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László Andor

Commissioner for Employment, Social Affairs and Inclusion

"We care, how can EU care?"

Social Platform's Annual Conference on Care

Brussels, 9 December 2011

Ladies and gentlemen,

Distinguished guests,

It is a great pleasure to have been invited to speak at the Social Platform's Annual Conference on Care. On behalf of the European Commission, I would like to pay tribute to the work undertaken by the Social Platform and its members. In these times of major budgetary constraints you play a key role in raising awareness of the need to protect the rights of people who need care, as well as those of carers, whether formal or informal.

I welcome your Recommendations on Care. I think that the holistic approach that you have adopted is key. I agree that care is not only vital for social solidarity and social cohesion, but can also be a major source of job creation and ultimately helps to support sustainable economic growth. It is also clear to me that more thought needs to be given to the fundamental rights aspect of care. These Recommendations make an important contribution to this and the wider debate on care. I am certain that my services will draw inspiration from working with you on this major topic.

Ladies and gentlemen,

The Commission is fully aware of the importance of ensuring access to adequate care, including long-term care, to all citizens who need it. My message to you today is that Europe does care and will increasingly devote more attention to caring issues.

Nonetheless, it is clear that at present, Member States are at very different stages in their efforts to address the need for help and care. The EU can and must provide valuable support by facilitating exchanges of best practice, knowledge and experience – in particular on the subject of long-term care.

The Social Open Method of Coordination (OMC) is the natural platform for this kind of exchange. Member States have already used it to agree on common objectives in health and long term care that aim to:

  • Secure ACCESS for all to adequate care;

  • Promote QUALITY in care; and

  • finally, ensure that adequate and quality care is delivered in financially SUSTAINABLE systems.

These principles have been the red thread throughout all the work implemented in the field since 2006 and will continue to guide our action. I welcome that recent EU Presidencies have given increasing attention to access and quality sides of Long-Term Care issues.

In the near future the Commission will publish a Staff Working Paper to map the issues surrounding care and the extent of current provision across the EU 27. It will also identify how the EU can best support the Member States.

And to build on this, in 2013 I plan to launch a Communication that takes a holistic approach to Long-Term Care issues. The Communication will look at all relevant policies and it will take into account the Social Platform's Recommendations.

Ladies and gentlemen,

Dignity in care is obviously very much about quality. This is something that the Commission takes very seriously. Together with the Member States, we have been working through the Social Protection Committee (SPC) to develop a Voluntary European Quality Framework for Social Services of Common Interest, in which Long-Term Care plays a prominent part.

This Framework aims to develop a common language and understanding of quality in social services. It also seeks to establish a common methodology for setting and assessing quality standards and it looks at a wide range of areas which have a direct impact on quality, such as:

- service provision itself, which needs to be accessible, affordable, person-centred and outcome-oriented;

- relationships between service providers and users; in particular, respect for user's rights and strong levels of participation;

- relationships between service providers, public authorities, social partners and other stakeholders; in other words, partnership and governance;

- adequate physical infrastructure; and

- human and physical capital.

Fostering quality services also means paying closer attention to working conditions in the sector, as well as investment in the training of workers. Services should be provided by skilled and competent workers under decent and stable working conditions. It is important that we look at the rights of both care recipients and carers.

Ensuring quality for both care recipients and carers is also an important part in preventing and tackling what I know is a big concern for many: elder abuse.

Since 2007, the Commission has supported a number of projects under the DAPHNE programme, the Health action programme and a pilot project on elder abuse. These projects have led to some concrete and very useful results – for example, we now have a European Charter for older people in need of long-term care and assistance and a checklist of measures needed for preventing elder abuse.

Last week the Commission organised a High level conference on dignity in ageing, which examined effective strategies for ensuring high quality in long-term care and for preventing elder abuse. The conference showed that we need to look at many different aspects of care to prevent, identify and treat elder abuse, and to ensure that people can age in dignity. Such as providing support to family carers, improving working conditions of professional carers and ensuring quality standards.

It is clear that only a comprehensive strategy which involves all the different levels of governance can offer effective protection for vulnerable elderly people.

It is, like many of the other challenges we are facing, not one that the European Union can solve alone. It requires commitment and action at all levels. The Commission stands ready to support the Member States in their efforts and we will continue to pay close attention to improving the quality of long-term care and protecting the dignity of older people.

Ladies and gentlemen,

Europe's demography is changing. Over the coming years our population will age, our birth rates will decline and the number of working-age individuals will shrink. Clearly this is a major challenge; but it is one we must overcome. I see three areas in particular – which I know tie in with many of the Social Platform's recommendations - where with the right measures we can make a significant positive impact:

Number one, we need to promote independent living. This means fostering healthy and active ageing to prevent, postpone, and mitigate the need for care – to allow people to live as independently as possible for as long as possible.

