Annexes to COM(2022)440 - European care strategy - Main contents
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This page contains a limited version of this dossier in the EU Monitor.
| dossier | COM(2022)440 - European care strategy. |
|---|---|
| document | COM(2022)440  |
| date | September 7, 2022 |
- on the Member States to address gaps in implementation and enforcement of EU labour law and working conditions acquis in the care sector and to ratify and implement ILO Convention 189 on domestic workers. It also calls on the Member States to take steps to formalise and regulate the specific situation of domestic workers and live-in carers;
- on the Member States to address workplace risks related to violence and harassment in the care sector and adopt the Council Decision authorising the Member States to ratify the ILO Convention 190 concerning violence and harassment in the world of work.
Legal migration can be a key driver to remedy labour shortages. Already today, many people from non-EU countries work in the care sector. But migrant care workers often work undeclared or in precarious conditions. The communication ‘Attracting Skills and Talent in the EU’ 20 underlines that sustainable and legal pathways for migration from non-EU countries to work in the care sector could provide an opportunity both for migrant care workers to start a career in the EU, and for EU countries to help meet their demand for jobs. These opportunities may also be valuable to people fleeing the Russian aggression in Ukraine, especially experienced care workers, who want to seek employment while residing in the EU. There is a need to assess whether and to what extent EU tools could help in improving the admission of migrant care workers to the EU, to the mutual benefit of all Member States and countries of origin, while ensuring the ethical recruitment of migrants.
Upskilling and reskilling opportunities will improve the attractiveness and quality of care work. In order to achieve improved quality in the provision of care as well as to reduce turn-over of staff, it will be necessary to ensure that all kinds of care staff are able to participate both in high-quality initial education and training as well as continuing professional development programmes over the course of their careers. Most long-term care workers have a medium level of qualifications and the skills required are constantly evolving and becoming increasingly complex. The sector needs workers with soft skills, digital skills and specialised knowledge (e.g. on certain types of diseases such as Alzheimer’s or chronic diseases, or on diagnostics and treatment methods, for instance via telecare).
The Commission will:
- by the end of 2022, launch a study mapping the current admission conditions and rights of long-term care workers from non-EU countries in the Member States. The Commission will also explore the added value and feasibility of developing EU-level schemes to attract care workers, taking into account the ethical dimension of such schemes, as set out in the initiative “Attracting Skills and Talent in the EU”. Talent partnerships could also be developed for several economic sectors, including long-term care, on a demand-driven basis, while remaining mindful of the risks of brain drain;
- promote the opportunities available for early childhood education and care staff under the Erasmus+ programmes to continuously develop their professional competences through the design of early childhood education and care programmes, innovative teaching methods and new material to support children’s learning;
- promote the establishment of a skills partnership under the Pact for Skills for the long-term care sector. The partnership should include digital skills and development of corresponding training and education curricula, in the context of the European Skills Agenda and build on synergies with large scale partnerships in relevant sectors (e.g. healthcare, proximity and social services). Calls under the Erasmus+ programme will support sectoral cooperation on long-term care (e.g. Alliance for sectoral cooperation on skills);
- take specific action on digital skills in health and care sectors under the Digital programme by launching calls for proposals for Master courses and short-term training and under the EU4Health work programme by providing professional development training opportunities for health workers, including nurses;
- bring forward skills intelligence on current and future skills needs and trends for the long-term care sector, in close cooperation with CEDEFOP. This work should build on the CEDEFOP innovative Skills Online Vacancy Analysis Tool for Europe (Skills OVATE) and the toolkit for labour market intelligence.
The Commission calls:
- on the Member States and EU-level and national social partners to take action to facilitate the upskilling and reskilling of care workers, in line with the European Skills Agenda and its actions, in particular the Pact for Skills.
3.2. A better balance between work and care responsibilities
Investing in the care sector would help ensure that informal care is a choice rather than a necessity. Caring for loved ones has a high societal and economic value. For example, the value of hours of long-term care provided by informal carers is estimated to be around 2.5% of EU GDP higher than the public expenditure on long-term care. Further, people with caring responsibilities should have a choice about the extent to which they want to combine care with paid work. Therefore, they should have access to services that enable them to reconcile their caring responsibilities with their professional lives.
