Salta al contenuto principale

As kindergartens, schools, day care centres and residential services closed during the Covid-19 pandemic, we realized the importance of social care and social services in our lives. The unspeakable tragedy that we experienced during Covid-19 in older people’s care homes across Europe underscored even more how important it is to change the current model of care. In this context, the Commission has launched today their long-awaited Communication on a European Care Strategy accompanied by proposals for Council Recommendations on the revision of the Barcelona targets on early childhood education and care (ECEC), and long-term care (LTC). The Commission underlines some of the key reasons behind the care crisis, acknowledges the role that social services play in caring for those in need, and makes a series of recommendations. While it is still early days, an initial assessment leads us to the following thoughts.

Supporting the most vulnerable children

The upcoming Council Recommendation on the Barcelona targets review on ECEC misses a key point that children from disadvantaged backgrounds are disproportionately likely to miss out on formal early childhood care and education. In some EU countries, children from high-income families are over four times more likely to use formal ECEC than children from low-income families. One of the most vulnerable groups of children not mentioned by the proposal are children in state care. ESN stresses the importance that ECEC services coordinate with social and other public services including health and child protection as they identify early signs of neglect or abuse. A focus purely on targets does not address the key issue of supporting the most vulnerable children to develop in the best possible way.

Improving affordability of care services

The Commission emphasizes the need to improve the affordability of care services since a third of households with LTC needs do not use home care services because they cannot afford them, but the question is, can they choose home care services in the first place? In the best-case scenario, coverage is at 30% in those countries that can provide most home care services (counting an average of 3h per day). In other countries, they have opted for reducing the number of hours to one a day to increase the number of days they can provide for care in people’s own homes, but this is hardly an adequate solution for people’s long-term needs.

Funding of care services is a key concern across public social services in Europe. Therefore, the Commission does well in underlining the trend of a shrinking and greying EU which is resulting in a lower tax base as well as increased demand for long-term care. However, the Commission seems to focus only on cost-efficiency, without recognising that the percentage of GDP invested in care and social services has decreased over the years. This is reflected in millions of people now waiting for an adult social care assessment or a direct payment to begin their care, or for their care to be  reviewed. The future Recommendation should address the need to increase resources and where to invest them -making acute hospital and residential care the focus of resources, without addressing care and support at home, means people deteriorate and even more will need hospital care.

Supporting the workforce

The Care Strategy focuses on improving wages supported by strong social dialogue. While this is an important element, there are others which are key to ensure the workforce is well supported, such as the improvement staff to population ratios, new and alternative ways of recruiting, and in particular accreditation and registration of social care workers.

Such a registration process, which previous ESN reports have highlighted is now being implemented in several EU countries, can be linked to training and career development opportunities and also recognises the practical skills and experience acquired in an informal context. This in turn would improve quality of care and therefore benefit care workers, their employers and service users.

The Commission can play a much stronger role in this area by supporting countries to work towards the harmonization of qualifications in social work and social care. To start, Directive 2005/36/EC could be amended to include the social work profession. This would make it easier for employers and public authorities to recognise qualifications held by EU nationals and would help to address the recruitment gap that exists in many EU countries.

Improving Quality of Care

We welcome the Commission’s focus on quality of care. The Commission makes a series of references to quality standards, but these are not outlined. Based on our analysis of quality frameworks across Europe, quality means improving people’s lives, hence any quality standard which is proposed in future Recommendations should be guided by this principle. The Commission could propose specific outcomes focused on people’s recovery measured, for instance, by the proportion of older people who are supported in their own homes long-term. In focusing on quality, future proposals should highlight the role of Care Standard Authorities (CSA) as essential in quality assurance and continuing care improvement.

Finally, future Recommendations should recognise the need of A Care Guarantee for All.

Different groups in need should have a similar right to access quality care and support. A common thread across all social protection principles of the European Pillar of Social Rights is the need of support for different populations. The Care Strategy falls short of proposing the right to quality care for all those who may need care and support at a certain time in their lives. A care guarantee for all recognized in future Recommendations would bring together European initiatives on children, youth, disability, and long-term care.