Social care workers call on strengthening the workforce perspective in the transition from institutional to community-based care

The Working Group Social Services on 26 February 2019 in Brussels was attended by 52 colleagues from 19 countries and 30 EPSU affiliates as well as by 8 guest speakers. The morning session was devoted to a technical seminar on the transition from institutional care to community-based care and how this transition can be designed and realised in a way that would also work for the social care and health workforce. In the afternoon session around the "usual" agenda the focus was on three topics, 1) social dialogue in the field of social services, 2) the establishment of European Works Councils in the elderly care and childcare sector and 3) the childcare services and workforce.

Technical seminar on the transition from institutional care to community-based care – How to make this transition also work for the social care and health workforce?

The morning session was devoted to a technical seminar on how to secure a transition from institutional care to community-based care that is also adequate and sustainable for the professionals and workers and that promotes access to quality services across Europe for persons with disabilities, elderly people and children needing care and support. The aim was to address or at least to touch upon the following questions: Which are the related challenges and opportunities from the perspective of the workforce? Which adapted regulatory and financial frameworks are needed to support the workforce in community-based care? How would such a transition need to be supported to work for those employed in the care services when it comes to key aspects of good working conditions such as work organisation, working time, health and safety, access to training/CPD and managing digitalisation, to name only some points. And: What does such a transition imply for the trade unions organising the care workforce when it comes to organising the workers, to the negotiation of collective agreements and workplace-based agreements?

The guest speakers at the technical seminar (cf. agenda) represented first EU-level provider and advocacy organisations, user organisations, the independent living movement, then a national agency in charge of financing and planning services for people with disabilities (from Belgium, for Flanders), but also the European Expert Group on the Transition from Institutional to Community-based Care as well as the EC services responsible for the EU Disability Strategy and the European Social Fund and finally the EP. De-institutionalisation means an approach to partly replace traditional institutional care by care and support services delivered at home, by assisted living units and/or by calling on the support of personal assistants. Reforms in a number of EU MS led to discussions on the appropriate administrative and financial requirements and which measures would best support user orientation, the realisation of user rights and their options for choice. All guest speakers see the de-institutionalisation is an important trend and concept in the redesign of long-term care for elderly people or for disabled persons and in the field of child care and child and youth welfare that also should get more relative weight as well as political and financial support.

The perspectives, experiences and demands of the various guest speakers were complemented by contributions of two trade union colleagues from Belgium – Jan-Piet Bauwens, SETCa-BBTK and Fatiha Dahmani, LBC-NVK – who are represented in the Board of the Flemish Agency for People with a Disability (VAPH). In their inputs they focused on how care workers, their representatives in the institutions and services for people with a disability and trade unions react to the setting up of de-institutionalised care models. In the question and answer session that followed a few colleagues from EPSU affiliates added their observations and views. Main points raised by trade unions are

  • the need to address the challenges for the organisation of social dialogue and for the representation and defense of the workers as well as the negotiation of collective agreements that stem from the shift to de-centralised structures, a community-based delivery of services for persons with a disability, elderly care and child care (which means a shift from collectively organised care to individually organised care), other financing models (e.g. personal budgets) and increased options for choice of the provider by the persons needing the support, care, education etc. as well as their empowerment. For the trade unions this meant e.g. in Belgium (or more precisely in Flanders) that they had to adapt to local structures of service provision, discussions and decisions on a regional and local level on staffing levels, qualifications of the care workforce (regarding both the individual workers as well as the appropriate skill mixes of teams). It also meant that the users, providers, but also the workers and trade unions are often struggling with insufficient budgets to make the transition to community-based care effectively work, to have the appropriate social and psychologial support and guidance in particular for persons with a disability, to be able to provide quality services, to take account of special needs of individual users;
  • the need for EU MS and the competent public authorities there to develop community-based care by encouraging and promoting home-based living and the provision of high-quality support services that help empowering the users, supporting choices about the care arrangement they prefer and realising their right to the best treatment possible as well as the rights enshrined in the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD);
  • the demand not to “demonise” institutional care settings in general, as they will be still needed for social service users with complex care and support needs and/or for users who prefer – for whatever reason – not staying in their household/family; EPSU colleagues from a number of affiliates underlined that with a shift from institutional to community-based care one consequence is that persons with complex and comprehensive care needs of people with severe disabilities would concentrate even more than before in institutional care. The change of "user profile" and a concentration of difficult cases poses a number of challenges, not least for the workforce in these institutions, e.g. with regard to the qualifications needed, but also additional psychologically and physically demands as the number of "easy" cases dramatically reduces;
  • the need to engage more with workers and trade unions and giving them a voice and say will make a difference in view of the need to secure the necessary investments in infrastructure, technology and human resources to make this shift a success, in particular in view of adequate staffing levels and the adequately qualified workforce, to advance decent working and pay conditions and to have more clarity and security for the care professionals and workers that are part of such a transition. In this regard collective bargaining and social dialogue are two important tools to make sure that workforce can influence the design of quality-driven de-institutionalisation processes in elderly care, disability care and child care and child and youth welfare.
  • the call on all relevant levels and institutions of policy making to systematically involve the care workers and their representatives and the trade unions organising them in the further work within the different countries as well as at EU-level. As the persons needing support and care, as the service providers and as the public authorities their voice and concerns also need to be taken into account on an equal basis.