Providing care has major consequences for informal carers, including negative effects on their current and future income and on their mental health. Women provide the bulk of care and this often leads them to adapt their work patterns to care responsibilities, including by taking career breaks, working part-time, or leaving the labour market entirely and prematurely. This is particularly challenging for single parents, the vast majority being women. Some face a double burden of caring for children and other dependent family members at the same time. In pre-pandemic 2019, about one third (32.6%) of women aged 25-49 outside the labour force indicated that care responsibilities were the main reason for not seeking employment, compared to 7.6 % of inactive men.
Care services are essential to enable people to combine work and care duties, but they are not sufficient on their own. This is why Principle 9 of the European Pillar for Social Rights states that parents and people with caring responsibilities have the right to suitable leave, flexible working arrangements and to have access to care services. Work-life balance measures should help workers to balance their care responsibilities with work, while care allowances can partly compensate for the hours of care provided. Increased access to special and family leave and flexible working time arrangements, such as part-time work, telework and flexitime, can help workers improve their work-life balance.
One of the root causes of the difference in time devoted to unpaid care work by women and men are stereotypes about the roles and responsibilities of women and men in the private and professional spheres. This can only be tackled by taking a transformative approach that aims to revalue care work and tackle stereotypes so that men and women are perceived as equally capable of providing care, and of being professionals or leaders in the care sector.
The Work-Life Balance Directive 21 , which the Member States had to transpose into national law by August 2022, fosters a more equal sharing of care responsibilities. It introduces non-transferable rights to family leave and flexible working time arrangements for both women and men. It is specifically designed to encourage the uptake of these rights by men. The Directive also states that carers who exercise these rights must not be treated unfavourably or discriminated against in the workplace. Workers with care responsibilities need to be aware of the new rights granted by the Directive and employers need to be encouraged to put in place work-life balance friendly policies also in light of the uptake of new (tele)working arrangements triggered by the COVID-19 circumstances.
Access to adequate support services and measures for informal carers such as counselling, psychological support or respite care is often scarce and uneven. Many informal carers do not receive proper training in caring for a dependent, sometimes resulting in feelings of over-burdening or even mental health issues (e.g. burnout). Especially for older informal carers, caring responsibilities can be challenging and affect their own healthy living. There is scope to foster good practice in supporting informal carers, for instance by tapping into the expertise of the World Health Organization. Policies to formalise informal care, for example by service contracts with public authorities, can benefit informal carers and their dependents and help recognise and value better care giving.
The Commission will:
- monitor the take-up of the new rights covered by the Work-Life Balance Directive, including through the monitoring framework drawn up by the Employment and Social Protection Committees on the uptake of family leave and flexible working time arrangements by women and men with care responsibilities;
- launch an awareness raising campaign on the new rights granted by the Work-Life Balance Directive;
- cover the unequal sharing of unpaid care work in its upcoming communication campaign on combating gender stereotypes;
- work with EQUINET to identify measures to tackle possible unfavourable treatment in Member States of workers who take family leave, including through cooperation between equality bodies and other actors;
- support schemes that promote family-friendly practices in companies, encourage the take-up of the new rights by both women and men and promote the role of men in care and family responsibilities under the Citizens, Equality, Rights and Values Programme;
- facilitate better use and outreach of WHO tools and training materials on the support measures available to informal carers.
The Commission calls on the Member States to:
- combat gender stereotypes and promote a more equal sharing of care responsibilities between women and men;
- design support measures for informal carers, e.g. counselling, psychological support, respite care and/or adequate financial support, which does not deter labour market participation, together with policies to formalise informal care.
4. Investing in care
Public spending on care varies considerably between Member States. This reflects different approaches to organisation, quality and valuing of care work and, in the case of long-term care, varying weight given to formal and informal care provision.
Long-term care is expected to be the fastest-rising ageing-related public expenditure item, projected to increase to 2.5% of GDP by 2050, with marked variations across Member States 22 .
Public support for the care sector is a social investment which, in parallel with action on sustainable financing, brings multiple returns for individuals, society and the economy. Increasing investment in care has a positive impact on children’s development and the well-being and dignity of care recipients, contributes to social fairness and gender equality and promotes women’s participation in the labour market and job creation. Recent research 23 shows that investment in care can generate additional tax and social security contributions from jobs created as well as from increased labour market participation of women. Overall, tax revenue from increased earnings and employment would rise, reducing the total funding requirement of care policy measures from 3 per cent of GDP (before taxes) to a net 2 per cent of GDP (after taxes) 24 . The ILO estimates that the rate at which Member States can recoup investments in the care sector is on average around 55%, depending notably on the amount of investment needed, the labour demand in the Member State concerned and the level of taxation.
