R.4. Health and Social Services

A. The EPSU affiliates meeting at their 8th Congress in Brussels from 8-11 June 2009 affirm that:

1. The health care and social services sectors are at the heart of the European Social Model; they are essential to ensure the fundamental right to health of each person and must be accessible to all people living in Europe including immigrants. These public services are crucial in improving working and living conditions, but also in enhancing social cohesion and providing social protection. The health care and social services sectors can only fulfill their missions if they are properly organized, governed and funded in an equitable, universal and solidarity-based way. They have to be built on sound and financially sustainable social protection systems. The role and responsibilities of European, national, regional and local public authorities in relation to public, private and non-profit providers need to be defined and strengthened. Any concept of health care and/or social services should reflect the diversity of services which exist in the different European countries. Respect for and understanding of the specific background against which these sectors have evolved across Europe is a basic precondition to develop a common European policy.

2. The health care and social services sectors serve first and foremost a public interest. Regardless of their ownership, they need to meet concrete standards based on quality, accessibility, equality, universality, continuity, affordability, proximity, social partnership, user protection and democratic control. The health care and social services sectors serve many different purposes. They are not only for sick, injured or vulnerable individuals and/or citizens in need; they are essential in improving and maintaining high standards in living and a high level of public health in Europe. An integrative approach of health care, social and other public services is needed to ensure good quality of life for all people in Europe.

3. Increasing influence of market forces and liberalization in the area of health and social services have shown to weaken solidarity and cohesion, exacerbate inequalities and to have a negative impact on living and working conditions and job security. Market principles and commercial interests, including the drive to make profits, clash in many cases with the public interest and the workers’ interests in the area of health and social services. Attempts by governments and financial and EU-institutions, to liberalize and/or commercialize health and social services should therefore be halted and replaced by the development of proper and social regulatory frameworks such as binding criteria for social procurement.

4. Demographic change and an ageing population will increase the demand for high-quality health care and social services in Europe. This demand can only be met through sufficient, motivated, well-paid, well-qualified and well-trained professional staff at all levels. The growing numbers of health care and social services workers which leave the sector or leave their region/country pose a serious threat to accessible and high-quality health care and social services in Europe. Investment in the sector and its workforce is urgently needed to tackle questions of existing and future staff shortages but also to address challenges related to qualification structures and new skill needs.

5. Changes in the organization and provision services in the health care and social services sectors give rise to growing concerns on trade union rights and representation. Bogus self-employment, outsourcing and subcontracting, the use of temporary agency workers, and the increase in fixed-term and part-time contracts makes it for trade unions across Europe more and more difficult to organize and represent workers in the sector through collective bargaining and social dialogue. The increased involvement of profit-making companies, non-profit organizations and small enterprises in the delivery of health care and social services also has lead to a rising number of employers who deny trade union rights to their workers and reject the implementation of collective agreements in their organizations. A common strategy has to be developed to strengthen European trade unions in the health care and social services sector.

B. The 8th Congress calls on EPSU and affiliates to:

6. Develop and raise through organizing, lobbying, mobilizing, policy development and social dialogue a strong trade union profile and voice in the public, private and non-profit health care and social services sectors, including:
-* Hospital services
-* Primary and out-patient health services
-* Child care and child protection services
-* Social Work and Social Support services
-* Long-term residential care for elderly and/or disabled people
-* Home & community care including home helps
-* Mental Health care
-* Community and Cultural services
-* Social Housing
-* Employment services

7. Continue to provide resources for research, training, information-exchange, awareness-raising and campaigning activities in the fight for quality health and social services and against various forms of marketisation. Offer alternatives to EU market and competition-based initiatives in the area of health and social services, by restating the responsibilities of public authorities and ensuring people’s rights.

8. Develop and continue campaigning activities with the objective to ensure that any present and future legal and non-legal European initiatives concerning the health care and social services sector, and in particular the (proposed) “Directive on the application of patients’ Rights in cross-border healthcare” will adequately reflect and safeguard the universality- and solidarity- basis of these services.

9. Press for equal rights, opportunities and treatment for all workers in the health care and social services sectors, and combat discrimination related to gender, cultural and ethnic background, nationality, physical and mental disabilities, sexual orientation, political and religious convictions and age.

10. Strengthen industrial relations in the health care and social services sectors at European, national, regional and local level, and set up joint activities and projects with relevant employer organisations.

11. Promote the implementation of cross-sectoral and sectoral European Social Dialogue texts.

12. Fight against exploitative and unethical practices in the cross-border recruitment of workers in the health care and social services sectors through the implementation and promotion of the EPSU-HOSPEEM Code of Conduct on cross-border recruitment. Take up issues concerning the reasons for migration of workers in the health care and social services sectors.

13. Build and strengthen alliances for high-quality health care and social services with relevant and representative organisations including but not limited to organisations as the PSI, the ETUC and other trade union organisations, employers, social non-governmental organisations, professional associations and user groups.

14. Build on the existing work and networks in the area of social services and develop further activities to strengthen trade union and EPSU involvement in the area of social services.

15. Contribute to the overall EPSU strategy in support of horizontal legal provisions at EU level for public services and a EU Action Programme based on the public services Protocol agreed by the 27 EU governments in 2008.
Use the general content of this Strategy as a framework to initiate amongst others debates about the concrete delivery of health and social services in relation to the public interest, citizens’ rights and their expectations.

16. Develop a strategy to protect workers in the health care and social services sectors from inhumane treatment and precarious work; and to support their retention through improvements to working conditions including but not limited to the areas:
-* Work-life balance
-* Working time; irregular working-hours, shift work and on-call duties (working-time directive)
-* Training, life-long learning and career opportunities
-* Health and safety
-* Employment status and terms of employment
-* Pay
Combat the undervaluation of jobs in the health care and social services sectors and support professionalisation of the workers.

17. Call for appropriate funding and long-term public investments in the health care and social services sectors in order to ensure adequate staffing levels including sufficient numbers of qualified professionals, appropriate pay and working conditions and an effective provision of services to the public.

18. Promote and advocate trade union rights for health care and social services workers in the public, private and non-profit sector including the rights to information, consultation, negotiation, collective bargaining and the right to strike and take industrial action.

19. Monitor the development and activities of the different multi-national enterprises in the health care and social services sectors and support the establishment of European Works Councils in the eligible companies.

Adopted 9 June 2009

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