Care workers are key to quality care

On the Global Day of Action for Care Workers, unions mobilise for investment and decent work.

Today, the trade union movement worldwide celebrates the Global Day of Action for Care Workers. This year, the motto is investment and decent work in care.

Yesterday, the European Federation of Public Service Unions (EPSU) drew attention to those goals in meetings which brought together care workers and members of the European Parliament. These will be followed up today with a symbolic demonstration in front of the European Commission and the Council of the European Union, underlining the urgent need to support care workers. Empty shoes of carers will symbolise workers leaving the sector, due to precarious working conditions, burnout and staff shortages.

Between 2019 and 2020, the residential-care workforce across the EU-27 diminished by over 421,000. The outbreak of Covid-19 exacerbated many problems in care identified by the EPSU. Lack of funding has been associated with worsening labour shortages, increased psychosocial risks for care workers and accelerated privatisation of services.

Slowly recognised

Due to the pandemic, this critical situation has however slowly been recognised by policy-makers. In June, the Social Protection Committee representing EU member states and the commission published a report on long-term care, affirming that an adequate workforce was key to meeting the rising demand for high-quality services. Yet the current labour shortage could intensify.

Last month the report of the Pan-European Commission on Health and Sustainable Development, convened by the World Health Organization director for Europe, called for more investment in social care:

The avoidable deaths of so many people living in residential facilities will, for many families, be remembered as a defining characteristic of the pandemic. For too long, social care has been the poor relation of the health system. Few governments have put in place systems to fund it adequately, despite clear warnings from demographers about ageing populations.

Last year, the EPSU, together with the European Disability Forum and Age Platform Europe, urged the European Parliament to establish a committee of inquiry into the devastating mismanagement of the pandemic in long-term care facilities. This demand was supported by almost 90 MEPs.

More recently, in her ‘state of the union’ speech, the commission president, Ursula von der Leyen, heralded an EU care strategy. It is not clear what and who will be included in this but more information is expected at the end of the next year. The strategy should help family members delivering care and, more importantly, concentrate on long-term care and workers in social care who have long been neglected.

The increasing importance of care has been recognised in Scotland, where the government is consulting on a National Care Service, against the background of the (UK) National Health Service. In England, the trade union Unison has supported such a service, based on the principles of the NHS and integrated with it. Not only would this allow for universal access to care but it would also make the sector more resilient.

The UK has of course now left the EU but, vis-à-vis the member states, in recent years there has been more focus in the European semester on increasing investment in long term-care. In 2020, for instance, the country-specific recommendations for Portugal called for equality of access to be ensured. Similarly, the 2019 recommendations for Slovakia included enhancing affordable, quality, long-term care.

From declarations to actions

Given the growing significance of social care in public discourse, unions and civil-society organisations more broadly must keep applying pressure, so that attention is matched by action. Action should focus on rebuilding social care after the pandemic to ensure universal access, quality services, adequate staffing to meet need and decent working conditions.

The EPSU report,Resilience of the Long Term Care Sector: early key lessons learned from the Covid-19 pandemic, published this week, provides key recommendations:

• increase funding for, and investment in, public services in general, to guarantee accessible, quality care and to realise the right to care;
• raise wages and improve working conditions for care workers, to prevent a workforce exodus, attract new workers and alleviate chronic staff shortages—taking a gender-sensitive approach to close the gender pay gap and tackle the longstanding pay discrimination suffered in a female-dominated sector;
• defend care workers’ rights by strengthening collective bargaining and social dialogue;
• improve occupational health and safety for care workers by drawing more attention to the risks they face—including, with hundreds of thousands of care workers suffering ‘long Covid’, recognising this as an occupational disease—in the proposed the EU OSH strategy (2021-27), ensuring the preparedness of the sector with personal protective equipment, training and planning and developing a designated directive on psychosocial risks and stress;
• reform public procurement models: public contracts for long-term care should not be awarded to companies which avoid paying taxes or eschew collective agreements;
• reverse the growing trend of privatisation of care services and investigate profit-making in long-term care, rampant in the sector;
• investigate the failures of long-term care services and hold decision-makers to account, and
• integrate social care better with health services.

The recommendations should be predominantly implemented by member states, which are responsible for delivering social care. But the EU can play a decisive role. EU funds, for example the Recovery and Resilience Facility or even the EU4Health programme, can be invested in social care.

More practically, the next OSH strategy, along with public procurement—both competences of the EU—should focus more on care workers. Furthermore, the key recommendations in the EPSU report should be guiding principles for the EU care strategy. The initiative on Long Term Care, signalled for next year in the European Pillar of Social Rights Action Plan, will also be important in directing the EU approach to care. 

On the Global Day of Action for Care Workers, European carers are demanding actions, not just declarations. We urgently need to address the retention and recruitment challenges,to  ensure that the profession provides an attractive career path. In the wake of the pandemic, more than ever, access to quality public services, including social care, should be at the very heart of our societies.