Unlocking the potential of early intervention and prevention measures can contribute to fiscal sustainability of public budgets. Health promotion, disease prevention, timely and good quality healthcare as well as healthy living policies have great potential to postpone or reduce the need for health care and long-term care while enabling ageing at home for as long as possible.
Furthermore, the lack of investment in long-term care and prevention risks shifting the costs to pensions, social assistance and healthcare budgets. The Healthier Together initiative and Europe’s Beating Cancer Plan address the prevention, treatment and care of non-communicable diseases, to ensure that patients can live long, fulfilling lives and that challenges faced by families and carers are addressed.
Fiscal sustainability of care services can be improved by ensuring their cost-effectiveness. Cost-effectiveness can be improved by creating a coherent and integrated governance framework, continuous monitoring and ensuring that the available resources are well-targeted and, for long-term care, support for independent living and that services match the needs of the individual. Achieving this can benefit from mapping available infrastructure and services and establishing a gap analysis, while taking into account territorial inequalities and demographic challenges. Innovative, integrated care solutions and the ethical use of new technologies in care can also help improve the fiscal sustainability of long-term care and healthcare systems.
Care providers need stable and sustainable financing mechanisms and they need clear and enabling regulatory environments. Given their clear social function, long-term care services are a public good. When provided by public authorities and associations, long-term care services are primarily considered social services of general interest. 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. Stronger support for regional and local care providers can create jobs and empower local communities.
Social economy actors bring an added-value to the provision of high-quality care services due to their person-centred approach and the reinvestment of profits into their mission and local communities. As called for in the Social Economy Action Plan 25 , policy and legal frameworks should create the right environment for the social economy to optimise its contribution to care services. The systematic use of socially responsible public procurement could boost the potential of social economy to contribute to high-quality standards in care and to provide fair working conditions. The forthcoming report of the high-level group on the future of social protection and welfare states in the EU will provide further insights on sustainable financing and the role of social services in the welfare states.
There is a need to increase public and private investment at national level, and EU funding can complement this. Member States can tap into EU funding opportunities such as the European Regional Development Fund (ERDF), the European Social Fund Plus (ESF+), including its Employment and Social Innovation strand, the European Agricultural Fund for Rural Development, the Just Transition Fund, the Horizon Europe or Digital Europe programmes. In addition, the Recovery and Resilience Facility (RRF) can finance eligible reforms and investments in the context of the recovery from the COVID-19 pandemic. The Technical Support Instrument can also support reforms and investment. At the same time, Member States should pursue policies conducive to the sustainable funding of care services that are coherent with the overall sustainability of public finances.
In the programming period 2014-2020, the European Social Fund (ESF) has supported several actions related to long-term care ranging from the reskilling and upskilling of the workforce, expanding access and coverage, supporting integrated care services and independent living, to active and healthy ageing. ESF resources have also been allocated to regional and local level projects to enhance childcare provision, to address the gaps experienced by disadvantaged children, to assist parents in accessing the labour market and to make efforts towards addressing disparities in employment between men and women.
Programming for the period 2021-2027 is ongoing, and access to the ERDF and the ESF+ is conditional upon the existence of national or regional strategic policy frameworks for health and long-term care.
The European Child Guarantee provides Member States with an opportunity to leverage ESF+ funding to strengthen access to early childhood education and care. It can also be used to support the quality of provision in formal and informal settings, and to improve the inclusion of children with disabilities, children at risk of poverty or social exclusion, and children from marginalised communities.
The European Agricultural Fund for Rural Development (EAFRD), based on the relevant evidence and facts described in the Long-term Vision for Rural areas, also provides Member States with the possibility to support rural childcare and long-term care.
While the main aim of the Just Transition Fund is to support investment to mitigate the impact of the climate transition, where duly justified, territorial just transition plans may contain activities in the areas of education and social inclusion including, investments in infrastructure for the purposes of training centres, child- and long-term care facilities as indicated in territorial just transition plans.
