REPORT " The European Care Strategy: challenges and the way forward "

REPORT

Keynote speeches

Christa Schweng, President of the EESC, opened the hearing with the statement that the care sector was facing a structural crisis of chronic underinvestment and a shortage of workers, combined with increased demands for care. The gender gap in care was having a negative impact on the personal and working lives of the 90%-female work force in the formal and informal sectors. She also announced that three EESC opinions were looking at the EU Care Strategy, and that they proposed some recommendations for transformative approaches to care, including the proposal for a European Care Guarantee, which would ensure lifelong access to affordable quality care, as well as provisions for the needs of informal caregivers, and changes to community-based – rather than institutionalised – care.

Katarina Ivankovic-Knezevic, Director for Social Rights and Inclusion at the European Commission's DG EMPL, drew attention to Europe's ageing demographic and the predicted 7 million increase in the number of people in need of long-term care (LTC) by 2050. This represented great job creation potential, and it was intended also to appeal to male workers to fill such jobs. Ms Ivankovic-Knezevic stressed the need to promote skills for the informal and as well as the formal sectors, to combat gender stereotypes, to provide technical support for implementation of the strategy at national level, and to develop legal pathways for legal migrants to work in the care sector.

First panel – European Care Strategy: how to tackle its major challenges?

The opinion SOC/720 –  Health Workforce and Care Strategy for the future of Europe – was presented by its two Rapporteurs: Zoe Tzotze-Lanara and Danko Relić.

Ms Tzotze-Lanara commented on the challenges linked to the implementation of affordable, equitable and accessible care. These included low wages, lack of support for community-care, grey areas of informality and much-needed answers to the abuse of the elderly and children. She also highlighted the importance of the new digital potential for enabling a transformative approach to care.

Mr Relić focused on the challenges relating to the health workforce. He felt that to achieve truly integrated care, it was necessary to further develop it both horizontally and vertically, in order to ensure continuity of information, procedures and guidelines. He also stressed the importance of processes and primary care. He concluded by calling for better recognition of the role played by nurses and their requirement to follow appropriate specialisation.

 

Pietro Barbieri, Rapporteur for Opinion SOC/730 - The role of family members caring for people with disabilities and older persons: the explosion of the phenomenon during the pandemic – mentioned the psychosocial consequences of work as informal carers. Women represented the vast majority of workers in the sector; it was often impossible for them to work or to work full time, to practise sports or to engage in cultural activities. In addition, they were excluded from social security schemes and pension rights. Mr Barbieri called for informal caregivers to be recognised in their roles, for steps to be taken to avoid their marginalisation, for psychological support services to be provided for them, and for them to receive assistance with administrative services as well as medical support services, incorporating an overarching financial support scheme.  

Dennis Radtke, EPP Group Coordinator of the Employment and Social Affairs Committee, suggested that subsidiarity be rethought in issues relating to care, not the least because of the reliance on the international mobility of workers in the care sector to fill in existing shortages. Mr Radtke drew attention to the black market, especially in elderly care, and the ensuing need to share best practices and develop European-wide standards for health and safety practices for care givers, as well as for the "European Qualification Profiles", recognising their training and qualifications inter-institutionally.

Hans Dubois, Research Manager at the European Foundation for the Improvement of Living and Working Conditions (EUROFOUND), referred to three potential risk areas for implementation. There needed to be increased emphasis on the multidimensional nature of quality care, on recognising and answering needs, for instance assessing whether legal entitlements effectively reached patients, and on the provision of social inclusion support. Also, working conditions had to be improved in the care sector in order to address the labour shortage and attract qualified staff, as well as in the informal sectors for carers of pension age in order to support them in their responsibilities. Lastly, prevention had to be envisioned holistically, by including, for instance, considerations of good housing and public space as a means of prevention and as an essential element of LTC.  

Jan Willem Goudriaan, General Secretary of the European Public Service Union (EPSU), spoke of the pressing need to address the lack of staff in the formal care sector through collective bargaining and dialogue between social partners. He drew attention to the link between a sustainable public budget, taxation and redistribution of wealth, and public child, adult, elderly, social and mental health care. This included a break in the commercialisation of care. The EU sectoral social dialogue committee had to be developed in order to improve working conditions through collective bargaining.  

