Foundation Forum: Debate 4

• Moderator: Bob Collins, broadcaster
• Introduction: Robert Anderson, European Foundation
• Discussants:
  1. Christina Christova, Minister of Labour and Social Policy, Bulgaria
  2. Gail Hunt, National Alliance for Care-Giving, USA [Abstract]
  3. Tine Rostgaard, National Institute for Social Research, Denmark [Abstract, PDF, 23KB]
• Rapporteur: Henrik Litske, European Foundation

Summary of the debate by Henrik Litske:

Here are the main points:

Challenges and trends

Demographics:
Welfare systems in Europe, and to an extent in the USA, are facing low fertility rates and an ageing population. The family has traditionally been the key provider of care but it is facing high divorce rates, and people tend to marry later. Women provide most of the care in Europe, and their increased employment rates also put further strain on families and their possibilities to provide care for children and the elderly.

Policy status:
According to the workshop participants, care provision is better developed for children than for the elderly, and investment in the social and health sectors is needed to support care for the elderly.

Cultural problems:
In the European Union the care sector has a poor image, poor working conditions and is predominantly female. Surprising results were presented from the USA, where 40% of men claim that they have care responsibilities. However, in Europe at least, there is a need for more men in the care sector.

Key policy suggestions

1. The issue of provision of high quality, affordable care was seen as the top priority of the group. Services rather than cash provision were also recommended. Quality could improve if services in health, employment and social security were better coordinated.
2. Secondly, the principle of choice should be catered for as people have different care needs throughout their lives. Surveys show that people wish to stay at home as long as possible rather than moving to institutions. Services in support of this should be considered, such as home help.
3. Another way of ensuring that people can stay at home into old age is by public health initiatives. In conjunction with this, housing policies can also make it easier to stay at home.
   US surveys show that the health of care workers is much worse than that of average workers, especially for carers engaged in intensive care, because of stress, time pressure and severe work-life balance problems. European surveys show that the care workforce is ageing and there is a need for occupational health i nitiatives to improve the conditions.
4. The group touched upon the issue of whether immigrants could be a solution to the problem of insufficient care workers. Some countries, such as Italy, have programmes to get workers from abroad trained to do care work. Immigration is surely part of a solution but it has to be approached carefully. Often the elderly prefer care from people they know, rather than from strangers. Movement of care workers from other countries may leave behind greater needs in the country of origin. The EU’s free movement policies can have negative social implications.

Funding and organisation

The group felt that companies could contribute more by showing social responsibility and providing day care facilities for employees, and support for childcare and elder care in the local community in partnership with NGOs and the public sector. The public sector was seen to be one of the main contributors to care provision. Some countries are experiencing high unemployment rates and the public sector and social partners could develop training programmes to assist those becoming unemployed because of globalisation and new technologies by quickly training them to take on board formal care responsibilities in the labour market.