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Questions and Answers: European Care Strategy

Met dank overgenomen van Europese Commissie (EC), gepubliceerd op woensdag 7 september 2022.

What is the European Care Strategy about?

Care concerns us all. We and our loved ones will either need or provide care in our lives. Care workers are essential to meet society's care needs, but their work is often undervalued. The COVID-19 pandemic highlighted even more the importance of care work and showed that we need to improve the resilience of our care services for both care receivers and carers. With an ageing Europe, there is an increased demand for care services.

The European Care Strategy sets an agenda to improve the situation for both carers and care receivers. The Strategy aims to ensure quality, affordable and accessible care services with better working conditions, gender equality and work-life balance of carers. It will also help advance the implementation of the European Pillar of Social Rights and the 2030 EU headline targets on employment, skills and poverty reduction.

The Strategy consists of:

Why do we need affordable high-quality care?

Care services should be affordable to all, regardless of age, gender or social status. They should be of high quality and person-centred to empower people to maintain their autonomy and live in dignity, exercise their human rights, and prevent poverty and social exclusion. For many people, however, this is not a reality yet:

  • While around 1/3 of children below the age of 3 and close to 90% of children aged between 3 and compulsory school age are already in early childhood education and care, many parents are not able to enrol their children because the services are either unavailable or too expensive.
  • Around 1/3 of households with long-term care needs do not use home care services because they cannot afford them.
  • Almost 1/2 of people aged 65 and over with long-term care needs have an unmet need for help with their personal care or household activities. And 38.1 million people in the EU will need long-term care in 2050, 23.5% more than in 2019.

Investment in care services and carers' rights is also crucial both to enable people with caring responsibilities to participate in the labour market and to create more jobs in the sector:

  • More than 9.1 million people, mostly women, work in the care sector in the EU. Challenges in formal care work, such as poor working conditions and low wages, make retaining and attracting workers difficult.
  • Many among the 52 million Europeans who provide informal long-term care to family or friends are not able to participate fully in the labour market. This in turn decreases public revenues and increases labour shortages in the EU.
  • In 2019, Member States spent on average only between 0.1% and 1.7% of GDP on early childhood education and 1.7% of GDP on long-term care. The International Labour Organization estimates in a forthcoming publication that an annual investment of 0.8% of GDP in early childhood education and care and an investment of 1.9% of GDP in long-term care would create an additional 13.6 million jobs in the EU by 2030.

Finally, when it comes to long-term care, better quality care can also decrease hospital admissions, therefore potentially alleviating the pressure on resources also in the healthcare sector. Both public and private investments in long-term care should take place in a clear regulatory environment with high quality standards that takes into account the social value of care services and the need to uphold the fundamental rights of persons in need of care and fair working conditions and wages for care staff.

How will the European Care Strategy promote gender equality?

Women on average shoulder the biggest share of unpaid care work, women are the main providers of informal care at home - 7.7 million women are estimated to be out of the labour market due to care responsibilities. Furthermore, women make up 90% of the care workforce, often in low-paid, precarious jobs, with few career development opportunities.

Availability of affordable high-quality care services, promoted by the European Care Strategy, will support women's participation in the labour market and help tackle ensuing gender gaps in income and pensions, thus contributing to improving gender equality.

In addition, improving working conditions through higher wages and training opportunities for care workers will also help reduce the gender pay and pension gaps. Finally, the strategy will combat gender stereotypes by supporting a more gender balanced sharing of care tasks and attracting more men into care jobs.

How will the European Care Strategy benefit persons with disabilities?

For many persons with disabilities, the lack of care services and insufficient support for families and personal assistance undermines their right to independent living. Quality, accessible and affordable care services are key to providing choices for care receivers and their families and to enable carers, particularly women, to better balance their work and family lives.

Half of children with disabilities are currently cared for only by their parents. It is therefore important to ensure that care services are accessible, inclusive and combined with targeted measures that help address specific needs, e.g., tackling barriers and segregation, equipping staff with the necessary competencies, and hiring dedicated staff to address individual needs.

What EU funding and technical assistance is available to support investments in the care sector?

