Population ageing is a global trend but public spending on long-term care (LTC) is not keeping pace with demand in the EU, according to a recent report by social service provider Caritas.
The report provides an overview of current trends in LTC and is based on the perspectives and experiences of care recipients relying on the services of Caritas care staff. Caritas Europa, with its network of organisations, is a major provider of LTC services throughout Europe.
The EU population is ageing rapidly with 21.1 % of people who are 65 or older and with a median age of 44.4 years in 2022. The median age is projected to increase to 48.2 years in 2050. Currently, 80 % of all long-term care in Europe is provided by informal carers, often deprived of fair working conditions, which deepens a gender-based inequality. 1,6 million more care workers will be needed by 2050.
Additional care workers are also needed because the number of so-called ‘potential dependants’ in the EU is forecasted to increase by nearly a quarter, from currently ca 31 million to 38 million in 2050. The prevalence of a physical or mental disability increases with age, which often leads to dependency on help and the need for long-term care.
The European Commission has called on the EU Member States to develop a mechanism for forecasting long-term care needs at national, regional and local levels and integrate this into the planning of long-term care provision.
The right to care must be recognized by the EU but there is not enough pressure for it, said Dr Milan Brglez, a Slovenian MEP (S&D), at a seminar discussing the report in Press Club Brussels Europe before the Summer break.
“In fact, the recognition of right to care is already an adopted position of the European Parliament,” he told The Brussels Times. “It was included in the resolution ‘Towards a common European action on care’, for which I was rapporteur, and adopted in June last year."
The resolution calls on the EU Member States “to recognise the right to care and to reform and integrate their social services and protection systems in such a way as to provide effective, comprehensive equal and timely access to care services and treatments throughout the life course, incorporating in their social protection systems solutions ensuring a personalized approach”.
He is in favour of a European Care Deal that would lead to better protection of the right of all persons in need of care and support as well as the care workers.
“This package should include a framework directive on long-term care that would set equal minimum standards of employment and/or working conditions for all carers, formal and informal, both EU and third-country nationals, without any discrimination. Within this framework, there is also room to integrate a Care Guarantee, as proposed by Caritas and some other stakeholders.”
“The European Commission appreciates your work,” said Dana-Carmen Bachmann, Head of the Social Protection Unit at Directorate Employment, Social Affairs and Inclusion. She found a conversion between the key messages and recommendations in the Caritas report and the European Care Strategy and the recommendations to the EU Member States.
In September 2022, the European Commission adopted the European Care Strategy for care givers and care receivers. The strategy was followed in December 2022 by Council recommendations to the Member States on access to affordable high-quality long-term care.
The recommendations call on the Member States to ensure the adequacy of social protection for long-term care, to continuously align the offer of long-term care services to the respective needs, as well as to ensure that high-quality criteria and standards are established for all care settings and applied to all providers.
Furthermore, the Member States should generally improve the profession of long-term carers, support quality employment and fair working conditions in the sector, address skills and labour shortages in the sector, as well as support informal carers (care workers who are not hired as professional long-term care workers).
Care-workers from non-EU countries
The situation and status of care workers in the EU from non-EU countries was also raised at the seminar. They are often working in the informal sector without work permit and social benefits, overworked and underpaid. They take care of other people and often develop a bond with them but can hardly take care of their own needs or visit their families back home.
If they complain about their work and wage conditions, they risk of loosing the job or being expelled from the country. In Belgium, FAIRWORK, is trying to help them and other employees with a precarious situation to claim their wages and rights and improve their conditions.
In principle, care workers in the EU should enjoy the protection of the ILO Convention 189 on domestic workers. It was adopted in 2011 and establishes global standards for all domestic workers but does not address matters concerning migration, according to a spokesperson of the European Commission.
Should the Convention become part of EU law (acquis)?
“Overall, 36 countries have ratified the Convention, out of which 9 are EU Member States (Belgium, Finland, Germany, Ireland, Italy, Malta, Portugal, Spain, and Sweden),” the spokesperson replied. “The Convention is fully compatible with the EU acquis and policies.”
“The Commission considers that it is important to ensure social justice in the EU and encourages EU Member States to ratify and implement the Convention.”
Furthermore, in its Communication on the European Care Strategy, the Commission called 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.
Despite the ILO Convention, which Belgium adopted already in 2015, there is still a need of a legal framework to protect care workers from third countries and tools for supervising that the rules are complied with, Omar Garcia from FAIRWORK said. There are no reliable figures about the number of care workers in the Belgian informal sector.
A recent report by the federal migration center Myria showed that a total of 9,900 visa applications were made in 2022 for occupational reasons, an increase by 59% compared to the previous year. So-called "combined licenses", which combines work and residence permits, were much higher.
Normally, a work permit has to applied for abroad. A family which needs a care worker cannot apply for a permit to employ someone from abroad. Since 1 January 2023, third-country nationals who are already working legally in the country but whose stay is coming to an end can now apply for such a permit while still in Belgium.
Care workers in Belgium from non-EU countries are entitled to the same rights as other workers irrespective of their residence status, FAIRWORK told The Brussels Times. Their residence status is not affected if they would claim their rights in a court as the migration authority is not involved.
“They could risk losing their job and might have to look for another job. Filing a complaint is a last resort if the employer is exploiting them economically. If they have been exposed to human trafficking, they could get a residence permit but the threshold for that is high.” FAIRWORK advocates a harmonized legal framework in the EU for care workers from non-EU countries.
Is there a need for harmonization on EU level of the legal framework for care workers from third countries?
The Commission replied that legal migration can be a key driver to remedy labour shortages in the care sector. “To tackle this, there is a need to assess whether and to what extent actions at EU level could help improving admission to the EU of essential workers for the care sector.”
To this end, it has launched a study mapping the admission conditions and rights of long-term care workers from non-EU countries in the Member States. The study, which will be concluded by the end of 2023, aims at exploring the role of non-EU nationals in the long-term care sector and what options could be developed at EU level in order to attract more long-term care workers to the EU.
To streamline migration procedures and reinforce the rights of non-EU citizens in the EU, the Commission has already proposed the ‘Skills and Talent Package’, which includes legislative proposals for the revision of the Permit and Residency Directives. There are also discussions on ‘Talent Partnerships’ and launching the ‘EU Talent Pool’.
According to the Commission, some care workers might already fall under the EU legal migration directives, such as the EU Blue Card Directive, but FAIRWORK doubts that these directives are relevant for them. They are more intended for highly qualified workers with much higher salaries. It also depends on how the directives are applied by the member states.
Is a breakthrough in the care strategy and protection of care workers expected during the Spanish and Belgian EU-precedencies?
The Belgian and Spanish Presidencies have ambitious social programmes and the Commission stands ready to closely work with them, the spokesperson replied. The issue has already been discussed at an informal Council meeting in July. The Spanish Presidency is planning a high-level event in October focusing on “Right to care, fair recuperation and economic redistribution”, as well as a high-level conference on labour migration in November.
By mid-next year, member states will also have to report to the Commission on the implementation of measures taken or planned in relation to the Council recommendations. “We hope that the plans will set in motion a number of actions to reinforce long-term care systems across the EU. Care policies lie primarily within the competences of the Member States.”
M. Apelblat
The Brussels Times