A little bit of background information on the topic "transition from institutional care to community-based care"

Regular Working Group mainly dealing with three issues

In the afternoon the focus was on three topics, 1) social dialogue in the field of social services, 2) the establishment of European Works Councils in the elderly care and childcare sector and 3) the childcare services and workforce. The last points comprises the activities of the EPSU Network on Early Childhood Education and Care (ECEC) as well as EPSU's involvement in and contributions to the DG EAC Working Group “Early Childhood Education and Care” set up in November 2018. Information on these thee topics and a forth issue is presented below.

Social dialogue in the field of social services

  • Participants were informed about the thematic page the EPSU Secretariat has set up in order to bring together the main deliverables from and bits and pieces of information on all 4 PESSIS projects so far since 2012.
  • The Joint Position Paper of the Federation of European Social Employers and EPSU "Digitalisation in the Social Services Sector – Assessment of Challenges and Opportunities" elaborated in the context of the PESSIS+ Project and based on the 2nd Technical Seminar organised on 24 October 2018 was in principle endorsed (see also above under section 1.).
  • Colleagues assessed the contents and outcomes of the 3rd Technical Seminar on "Recruitment and Retention in Social Services: Improving the sector’s attractiveness" held on 14 February 2019 in Brussels. It had focused on social partner initiative to improve 1) the recruitment of younger workers, 2) the retention of older workers and 3) the employment of male workers in the female dominated sector. The Federation of European Social Employers is working on a first draft of a joint position paper on recruitment and retention that will be shared with the EPSU Secretariat in May 2019, revised to include points important for EPSU (as set out in the EPSU Scoping Document on Recruitment and Retention) and shared over the summer with EPSU affiliates for comments.
  • Colleagues were informed that DG EMPL has approved the project “DialogueS” (2019-2020), submitted by the Federation of European Social Employers with the support of EPSU. It will focus on capacity building measures in 5 countries (Greece, Hungary, Poland, Slovakia and Romania). It will also again comprise 2 or 3 EU-level thematic meetings, starting in autumn 2019. Summary information on the project is being prepared by the EPSU Secretariat.

Colleagues were also informed on EPSU’s involvement in a series of technical seminars DG EMPL organises in 2019 to take stock of EU action in the field of long-term care (LTC) and to consult on its future priorities.

Establishing European Works Councils in the elderly care and childcare sector: Information on the state of play with regard to negotiations to set up a EWC in ORPEA and KORIAN and on the selection procedure for potential future “target” EWC for EPSU in the HSS sector was shared. Underpinning EPSU’s work on MNE in HSS and on the establishment of EWC, EPSU directly supported its German affiliate ver.di and coordinated solidarity actions of its affiliates, on CELENUS, a subsidiary of French private elderly care company Orpea in Germany, where a 202 days long strike action and anti-trade union activities of the management could eventually be resolved by the conclusion of a collective agreement on 18 February 2019, also based on rulings of the regional labour court in favour of the employees that had been sacked and in support of the demands formulated by ver.di. 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.

The participants assessed the work so far of the EPSU Network on Early Childhood Education and Care (ECEC), following a first online exchange on 12 December 2018 (cf. Annotated Agenda & Notes). It has been set up to provide a resource for affiliates active in ECEC to exchange ideas but also to participate in the development of the EPSU policies in the field to facilitate the exchange of good practices among EPSU affiliates involved in childcare. The network also supports the EPSU’s representatives in the DG EAC Working Group “Early Childhood Education and Care” – Viktória Szűcs, BDSSZ, Hungary, and Darragh O’Connor, SIPTU, Ireland – to consult and agree with other EPSU affiliates on the contributions to be made on “staff professionalisation in ECEC”. The second online meeting on 8 March 2019 focused on the use of video surveillance and what trade unions can do to defend the privacy for childcare workers (cf. Annotated Agenda & Notes).