(30 April 2019) 54 colleagues from 34 affiliates from 22 European countries and a guest speaker from the WHO European Observatory on Health Systems and Policies participated in EPSU's Standing Committee "Health and Social Services" (SC HSS) organised on 27 February 2019 in Brussels. The participants took several decisions and orientations for EPSU's sectoral work and addressed a number of topics.
The participants received updates on the current state of the EPSU Programme of Action 2019-2024 and the provisional agenda of the EPSU Congress. The French affiliates had submitted an own affiliates resolution on health and social care entitled “For public health and social care services that meet people’s needs” which is supported by the Executive Committee. A number of EPSU Congress Briefings to assist the congress delegates and the EPSU affiliates to prepare and reflect on the work that has been done and is proposed have already been published.
A first exchange about thematic priorities EPSU affiliates would like to see reflected in the Work Programme SC HSS 2019-2024 took place. Three broad topics were put forward:
- Addressing the root causes for understaffing and the lack of qualified staff in health and social care. This entails the work on safe and effective staffing provisions and levels, on a better societal and financial recognition of the care work, on questions in relation to skills mix, task shifts, professional profiles and the cross-border recognition of professional qualifications as well as, on safe and healthy workplaces and on an improved access to and funding of continued professional development for all workers in health and social services.
- Addressing the challenges and problematic developments due to privatisation (including sub-contracting), marketisation and/or commercialisation of health and social services. This comprises the work with multi-national companies, including continued efforts to set up European Works Councils in the field of health care, elderly care and child care.
- Shaping the regulatory framework to address the impacts of digitalisation, robotisation and artificial intelligence on the workforce and a continued exchange of experiences of the related trade union work.
These issues also figure in the current work programme (confirmed and updated based on an evaluation done in 2017) and/or are reflected in the thematic priorities for social services since the last EPSU Congress (confirmed and updated based on an assessment in 2017 of what has already been done and achieved).
Looking at selected issues at the global agenda in health and social services, Baba Aye, Health and Social Sector Officer, Public Services International (PSI), informed on a report on “Global Skills Partnerships” commissioned by PSI and the related thematic workshop organised by PSI at the Global Forum on Migration and Development from 5 to 7 December 2018 in Marrakesh, Morocco. He also recalled the involvement of PSI in the International Platform on Health Worker Mobility. He provided an update on the state of play of the PSI Campaign “Human Right to Health” where trade unions in Europe are concerned. This also included an outlook on the PSI-related activities linked to the World Health Day 2019 that would focus on Universal Health Care. He informed on the ongoing and planned PSI research activities and deliverables in the field of health and social services.
A few organisational tasks are still outstanding prior to the launch of the EPSU-PSI Online Platform on Safe and Effective Staffing Levels, planned for May 2019. It will contain material (reports, studies, results of surveys, etc.) and “success stories” (articles, brochures, videos, etc.) showcasing achievements based on activities, mobilisations and struggles of our members across the globe. It is intended to be a source of information on the topic of safe and effective staffing levels in health care and social services, but should also serve as a thematic communication and campaign tool for both organisations and their members.
Participants agreed on the benefit and need to pursue the work on positioning EPSU as the EU-level platform/representative organisation and voice of health care assistants/the health care support workforce at EU-level and/or towards European institutions. This entails a continued mutual exchange amongst EPSU affiliates. It will be based on the insights gained by two studies published in 2014 and 2018 co-funded by DG SANTE. UNISON, UK, and SIPTU, Ireland, plan to set up and moderate a virtual platform and to organise a technical seminar in the first half of 2020 to learn more on a range of issues in relation to the education, professional qualifications, roles and provisions on CPD for health care assistants/health care support staff.
The colleagues were informed about the planned activities of Belgian and Dutch affiliates and of the EPSU Secretariat in relation to mobilisations around World Health Day on 7 April 2019. They endorsed the document “European Parliament Elections 23-26 May 2019: Priorities EPSU & Standing Committee Health and Social Services” (available in EN, FR, DE, ES, RU and SV). EPSU affiliates organising in health and social services are invited to use this document for their own activities and/or campaigns for the European Parliament Elections end of May and in relation to their activities linked to this year’s World Health Day in the beginning of April.
The SC HSS continued its intensive work on trade union activities, responses and demands to better address the challenges for the health and social care workforce stemming from digitalisation, robotisation and artificial intelligence and effective instruments to do so.