We need innovative solutions to existing and emerging problems. New technology in particular can make a big difference; for example, by enabling age-friendly adaptations of homes and the external environment.

We have already seen an increasing number of relatively cheap, accessible and user-friendly technologies that help elderly people to remain independent for as long as possible. What we need to focus on now is better and far larger scale deployment.

We also need to fully exploit existing systems in terms of prevention, early detection and efficiency gains, in order to ensure the long-term sustainability of Long-Term Care systems.

Number two, we need to promote stronger partnerships to develop and implement better solutions. This is where our new European Innovation Partnership on Active and Healthy Ageing comes into the picture. It forms part of the wider Europe 2020 strategy which has a strong focus on innovation-friendly policy.

This major initiative brings together the public and private sectors to translate innovative ideas into concrete innovative solutions specifically designed to help older people lead more active and independent lives.

This brings me to point number three – we need to see Long-Term Care as an opportunity for the EU economy. First, as an important source of employment; and second, as a potential market in its own right.

The health and social sector created 4.2 million jobs in the EU over 2000-2009. This was more than a quarter of total job creation in that period! Today, the "white jobs" sector – in other words, jobs in health and social services - accounts for almost 10% of EU employment.

This is reflected in the Commission's Annual Growth Survey 2012, which recognises the health and social sector as one of the three sectors with the highest employment potential in the EU (together with green jobs and ICT). Member States need to capitalise on this by prioritising initiatives that further develop these sectors.

Nonetheless, we must also recognise that over the next decade large number of health workers will be leaving the labour market. We need to make sure that this does not lead to a mismatch between labour demand and supply or indeed a decrease in the quality of health care.

In order to address the potential of labour shortages in the health and social sector, we need to look at ongoing challenges affecting employees, like:

- barriers which limit intra-EU mobility, for example those linked to social security and in particular pensions;

- the issues surrounding immigration from third countries (i.e. for doctors and nurses);

- and of course working conditions.

Therefore, as announced in the Europe 2020's flagship initiative "Agenda for new skills and jobs", the Commission will be working together with the Member States to develop an action plan by the end of 2012 to address the gap in the supply of health workers. The plan will also provide an opportunity for us to address other issues related to health workforce such as ethical recruitment and retention and recruitment strategies.

Ladies and gentlemen,

Research has shown that over the coming years there will be an increase in the care needs of people with a disability, as well as older dependent persons.

Home care services are one way of providing care and support for older people and for those with disabilities in a financially sustainable manner. These kinds of services are already prevalent across the EU. According to data from Eurostat, personal services in 2010 in the EU represented 5.4 millions jobs, a number that will increase in the future to respond to the growing demand.

Nonetheless, there is also a strong tradition of informal care across the EU. A recent Eurofound report shows that about 80% of time spent caring for people with a disability or older dependent persons is provided by informal carers, whether family, friends or neighbours. This is a highly commendable expression of social solidarity with the most vulnerable. But it also brings with it its own difficulties.

Undeclared supply of personal services represents roughly 17.5 million workers in the EU, which has potentially significant implications on social security contributions, such as pensions.

It also gives rise to the question of training and whether people involved in caring duties have access to adequate levels of training. As well as, the wider issue of working conditions.

Moreover, there is a strong gender dimension to Long-Term Care, notably:

- three-quarters of people in need of some form of long-term care are women;

- and 4 out of 5 carers in the EU are women.

We need to give more attention to the rights of informal carers including in relation to pensions, which is why I brought this issue up in the Green Paper on Pensions.

And we need to open the debate about the cost and the advantage of a public intervention in care. In many EU Member States, systems have been put in place with a view to reducing the risk of these services being taken over by informal economy and undeclared work. This means effectively waiving direct or indirect social contributions and taxes associated with these jobs, the main example being vouchers ("chèque service"). These kinds of ideas - and whether they work or not - are definitely worth exploring further.

* * *

Ladies and gentlemen,

In less than a month we enter into 2012, the European Year for Active Ageing and Solidarity between generations.

This is a great opportunity not just to raise awareness, but as a catalyst for action that brings about real change that supports our older citizens. As you know, the European Year is built around three pillar: working longer, participatory ageing and independent living.

Our approach to caring needs to be centred around enabling more people to live as independently as possible for as long as possible manage with a little help from their friends, family or the wider community.

My answer to this conference is: yes, Europe does care and in many different ways. Let's work together to overcome the challenges linked to Europe's ageing population, to support older people to continue to take an active part in the economy and in the wider society and to turn our care needs as we grow older into employment opportunities for younger people.

Thank you for your attention.

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