European Care Strategy – The EU as a driving force for better care for all?

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photo by Jusfilm on Unsplash

On 15 September, in her State of the Union speech, European Commission president, Ursula Von der Leyen, announced the launch of a European Care Strategy:

“If the pandemic taught us one thing, it is that time is precious. And caring for someone you love is the most precious time of all. We will come forward with a new European Care Strategy to support men and women in finding the best care and the best life balance for them.”

With this initiative, the Commission seeks to materialise the European policy initiative on long-term care that had been announced for some time. It is also part of the commitments of the Action Plan of the European Pillar of Social Rights.

As we call for in our response to the Green Paper on Ageing and in our proposal for an Age Equality Strategy, a life-course approach in public policies is a must to ensure equality and solidarity between generations. We hope that the new European Care Strategy will support this approach.

But what do we expect from this new policy? And where do AGE and our members stand?

The decisive role of the EU

The European Union does not have the main competence in the field of care. This remains mainly a national issue. Therefore, why should the EU deliver on it? Why are we advocating for a more active EU role in care?

Over the years, the EU has demonstrated to have an impact on national policymaking in fields where it does not have a strong competence, such as pensions. The EU does have the power to guide and influence how EU countries shape their policies in those areas; it can set higher standards, push countries to lift their level of ambition and monitor how well countries do.

Through our task force on Dignified Ageing and our advocacy campaigns, AGE members have consistently expressed over the past years a strong call on the EU to become a true driving force for better access to better care and support for older people. Time has come for the EU to be up to.

The evidence is there!

The launch past June of a joint report of the Social Protection Committee and the European Commission – which is an update of the one published in 2014 – show how the EU can generate evidence and provide a solid assessment of the situation in the field of care. We warmly welcome this report, which points to some key shortages in care, including:

  • Insufficient access – only 1 in 3 older people with severe difficulties in activities of everyday life had access to homecare services in 2014.
  • Unaffordability – the high costs of care are the main reason why older people do not access professional care, or not as much as they would need. Social protection is often insufficient to make care affordable.
  • Quality issues – with approaches in quality assurance systems that do not always put the focus on the individual experience of people in need of care; there is a lack of a shared European understanding over what quality care means..
  • Difficult working conditions and over-reliance on informal carers – the work of informal carers has an economic value of between 2.4 and 2.7% of EU’s GDP, which is higher than the expenditure on professional care in many EU countries.

Despite the lack of a compelling future vision for care in the report, as we highlighted with other NGOs in a joint response coordinated by the Social Platform, this report is a solid evidence base. Co-authored by the European Commission and national ministries responsible for care, the conclusions of this report were endorsed on 14 June by national ministers responsible for care. Such endorsement justifies the legitimacy of the EU to deliver an ambitious Care Strategy.

Evidence and political commitment seem to be there: now let’s move forward!

What we want to see in the European Care Strategy

The European Care Strategy can make a true difference in Europe’s care systems and in the ways governments and societies think about care. But how concretely?

In our contribution to shape the Action Plan to implement the European Pillar of Social Rights, as well as in our response to the Green Paper on Ageing, we identified the measures the European Union should adopt.

In short we believe the EU should:

  • promote a life-course approach to care demonstrating the link between investments in people’s health throughout their lives and the levels of long-term care needs in older age.
  • develop a quality framework for care services which puts the emphasis on people’s experiences of care and on quality of life. This piece can be linked with the quality framework for social services to persons with disabilities announced for 2024 in the European Disability Rights Strategy 2021-2030.
  • monitor the negative impacts associated with the lack of access to quality professional care and support, including on gender equality, increase in mental and physical health conditions among informal carers, avoidable use of healthcare resources or loss of income associated with unaffordable care costs and informal care provision, among others.
  • introduce EU-wide access indicators and access targets, similarly to the Barcelona targets for childcare, disaggregated by care setting – at home, in the community and in institutions.
  • develop guidelines for the implementation of integrated care, within and between health and social care services.

Moreover, the Strategy can be a turning point in the way the EU talks about care. It can materialise a shift from care as a problem to care as a solution that enables people of all ages to participate, contribute and remain included. The EU must take up the challenge: we need it to put forward a positive vision of care that can trigger more ambitious action across the continent.

Playing our part: we are re-thinking care

What about AGE’s contribution to such a constructive approach to care? Aren’t we well placed, as a network of committed civil society organisations, to challenge misconceptions around care and encourage society to see it as an opportunity?

Between June and October, we are running with AGE members a process that we have called Re-thinking Care. Through 4 workshops, we have discussed:

  • The status quo – what care systems are like at present and the diversity of viewpoints we can use to discuss care.
  • Our vision – the horizon we put forward for care systems, the ambition we identify as civil society.
  • A pathway – the steps that need to occur in policies and services to make our vision a reality.
  • A movement – our advocacy role at EU and national level to ensure such steps are made.

Through this process, AGE members have expressed that care should empower everyone to live as equals, participate and remain included. In our vision, care services are not the goal, but the means to preserve or achieve a good quality of life.

Our next steps will include publishing a policy brief with the conclusions of the process, which we will disseminate widely to set out the level of ambition that we, as organisations of older people, want for our care systems.

This is a key moment to influence policies, services and societies and make sure we can all access the care we need at any moments of our lives. Let’s make it happen, together.

by Borja Arrue Astrain

Read our Policy Brief Care must empower us throughout our lives

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