EU funding has a complementary role to national funding in care. The EU funding and technical assistance available to support Member States' investments in care includes:

  • The European Social Fund Plus (ESF+), the main EU instrument for investing in people and the implementation of the European Pillar of Social Rights, can be allocated for instance for upskilling and reskilling the workforce, gender-balanced labour market participation, equal and timely care services and better working conditions in the care sector. Some examples of national ESF+ programmes for 2021-2027 used for care are:
  • In Bulgaria, €323 million will go to a national long term care strategy, which will ensure equal and increased access to services at home and in the community for people in need of care, establish social and integrated health and social services and attract and train more workers.
  • In Czechia, €165 million will be used to improve health and social care facilities, support community-based services and develop further healthcare and long-term care services for persons in need of care, in particular persons with disabilities. An additional €60 million will also help more than 5,000 children access early childhood education and care.
  • In Lithuania, €71 million will be invested in care services and the training of professionals in the long-term care sector.
  • The Technical Support Instrument, which is used for care-related measures in a number of Member States.
  • The Recovery and Resilience Facility via the national recovery and resilience plans, which so far envisage 33% of the social expenditure for health and long-term care (around €45 billion), another 33% for education and childcare (around €45 billion), and 14% for social policies (€19.7 billion). Some examples of care-related reforms and investments included in the plans are:
    • Portugal plans to support the National Health Service in the fields of primary, mental and long-term care to anchor them strongly in local services and community-based care.
    • Slovakia plans initiatives to modernise mental care and improve long-term care and investments in digitalisation. Healthcare reforms, including of the hospital network, aim to contribute to improving long-term fiscal sustainability.
    • Croatia plans to improve access for children aged 3 or more and support participation in early childhood education and care, especially for children from disadvantaged groups. To this goal, Croatia intends to create 22,500 new places, thus reducing regional inequalities in the availability of early childhood education and care.
    • Germany plans to increase the availability of early childhood education and care by creating 90,000 additional places.
  • Horizon Europe or Digital Europe programmes, which fund research projects in the area of long-term care.
  • Erasmus+, which provides opportunities for developing training and actions for early childhood education and care.

Early childhood education and care

What are the Barcelona targets for early childhood education and care?

The initial Barcelona targets on childcare were set by the European Council almost 20 years ago. The aim was for Member States to incentivise female labour market participation and provide childcare to 90% of children from age 3 until mandatory school age and to 33% of children under 3. The targets are currently reached in the EU on average, but with great discrepancies across Member States.

What is the Commission's proposal for a Council Recommendation on early childhood education and care about?

The Commission's proposal presents revised Barcelona targets and highlights the need to improve the quality, accessibility and affordability of early childhood education and care to increase parents' trust in and access to education and care services. It also seeks to put a greater emphasis on children's development and social inclusion.

The revised targets aim at ensuring that, by 2030, at least 96% of children from age 3 until compulsory school age (in line with the target already agreed in a Council Resolution in 2021 under the European Education Area) and at least 50% of children under 3 years of age participate in early childhood education and care. Setting this ambition will boost the provision of early childhood education and care and encourage more investment in this important sector in the EU.

Next to these revised targets, other dimensions are added:

  • Sufficient number of hours of attendance to allow parents, predominantly mothers, to meaningfully engage with paid work, and
  • higher participation of children at risk of poverty and social exclusion for educational equity.

Long-term care

What is long-term care?

Long-term care comprises a range of services and assistance for persons who, as a result of mental or physical disability, are dependent on help for personal care and household activities.

‘Formal' long-term care services are provided by professional care workers and include home care, community-based or residential care.

‘Informal' long-term care is provided by someone in the social environment of the person in need of care not hired as a long-term care professional. Most often this is a partner, child, parent, neighbour or friend.

How will the Commission's proposal for a Council Recommendation on access to affordable high-quality long-term care make a difference?

The proposed Council Recommendation on affordable high-quality long-term care provides a policy framework to:

  • Improve the adequacy of social protection for long-term care so it is timely, comprehensive and accessible to those who need it;
  • Increase the offer of long-term care services and provide a balanced mix of services in all care settings (e.g., home care, community-based care and residential care) irrespective of the status of providers (e.g., private or public, for-profit or not-for-profit). To this end, the Commission recommends that Member States ensure a quality framework, guided by EU-level quality principles, and an appropriate quality assurance mechanism;
  • Drive forward reforms and investments at national, regional and local level;
  • Improve the working conditions, increase wages, strengthen social dialogue and provide continuous training opportunities for workers in the long-term care sector to make care jobs more attractive and treat carers fairly;
  • Address the specific challenges of vulnerable groups of workers, such as domestic long-term care workers, live-in carers and migrant care workers;
  • Support informal carers, who are usually relatives and most often women, through training, counselling, psychological support, semi-residential care and financial support; and
  • Improve fiscal sustainability by ensuring cost-effectiveness of long-term care, for example, through a coherent and integrated governance framework, better targeting of long-term care to personal needs, improved health prevention (that reduces or postpones long-term care needs) and support for independent living.

For More Information

Press release - European Care Strategy

Factsheet - European Care Strategy for carers and care receivers

European Care Strategy Communication

Proposal for a Council Recommendation on the revision of the Barcelona targets on early childhood education and care

Proposal for a Council Recommendation on access to affordable high-quality long-term care

2021 Long-term care report


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