Individuals with long-term care needs and children in the care of the state face unique challenges, making their safety and wellbeing deeply dependent on the actual level of care they receive. Even across Europe, where the right to access social services is frequently enshrined in national law, stark disparities persist in the availability, accessibility, and adequacy of support.
These territorial inequalities were a major focus of discussion at a recent meeting held in Brussels within the framework of the European Social Services Index (ESSI). Coordinated by the European Social Network (ESN), this year’s Working Group collected national data on social services across 19 EU Member States, confirming the initiative’s steady growth since its launch in 2023.
At the meeting, Ivanka Shalapatova, ESN’s independent consultant who analysed this year’s ESSI comparative data, highlighted a critical truth: “Just because there is a right or system recognised, it does not guarantee that the rights of the service users are protected in practice”.
Translating rights into practice relies on two distinct elements: quantity and quality.
Quantity: When the legal minimum is not enough to meet actual needs
Italy recently recognised home care as one of the Essential Levels of Social Assistance, established by Law 328/2000, which define the minimum set of social care provisions that local authorities must legally guarantee, in this case for individuals with increased vulnerability due to old age or disability. While this is a welcome legislative development, serious concerns were raised about whether this new framework can meet actual needs.
The 2026 Budget Law sets the guaranteed national baseline at just one hour per week. Although it clarifies that this should be adapted to individual needs, it explicitly ties adjustments to available resources, suggesting budgetary restrictions are poised to prevent people with long-term care needs from receiving adequate support beyond the bare legal minimum.
In 2022, 134,234 people aged over 65 received social home care through their municipalities. According to 2025 figures, an additional 1,625,785 older people received health home care, delivered by the National Health Service and focused primarily on short-term, acute health needs, and 77,401 older people received both forms of care simultaneously.
While our 2026 ESSI findings show that Italy has one of the highest coverage rates among the 19 Member States for older people with care needs receiving home care, this does not automatically translate to adequate care. In fact, 2021 data shows that those receiving social home care received an average of 98 hours per year. This equates to under two hours per week in total. For a target group that often needs daily assistance to remain safely in their homes, it is difficult to imagine how such a restricted timeframe allows for providing sufficient support.
Quality: When the standard of care is not good enough to ensure true protection
Ireland is experiencing a worrying shift toward private, for-profit residential care provision. In 2024 alone, Tusla, Ireland’s Child and Family Agency, contracted and paid €270 million to private provider groups in this regard. This situation stems from an ongoing emergency: Tusla has struggled to keep up with a massive influx of child protection and welfare referrals, which rose by over 52% between 2020 and 2025. At the end of 2025, 5,879 children were placed in alternative care, including 609 in residential settings. Of the latter, more than half were placed with private providers.
While residential care represents only a small portion of Ireland’s total alternative care system, placing the country among the top performers in this year’s ESSI cohort for family-based care provision, the commercialisation of residential placements raises urgent quality concerns in light of a critical regulatory gap.
While the National Standards for Children's Residential Centres set by the Health Information and Quality Authority (HIQA) apply to all designated facilities, private centres fall outside HIQA’s legal remit. Instead, they answer to Tusla's Alternative Care Inspection and Monitoring Service, the very same agency that funds their contracts.
Children separated from their families are already highly vulnerable and deserve stable, therapeutic, and ideally family-based environments. The risks associated with residential care are well documented, and as Caroline Strong, Chief Operations Officer of the Irish Association of Social Workers, powerfully stated during the Working Group meeting: “Children in the care of the State deserve a home – not a contract”.
Securing the future of social care
The 2026 ESSI findings from Italy and Ireland are two of several examples which demonstrate that recognising a right or system is meaningless if budgets cap the quantity of care and fragmented regulatory oversight and privatisation compromise its quality. To build truly effective social care across Europe, Member States must match their legal frameworks with sustainable funding and uncompromised, independent enforcement. Only then will the right to social care translate into meaningful dignity in practice.
For further insights into the state of social services across Europe, consult ESN's country-specific factsheets from the 2026 European Social Services Index. Later in 2026, we will also be launching the 2026 ESSI Cross-Country Analysis.
