The European Care Strategy has come a long way. What does it change?
Published after one year of work and consultation, the new European Care Strategy sets out for the first time an EU vision on long-term care. After the dramatic situation experienced during the COVID pandemic, a strategy on care is overdue and highly welcome, yet will it live up to expectations or remain an empty shell?
When we came out of the first waves of the pandemic, seeing the violations and disrespect for the rights of older persons, and learning that about half of the deaths linked to the virus in the first year of COVID-19 occurred in residential long-term care settings, we knew that we needed to change gears to defend the right of everyone in need for care to access thee services that best support their independence and health.
We were of course not alone: the UN Secretary-General called for greater respect for the rights of older persons, supported by 146 UN Member States, including the whole of the EU. Simultaneously, during the first lockdowns, in many EU cities, people clapped at the work of those on the frontline of the pandemic – care workers first and foremost, and all other workers deemed ‘essential’. Soon, there were calls for better support, protection and working conditions for these workers. Also in the EU Council and the Parliament, calls for better respect of the rights of older persons were proposed, discussed and adopted, and the European Commission started the reflection process of the EU Green Paper on Ageing.
Within AGE, we conducted a long brainstorming exercise, determining our vision for long term care: care that empowers, care that supports independence, care that leaves choice to the persons in need for care – meaning that all must have access to different care options. We stressed also that quality care cannot be achieved without quality working conditions and support for informal carers. We were therefore looking forward to September and the release of the European Care Strategy, announced more than one year ago in the Action Plan on the European Pillar of Social Rights. The President of the European Commission, Ursula von der Leyen, herself raised the priority level given to the care strategy within the European Commission in her 2021 State of the European Union speech.
Defining an EU vision
The Commission initiative on care takes the form of a communication – reflecting the intent of the Commission, with recommendations to itself and to Member States – and a proposal for a Council recommendation. The Care Strategy touches upon all the domains that we identified as important :
It affirms the right to care and the role of persons in need for care to be in the driver’s seat of how they receive care
It underlines that the design, implementation, evaluation of care systems at all levels must go hand in hand with stakeholders: persons in need for care, informal carers, workers’ representatives, care providers. It clearly sets out care services as ‘Services of general interest’, which can enjoy special protection by Member States
It calls for a social protection model for financing care to make it accessible to all and for more services and options
It defines quality principles for long-term care, based on the respect for the person in need for care
It reminds on Member States of their responsibility to better support informal carers with income and services by implementing and upgrading the provisions of the EU Work-Live Balance Directive
It emphasises the need to integrate and coordinate health and social care, to invest into innovative digital and non-digital solutions to improve care, to improve working conditions and invest in skills of the care workforce, to attract third-country nationals to tackle the workforce shortage in the field, the importance of prevention to reduce the rate of increase of long-term care needs and many other points.
Does the EU Care Strategy have the power to transform care in the EU?
While the rhetoric holds a lot of potential, there is no mandatory action for Member States, as the EU does not have legislative power in this domain. Still, the Commission proposes a number of tools to encourage action by Member States:
Member States have to nominate national long-term care coordinators and present action plans on long-term care within one year
Monitoring of the long-term care plans and other principles of the Care Strategy will be performed through the European Semester, the EU’s cycle of social and economic policy coordination (raising the question of how this will be possible in light of the budgetary rules of the EU)
The work on long-term care statistics will continue and aim to develop tangible tools to measure long-term care quality and accessibility
There will be no new EU funds dedicated to the Care Strategy, but existing funds will put more focus on developing long-term care, such as the European Regional Development Fund, the European Social Fund, the Recovery and Resilience Fund etc. Some dedicated programmes will be opened in the Horizon Europe fund (supporting research and innovation, specifically on inequalities and integrated care) and the ‘Technical Support Instrument’, which helps Member States in reforming public services.
A special attention will be put on care provision in rural areas and developing mutual learning between Member States on all dimensions of care
In our Press Release, we largely welcomed the initiative as many of our concerns are reflected in the Strategy. Yet, we would have expected it to be more specific in many areas. Particularly in the area of data collection, we expected some more tangible outcome.
Our main concern with the Care Strategy is that Member States have much leeway to implement it, given it is only based on ‘soft-law’ instruments. AGE will therefore call on the EU Council to adopt the proposed Council recommendation swiftly. And, more importantly we must support our members in drawing up national Long-Term Care Action Plans, so that the Care Strategy can deploy its full potential.
In addition to this, the Care Strategy is missing a fundamental point: we affirm that care settings are part of life, and that care should enable us to exercise all other rights that are linked to our well-being, from social inclusion, to culture, education, physical activity, housing and being part of a community. While the principles in the Strategy go into this direction, the root issue of ending the segregation between people in need for care and the rest of society remains a larger and more challenging quest.
The EU Care Strategy as a starting point
The Care Strategy is not an accomplishment, but a starting point. It will provide the impetus to discuss many of the existing good practices and to try to implement them in other Member States, to create a European conversation on long-term care.
The new report “Developing the Long-Term Care Empowerment Model”, recently launched by the the Biscay government with AGE Platform Europe's collaboration, provides further solid fuel for this discussion. This report is the outcome of two years of our collective work with the Biscay Provincial Council in Spain, responsible for the care provision to thousands of citizens, in revising their vision of long-term care. The principles outlined in the report r that can be implemented everywhere, if the political will is there. The Care Strategy will enable us to promote practices like these in the future.
by Philippe Seidel