A Silver Deal for Europe: EU and its Member States should assure quality long-term care for its older population in a regulated market

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An EESC report finds the situation in the live-in care sector to be unsustainable, with working conditions of carers bordering on sheer exploitation and care recipients struggling to find affordable and quality care. This state of affairs has emerged due to a lack of state support for the care industry and is a product of political neglect.

The European Economic and Social Committee (EESC) has published a report on the future of live-in care work in Europe which points to an urgent need for stronger state involvement and effective action at national and European level to regularise the precarious situation of both caregivers and care recipients in this booming sector.

With demand for long-term and live-in care work continuing to increase due to demographic change, the ageing of the European population and rising chronic health needs, the state will not only have to invest heavily in the care economy to subsidise it in the near future, but it will also have a crucial role in the regulation and professionalisation of care work, the report said.

Defining live-in carers as workers employed to provide care services to older and disabled people who live in private residences as care recipients, the report recaps the EESC country visits to the United Kingdom, Germany, Italy and Poland, chosen on account of being both countries of origin and of destination of live-in care workers located across the EU.

The aim of the report was to gain a first-hand insight into the situation of live-in carers and their employers, mostly families with a member requiring 24-hour care. To do so, the EESC gathered input from live-in care providers, trade unionists, employers and their associations, and organisations dealing with ageing, labour mobility and migrant rights.

The country visits and the report are a follow-up to the EESC's 2016 opinion on "The rights of live-in care workers", the first policy document at EU level to address the issue of their working conditions.

People we talked to – whether they represented workers, employers or care recipients – shared a common critique of many of the structural problems of live-in care work. Their biggest reproach was that it functions through the exploitation of migrant and mobile women, and that this is not only unethical and shameful but also unsustainable, said EESC member, Dr Adam Rogalewski, who coauthored the report with Cambridge-based  researcher Karol Florek.

The report found that carers are required to work or be present for much longer than 48 hours a week but are rarely compensated for overtime work. They are on a 24/7 standby which is almost never adequately paid, with their basic working rights denied and often with no social protection.

Most live-in carers are migrant and mobile women, which only contributes to the precariousness of their situation. Non EU-workers can face difficulties related to their residence status, with work and residency permits depending on a particular employer, which further restricts their freedom of movement and increases the risk of exploitation.

It is crucial that the enforcement of employment standards be separated from immigration enforcement. Migrant workers need to be able to file a complaint without risking deportation, the report proposed.

On the other hand, workers from the EU who carry out live-in care jobs tend to be women over 50 years of age, Mr Florek said. They are too old to find a job and too young to retire, which makes them even more vulnerable.

We call them a hidden workforce, they are isolated, alone and badly paid because they are women, he maintained.

The situation is equally difficult for care recipients who in such an unregulated market cannot be sure if they will get the much needed high quality care or if they are going to be able to afford any care at home at all due to high financial costs, forcing them to turn to the informal care economy when looking for help at home.

With such irregular employment relationships, the exact size of the live-in care workforce is unknown as basic data are simply not properly collected at either national or EU level. It is difficult to calculate the overall number of live-in care workers. The estimates for Italy come to 85,000 and 100,000 for Germany.

 This informal labour market for live-in care did not appear by accident; it emerged due to a lack of state support, and is a product of political neglect, and, in some cases, of a legislative exemption from labour laws for workers in the household setting, the EESC report said.

The lack of state investment means that families and care recipients are left alone and have to find their own solutions, Dr Rogalewski said. We must have a silver deal for elderly people. We have to assure quality life for them, including accessible quality care.

He stressed the urgency of action at both national and the EU level. If we don’t develop sustainable policies, we will not have care work. Without the involvement of the state it will be impossible to solve this issue.

A discussion needs to take place to develop a European framework regulating the service provision of live-in care, while respecting the autonomy of the social partners and different models of industrial relations, the report suggested.

We need to prepare a strategy on live-in care at the EU level. It should focus on mobile workers from the EU as well as on the non-EU nationals coming here to work, so to make sure their qualifications are OK.  We need the guidelines on working time and we need to regulate the training needed to perform care duties, as well as certification and standards for agencies acting as intermediaries between workers and families, Dr Rogalewski concluded.


The EESC report also provides summaries of discussions in the countries visited, detailing the situation in each of their live-in care sectors, with case examples and forecasts of future developments. The countries were also chosen because of their different prevailing models of employment of live-in care workers.

The UK is seeing an informalisation of care, as people are increasingly priced out of the UK’s historically strong formal social care system. The situation of migrant workers providing live-in care was described as “modern slavery”, as they work for less than the minimum wage, have sham contracts and are on standby 24/7. Brexit was raised by stakeholders representing unions and migrant advocacy organisations as a particular risk for care workers with EU citizenship who could see their situation worsen if their status is downgraded to the level of non-EU migrants.

Estimates show that in one out of ten German households, there is a carer from Eastern Europe, with an increasing number of Ukrainians who are in a much worse position than EU workers. Most carers are hired through a chain of agencies (Polish and German) who are said to seldom take responsibility for their working or living conditions. Furthermore, the vast majority of posted workers are de facto bogus self-employed  (under the so called civil contracts)  and because they are not employees, they lack  the protection provided by the posting of workers directive.  There is also much undeclared and irregular employment.  Stakeholders representing both workers and employers strongly agreed that the situation of live-in care workers face is exploitative and scandalous, with frequent infringements of labour law.

Although Italy has signed and ratified the ILO's International Domestic Workers Convention 189, it is not being fully applied. Live-in care work remains almost exclusively reserved for migrant workers. More recently, figures show a decrease in labour migration of highly educated women from Eastern Europe and an increase of migrants from North Africa, including greater numbers of men entering these jobs. The intervention of the state on behalf of dependent persons is currently limited to a monthly payment of EUR 516, with some additional support available in some regions. Care costs far exceed this amount. There was agreement among stakeholders that the state is placing insufficient value on care in Italy and that there is a lack of adequate financing of the care system.

Poland finds itself in a unique position as both an importer and exporter of a live-in care workforce. The number of Ukrainian women working as care workers in Poland is unknown, but is constantly growing. Most people working in this sector are in the informal economy and have poor bargaining power. Almost all 24/7 care workers lack residence status; although most workers attempt to regularise their stay, work permit restrictions make it difficult or impossible. There is massive underinvestment in care infrastructure despite the rising demand for care workers due to ageing. Costs for families and the lack of state support create barriers to achieving formalisation and regular employment in the sector.

The full report is available here.

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