- The feedback received by a number of EPSU affiliates to the online survey “Artificial Intelligence and Robotics Impacting Health Professions” is analysed by the ETUI. They also continue their thematic work that would also cover the aspect of platform work(ers).
- The participants in principle endorsed the Joint Position Paper of the Federation of European Social Employers and EPSU entitled "Digitalisation in the Social Services Sector – Assessment of Challenges and Opportunities" elaborated in the context of the PESSIS+ Project and based on a Technical Seminar organised on 24 October 2018. It was agreed to do a written consultation allowing EPSU members to still share written comments and additions and to have the document translated in different languages.
- The colleagues agreed to use the report of the Joint FES/ver.di/EPSU Conference “How trade union can use collective bargaining to uphold and improve working conditions in the context of digital transformation of public services?” (available in EN, FR, DE, ES and IT) held on 26 and 27 June 2018 in Berlin is one important reference document for EPSU’s future thematic work also in the field of health and social services.
Regarding the work done in the context of the Sectoral Social Dialogue Sector for Hospitals/Health Care (SSDC HS),
- the document "Main Activities and Outcomes of the SSDC HS in 2018" (available in EN, FR, DE, ES, IT, RU and SV) was shared with the participants. As in the last years it was elaborated by the EPSU and HOSPEEM Secretariats to support the dissemination work and the use of outcomes of the SSDC HS by EPSU members in their own country.
- the document "Summary Information and Suggestions for Possible Next Steps" was adopted with the rewording proposed by HOSPEEM. It includes the take-home messages from the conferences in Amsterdam on access to continuing professional development (2017) and in Vilnius on the prevention and protection from musculoskeletal disorders and psychosocial risks and stress at work (2018) and the agreed priorities and possible next steps by HOSPEEM and EPSU and their national members on the three topics. Colleagues underlined that the need for the future Work Programme SSDC HS 2020-2022 to contain concrete follow-up activities on a number of points contained in the document.
- the participants endorsed the Joint HOSPEEM-EPSU Report “Follow-up on the Directive 2010/32/EU on the prevention from sharps injuries in the hospital and healthcare sector”, as agreed upon at the WG 1/2019 SSDC HS on 13 February 2019. A number of expectations on the role and activities of DG EMPL to support the implementation and enforcement of all provisions of the directive were formulated for a meeting with the OSH Unit of DG EMPL, in line with the joint letter of 6 February 2019.
- Colleagues discussed topics to be included in the Work Programme SSDC HS 2020-2022, thematic priorities for EPSU and the objectives and deliverables for a number of topics that continue work done in the context of the Work Programme for the last years.
- information on a new joint HOSPEEM-EPSU project which aims at strengthening the capacity of national sectoral social partners in hospitals/healthcare in national and EU-level social dialogue in 14 EU Member States in Central, East and Southern Europe was disseminated. It involved EPSU affiliates HSSMS-MT, Croatia, and Sanitas, Romania.
The participants exchanged with Dr. Matthias Wismar, researcher at the WHO European Observatory on Health Systems and Policies, on main approaches and a number of concrete reforms in the field of skills mixes and task shifts relevant for health professionals in different European countries. Skill-mix innovation is used in a number of countries in the context of primary and chronic care reforms for the improvement of the performance of health systems. This happens in the context of a shift from hospital-based care towards ambulatory care. Related measures play a role to both advance chronic care in response to the demographic changes – with regard to the patients, an ageing health workforce and a shrinking pool of labour market entrants –, but also the management of complex and costly multi-morbidities. The same holds for the strengthening of primary and chronic care and the unburdening of the hospital sector from inappropriate use. The OECD, the WHO and the European Commission are supporting research and pilot projects which are expected to have a backwash effect on a number of questions linked to the development of health care professions, of the scope of practice and curricula for nurses, midwives, pharmacists, doctors and allied health workers. The main aim for the future is, based on this first exchange, to work towards a better articulated trade union perspective and the “EPSU take” on the policy debates and initiatives on skills mixes and task shifts at EU level.
Colleagues also endorsed the proposal agreed upon at the Working Group Social Services on 26 February 2019 in view of the selection of multi-national enterprises (MNE) operating in elderly or child care on which the future work of EPSU to set up a European Works Council (EWC) is to be focused upon, in line with the strategic interests of EPSU affiliates. On 29 April 2019 EPSU signed an agreement with the French multinational Korian to establish a EWC. Negotiations with the French multinational Orpea to achieve the same goal are still underway.