(16 June 2021) On the 14 June 2021, the Council of the EU (EPSCO) endorsed a new report on Long Term Care (LTC) which was prepared by the European Commission (DG Employment) and the Social Protection Committee. The report was published during the COVID-19 pandemic which exacerbated the existing problems relating to the provision of quality care in Member States. EPSU has long criticized the persistent lack of investment and austerity measures that have gradually weakened the LTC sector. Furthermore, the commercialisation of care services, which allowed private companies to make profit from care, took place at the expense of working conditions, Occupational Safety and Health (OSH) and patient’s rights.
The report rightly stated that:
Systemic weaknesses were highlighted by high mortality rates in long-term care facilities, difficulties in ensuring continuity of care, and the impact on the well-being of older people and carers. Although it is too early to assess the effect of the COVID-19 crisis, it is important to draw lessons to improve systems on a structural basis and make them more resilient.
This is why EPSU is calling to establish an investigatory committee in the European Parliament. One of its aims should be to the learn lessons of the pandemic. This will assist in making the LTC sector prepared not only to face to a possible future health emergency but also to provide for the ageing European population, taking into consideration the ageing of the care workforce.
The conclusions of the report echoed EPSU’s demands both for health and care to have an adequate and needs – based number of workers. “An adequate workforce is key to meeting the rising demand for high-quality services, but the current labour shortage may intensify further”. It also rightly states that difficult working conditions and low salaries are one of the causes of staff shortages. Based on the experiences of our affiliates, EPSU underlines that employment conditions are one of the main causes of staff shortages, which hinder the delivery of care and put patients safety at risk. For instance, the report of Friedrich Ebert Stiftung and our affiliate Kommunal, Care Workers on the Corona Frontline, presented on 4 May, underlined how the pandemic intensified the existing precariousness of working conditions, which adversely impacted the delivery of care.
The report on the LTC endorsed by the Council proposes the following policy options to ensure adequate an long term care workforce: improving working conditions and pay, including through reinforced social dialogue; encouraging the recruitment of a more diverse workforce; improving work organisation; reskilling and up-skilling, especially regarding digital and transversal skills; and ensuring better health and safety at work.
EPSU welcomes in particular the referenced to pay and working conditions, OSH and the focus on social dialogue. Social dialogue and collective bargaining is very much interconnected not only with working conditions but also with access to training (upskilling) or general improvements of work organisation. For instance, the high level of collective bargaining in the health sector enabled the establishment of European social dialogue in the hospital sector, where EPSU along with employer organisation HOSPEEM negotiated agreements to improve OSH (the framework agreement which later become transposed into a directive on sharp injuries), the Framework of Actions on Recruitment and Retention, Guidelines on Ageing Workforce or recently Joint Declaration on Continuous Professional Development and Life- long Learning. The LTC sector and their workers should not be treated differently to their colleagues in the hospital sector and many workers have the same qualifications as nurses or healthcare assistants. To that end, there is a need to increase collective bargaining coverage and promote trade unionism. Currently, EPSU and the social employers’ organisation are working towards establishing a European Social Dialogue in Social Services.
EPSU agrees that a diverse workforce is important in all sectors of the EU. Better protection for migrant workers and ethnic minority workers is crucial. Decisive for the future of the sector is to ensure that it will be attractive to new workers. It should not become more dependent on migration, causing an irreversible care workforce drain from poorer countries including those in the EU.
The report echoes demands of EPSU in relation of more investment in the LTC sector:
Reforms of long-term care systems, and the investment related to it, need to be pursued further and should build on the lessons learnt from the COVID-19 pandemic. And that those reforms should address the common objectives of ensuring good-quality long-term care, accessible and affordable to all, delivered in a financially sustainable way.
According to EPSU, spending on care, like on any other part of public sector, should be treated as an investment, not government expenditure. It is of particular importance in the period after the pandemic to exclude health and care sector from any austerity measures and prevent a repeat of mistakes made during the previous economic crisis.
Finally, in terms of the affordability and financial and general sustainability and to ensure the resilience of LTC, it is crucial to reverse the commercialisation of the sector. One of the lessons learnt from the pandemic is that care should not be treated like commodity, but as a public good that no one should make a profit from.
 All quotes after the Council note.