Enrico Tormen, Advocacy Officer for Save the Children and member of the Alliance for Investing in Children, felt that the strategy's focus on the transition from institutional to community-based care had to be strengthened, as did concrete action plans and funding schemes, all set up in cooperation with stakeholders. Mr Tormen recommended that joint monitoring systems accompany implementation. The review of the Barcelona targets had to be supported by a better understanding in Member States of early childhood education and care (ECEC) and its impact on society. Mr Tormen concluded by expressing his concern that dynamic ECEC targets might foster uneven development within the EU.  

Marta Branca, Secretary General at the European Hospital and Healthcare Employers' Association (HOSPEEM), called for relief of the overburdened hospital sector through better-integrated, efficient and effective long-term care alternatives. LTC therefore deserved special attention as regards financing. She also urged that appropriate resources be provided for the promotion of safety and health standards at the workplace.  

Discussion

Katarina Ivankovic-Knezevic went into more details regarding the supposedly unmet ambitions of the Barcelona targets, highlighting that benchmarks were mere preconditions, while the underlying focus was to address the exclusion of children that were homeless, in precarious housing, belonged to minorities or had disabilities; she pointed out that these steps and the follow-up thereto would reflect the true ambitious nature of the project.

Jan Willem Goudriaan answered several questions regarding the availability of data for improving the care sector, by proposing that the priority should be sharing information across Member States. This included the drafting of qualitative approaches that asked care users to give their opinions.

 

Second panel – The potential of fostering healthy ageing and prevention

Miguel Ángel Cabra de Luna, Rapporteur for Opinion SOC/687 – Towards a New Care Model for the Elderly: learning from the Covid-19 pandemic – underlined the need to give older people the value they deserved in society. The silver economy needed to be considered as a wealth-creating element of society, while preventive approaches in health care had the potential to extend working life. To enable such opportunities, governments had to develop strategies that would stimulate active lifestyles with strong interpersonal relationships and access to community services, to training and to social cooperation structures.

Philippe Seidel, Policy Manager at AGE Platform Europe, called for a European strategy for older people. He also proposed a gradient in the assessment of needs in order to avoid costly institutionalisation, as well as further developing prevention through specific training such as balance training to prevent falls. He stressed that private formal care sector should prioritise the agency and independence of the people in need of care, above financial profit.

Caroline Costongs, Director of EuroHealthNet, welcomed the focus on healthy ageing, and proposed initiatives in which care services engaged with other sectors to promote health and prevention. This included social prescribing for non-medical, health-related needs, which took the form of access to community resources targeting mental, social and physical requirements. Health promotion had to be sensitive to health literacy and to incorporate holistic advice regarding everyday habits and well-being, while temporary interventions had to be sensitive to surrounding issues such as strengthening overall health before burdensome interventions. The digital gap had to be addressed in order to tap full potential.

Aude Boisseuil, General Delegate of the European Federation for Family Employment & Home Care (EFFE), and Aurélie Decker, Director of European Federation for Services to Individuals (EFSI), recommended a home-centred approach to many care trajectories, which implied control by receivers that guaranteed respect for their freedom of choice through person-centred care. Home care workers had the potential to become coordinators of complementary services but also early detectors of incipient health or structural needs. The sector had to be fostered in social dialogue capacity building and considered an integral part of the care strategy.

Discussion

The panel received a question regarding the meaning of "care" and how it should be translated to integrate multiple practices, to which Philippe Seidel answered that long term care should ideally be systematically complemented with "and support". Caroline Costongs recommended that increased attention be paid to the transfer of skills and the shift of tasks within the sector. New professions that covered the overlapping not-strictly-"care" needs determining social and mental well-being deserved attention so that transformative ambitions could become a reality.

Closing session

Zuzana Freitas Lopesová, Deputy Minister of Labour and Social Affairs from the Czech Republic, concluded the conference by summarising the work done by the Czech Presidency in this field and pointed out the importance of digitalisation, as well as the need to invest in technology for the home care sector. A sustainable mix of services would allow patients to choose how to design their relative autonomy.

Laurentiu Plosceanu, President of the SOC Section, concluded the event by summing up some of its key recommendations, namely in the field of LTC, on how to address work shortages in care, on the role of informal carers and on the importance of prevention and healthy ageing.

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20221207 Report