The Recovery and Resilience Facility (RRF) provides Member States with significant opportunities to fund reforms and investments in social resilience. A large number of Member States 26 mobilised the RRF for the long-term care sector. Examples of reforms under the Recovery and Resilience Plans (RRPs) include strengthening long-term care system and promoting a change in the model of support and long-term care, increasing human resources and infrastructure capacity for the provision of long-term care services, training, reskilling and upskilling of long-term care professionals. Additional reforms are also expected to improve long-term care provision by modernising or expanding social services, including community-based services, and by supporting long-term fiscal sustainability of long-term care systems. Of the 25 plans adopted as of 20 July 2022 under the Recovery and Resilience Facility, 12 include reforms and investments in the area of early childhood education and care, totalling around EUR 7.9 billion 27 . Those investments are expected to increase participation rates, in particular among disadvantaged groups, hence reducing inequalities. These measures are also supported by reforms aiming to improve access, inclusiveness and quality of early childhood education and care.
The Commission calls on the Member States to:
- ensure adequate and sustainable financing and investments in high-quality care systems, including by:
- pursuing policies conducive to the sustainable funding of care services that are coherent with the overall sustainability of public finances;
- promoting both public and private investments in care services, while ensuring a clear regulatory environment that takes into account the social value of care services and the need to uphold the fundamental rights of persons;
- using existing EU funding to improve equal access to high-quality long-term care, in particular community-based and home care;
- using existing EU funding to ensure equal access to inclusive and quality early childhood education and care services, including at parents’ workplaces, for all children, in particular children at risk of poverty or social exclusion and for marginalised groups such as Roma, children with a migrant background, children with disabilities, and children deprived of parental care. In this context, the Commission will continue to support Member States in guaranteeing free and effective access of children at risk of poverty or social exclusion to early childhood education and care, as outlined in the European Child Guarantee.
5. improving the evidence base and monitoring progress
Reliable and comparable data are essential to monitor progress and for evidence-based policy making. This includes ensuring a sufficient level of detail in the reference data on participation in early childhood education and care, e.g. with a breakdown by specific groups or age categories. Further, strengthening the evidence base requires better data on the type and consequences of informal care provision, i.e. to identify gender inequalities, working time arrangements and the uptake of family leave.
Despite some progress in building common long-term care indicators on access and financing, statistics on long-term care are still underdeveloped. They lack comparable administrative data e.g. on care expenditure and provision. Therefore, more work is needed to develop and harmonise data collection at EU level. In addition, taking a rigorous and systematic approach to projecting the evolving national needs for long-term care will help Member States plan ahead. Despite evidence of access to care being more difficult in rural and remote areas, data on territorial inequalities in long-term care provision is scarce; more evidence is needed on the main causes of these inequalities and on effective policy responses.
The Commission will:
- work to improve care-related data collection and analysis, in particular by increasing reporting on participation in early childhood education and care, in cooperation with Member States. It will also step up strategic cooperation with international organisations such as OECD and ILO, and exchanges with EU agencies, namely the European Institute for Gender Equality (EIGE) and Eurofound. Where feasible and relevant, data should be disaggregated by sex, age, disability and ethnic background;
- with input from EACEA’s Eurydice network and EIGE, monitor progress and work to develop and analyse indicators tracking early childhood education and care. This work will build on the work already carried out in response to the Recommendations on Early Childhood Education and Care and the Child Guarantee;
- create a task force on long-term care statistics to improve the evidence base for long-term care. This work will aid the monitoring and development of EU common indicators on long-term care, agreed by the Social Protection Committee;
- develop detailed projections on the demand for health and long-term care services in the EU (building on long-term population projections available at national and regional levels), to aid resource planning;
- finance research via a call for proposals under the Horizon Europe programme on addressing territorial inequalities in care and research into the development of integrated care solutions, including digital tools and telecare;
- support Member States in sharing evidence on care provision in rural areas through the Rural Observatory set up under the Rural Action Plan 28 and the common agricultural policy network.
The Commission calls:
- on Union agencies, such as EIGE, to collect data regularly, develop indicators and carry out analyses on the gender care gap, the gender pay gap, and the use of time in paid and unpaid work, individual and social activities by women and men with care responsibilities and on work arrangements throughout their working life;
- on the Member States to collect data, broken down by gender, age and other aspects of time use (preferably via time use surveys carried out in the context of Harmonised European Time Use Surveys), on the uptake of family leave and on flexible working time arrangements.
