ESN at public policy exchange debate

'How to ensure accessible and quality long-term care with an ageing population and growing costs?' – this was the main question discussed by researchers, policy makers and care providers at the conference Transforming Long-term Care in Europe that took place in Brussels on 28 January. From the European Social Network (ESN) Policy Officer Lisa Schönenberg presented on how public authorities transform care services for older people in order to address these issues.

According to the OECD report ‘A Good Life in Old Age? Monitoring and Improving Quality in Long-term Care’, the fastest-growing age group in OECD countries are people over the age of 80, with people living past this age set to triple by 2060. National care systems differ in terms of their organisation, funding, provision and care settings. There are also differences in quality measurement and equity, with only some Member States having set up quality measurement systems. Wojciech Dziworski from the European Commission explained how the Commission is becoming more involved in shaping national care systems. Within the Europe 2020 process, the Commission advises individual Member States to put more focus on prevention and rehabilitation, independent living solutions, and efficiency in care delivery, as suggested in the Social Investment Package. European measures that support the reform of care systems are the mutual learning initiatives – the European Innovation Partnership on Healthy and Active Ageing and the Open Method of Coordination, as well as the two funding programmes Horizon 2020 and the Health Programme.

How Members States set up long-term care systems also has an effect on the quality of care. Anna Schmidt from the European Centre for Social Welfare Policy and Research presented on which systems provide choice in form of cash benefits or/and benefits in-kind, and how this affects quality. Some countries like Germany are providing cash benefits and benefits in-kind under certain eligibility conditions, with other countries like Sweden starting to adapt a similar approach. However, the assumption that free choice has an impact on the quality of the services has its limits: service users do not tend to change care providers easily, as this is also a question of trust, so decisions are often taken under time pressure. Care provided at home is not easy to measure either. Moreover, choice has more multidimensional aspects: service users are able to stay at home, but the system also relies on informal carers, people whose life choices are limited by care responsibilities. Recent reforms in long-term care systems that focus on choice, as well as budget cuts put significant pressure on informal family carers, emphasised Frank Goodwin, President of Eurocarers: “They make a very big contribution to our GDP, in Ireland it is 11 million Euro per day, and this only in a small country as Ireland! We should think more about the overall contribution of informal carers in Europe, which is not acknowledged.” He also called for the development of an ‘EU carers strategy’ that would foster collaboration across sectors in order to support family carers more.

Lisa Schönenberg from ESN underlined that public authorities not only provide social protection against the risk of long-term care needs, but can also empower older people and their families to live independently and included in society. Depending on their role in the national long-term care system, public authorities finance, regulate, plan, case-manage and provide care services, thus they play a crucial role in the provision of person-centred care. “Practice examples from our members show that local service redesign around the needs of users, shifting care into the community, and early intervention with a focus on enablement contribute to older people’s wellbeing have a positive impact on public budgets. It is therefore important to continue a discussion and practice exchange about what works in long-term care systems”, she stated during her presentation.

The European Social Network (ESN) will investigate questions on active ageing, workforce, integrated care, and home care in its future work together with ESN members, stakeholders and service users.