacement implementation.On the basis of answering the question of the causes of policy implementation deviation,this paper proposes countermeasures on how to improve the rural neighborhood care policy.According to Smith’s policy implementation process model,easing the tension between different policy elements is an effective way to reduce the deviation of policy implementation.Therefore,in accordance with the principles of social justice,people-oriented and knowledge compatibility,this paper retains the policy ethics,ideality and intervention in the neighborhood care policy,and abandones or suspends the policy design of simplification,classification and certainty under the logic of welfare governance.It supports the complexity,diversity and autonomy needs of the target group,complies with the situational conditions in the environmental factors,and abandons the action principles of reciprocity,relationship and expediency under the ethics of private communication of the executive subject.As a concrete implementation of the theoretical solution,this paper proposes ways to relieve the tension through duty adjustment to change the task of policy makers,policy absorption to change the identity of neighborhood volunteers and service negotiation to safeguard the rights and interests of the elderly recipients.The analysis of personal social service policy toolbox found that the case management system is an integrated system that can alleviate many tensions,and it has policy foundation,organizational foundation and personnel foundation in rural areas of our country.The construction of case management system in rural areas is the choice of welfare system to promote neighborhood care in rural areas.In order to ensure the effective operation of the case management system,this paper finally puts forward countermeasures to strengthen the construction of the atmosphere of helping others,the construction of public opinion supervision and the construction of the neighborhood caregiver support system.