The successful implementation of the European care strategy requires a shared commitment of all stakeholders. In taking forward this strategy, the Commission will work in close partnership with other EU institutions and bodies, notably the European Parliament, the Council, the Committee of the Regions and the European Economic and Social Committee, Member States, social partners, social economy actors, civil society organisations and other stakeholders.
The Commission will:
- monitor implementation of early childhood education and care and long-term care policies, assess progress towards the Barcelona targets in the context of the European Semester process, and consider advancing country-specific recommendations when appropriate;
- expand the opportunities for all stakeholders to share their experience and learn from each other, through mutual learning programmes on all dimensions of care.
The Commission calls on:
- the Member States to create the conditions to enable care providers, including civil society organisations and social economy actors to play an active role in the design and delivery of high-quality care services and improving working conditions in the sector and support regional and local authorities’ efforts to invest in care services;
- the Member States to swiftly agree on and implement the proposed Council recommendations on the revision of the Barcelona targets on early childhood education and care and on access to affordable and high-quality long-term care.
6. Conclusion
The way we value care should reflect the way we want children, older people, persons with disabilities and carers to be valued.
This strategy is a cornerstone of the EU’s approach to social policies to help adapt to demographic change, eliminate persistent gender and other inequalities, tap into the potential of the green and digital transitions, and increase resilience to significant external shocks. It is designed to benefit people in need of care at all ages by improving their access to affordable, accessible and high-quality care. It is about living in dignity, upholding human rights, leaving no one behind and providing opportunities for better life and career prospects, the backbone of our European way of life.
Improving the care sector helps ensure that both women and men can participate in work and society on an equal footing, while caring for their loved ones. It aims to ensure that care workers benefit from better working conditions, which should make the sector more resilient and attractive and help create new jobs to meet the rise in demand.
The Commission calls on the EU institutions, Member States, local and regional authorities, civil society, social partners, and other stakeholders to endorse this strategy and contribute to implementing it.
(1)
State of the Union speech, 15 September 2021.
(2)
A Commission Staff Working Document accompanying the Commission proposal for a Council Recommendation on access to affordable high-quality long-term care (SWD(2022) 441) provides evidence underpinning the key challenges in the sector and specific examples of how to address the challenges, inspired by measures taken across the EU Member States.
(3)
European Parliament resolution of 5 July 2022 towards a common European action on care (2021/2253(INI))
(4)
Commission Staff Working Document (2022) 440.
(5)
Conference on the Future of Europe, Report on the final outcome, May 2022, Proposal 15.
(6)
Council Recommendation of 22 May 2019, OJ C 189, 5.6.2019.
(7)
COM(2021)142 final
(8)
Council Recommendation of 14 June 2021 OJ C 223, 22.6.21.
(9)
Barcelona European Council, 15 and 16 March 2002. (2002), SN 100/1/02 REV 1
(10)
COM(2020) 620 final, 7.10.2020, OJ 2021C 93/01.
(11)
COM(2022) 197 final
(12)
See SWD(2021) 167final
(13)
See SWD(2021) 41 final.
(14)
COM/2020/274 final.
(15)
Directive (EU) 2019/1152 of 20.06.2019.
(16)
COM/2021/323 final.
(17)
2019/C 387/01.
(18)
See COM/2021/762 final.
(19)
See COM/2021/93 final.
(20)
COM/2022/657 final.
(21)
Directive (EU) 2019/1158, OJ 2019, L 188
(22)
European Commission and Economic Policy Committee, 2021, The 2021 Ageing Report – Economic and budgetary projections for the 27 EU Member States (2019-2070).
(23)
International Labour Organisation (ILO) report – Care at work – Investing in care leave and services for a more gender equal world of work, 2022.
(24)
International Labour Organization (ILO). 2022. ILO Care Policy Investment Simulator (Geneva, forthcoming).
(25)
COM/2021/778 final.
(26)
See SWD (2022) 441.
(27)
AT, BE, CY, CZ, DE, EL, ES, HR, IT, LT, RO, SK.
(28)
COM (2021) 345 final.