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Future plan for care workers and care services – local and regional opportunities in the context of a European challenge  
​​​​The European Committee of the Regions is in the process of elaborating its position on its opinion on "Future plan for care workers and care services – local and regional opportunities in the context of a European challenge".

An exchange of views on the basis of a Working Document by the Rapporteur, Mr Heinrich Dorner (AT-PES), is scheduled on 17 February 2021, within the framework of the meeting of the CoR Commission for Social Policy, Education, Employment, Research and Culture (SEDEC).

General context

According to scientific findings and projections of demographic trends, Europe has low population growth and an ageing society. The population is steadily ageing thanks to advanced healthcare and rising living standards. Currently, 20% of people in Europe are aged 65 or over, but this will rise to an estimated 30% by 2070. This will also lead to an increase in the number of people requiring care and a greater demand for qualified care workers. Additional requirements due to a flexible world of work, changing social structures and declining family cohesion make both professional and informal care for people in need more difficult.

From today's perspective, the growing demand for professional and informal care cannot be sufficiently met by the human resources currently available. Without targeted countermeasures, there is a risk of a Europe-wide shortage of care workers, as is already the case in some European regions, including Austria. To maintain the current ratio of five long-term care workers per 100 people aged 65 and over, the number of workers in this sector needs to increase by 13.5 million by 2040 in OECD countries.

In the care sector, a distinction needs to be made between informal care (also known as lay care) and formal (professional) care. Lay care generally refers to people looking after a relative or acquaintance and supporting them on a daily basis without relevant training. Professional care, such as hospital care, requires specially trained care workers, depending on the specialist area. Outpatient and inpatient care are two types of professional care. The way in which care needs are addressed varies considerably across EU Member States.

As well as institutional care – inpatient, semi-inpatient and outpatient – there is home care. Studies conducted by the European Commission and a survey carried out in Burgenland have both shown that people prefer to be cared for and grow old in their own homes. Home care is often informal care provided by relatives without relevant training. In Europe, around 80% of care is provided by relatives, two thirds of whom are women. In Austria, 71% of care allowance recipients are looked after by relatives. As such, informal care plays an important role in both Austria and Europe as a whole.

Other forms of care in the homes of people requiring assistance are mobile care services and 24-hour care. The latter is often provided by care workers from other European countries. While the free movement of people and services is one of the four freedoms of the EU and offers many benefits and opportunities, cross-border labour mobility also poses challenges. During the COVID-19 crisis, temporary border closures made cross-border commuting difficult or even impossible for workers, including many care workers. These limitations also revealed weaknesses in the care system, in particular the dependency on foreign workers in the 24-hour care sector. While temporary solutions have been found to ensure security of supply, in the long term a rethink is required, alternatives must be sought, and framework conditions and solutions are needed at EU level.

Major challenges in the care sector include ensuring security of supply and putting in place targeted measures to prevent or tackle shortages in care workers. To successfully address these problems, care sector job profiles must be made fundamentally more attractive to address the shortages in qualified staff. A change of image is needed to permanently improve the status and social prestige of the profession. To achieve this long-term goal, better working conditions are required for care workers, as well as resilient employer structures so that the growing need for care can be met over the long term with high-quality personnel services. Other challenges faced by care workers include an improved work-life balance, the provision of training and skills development opportunities, including in informal care, and professional recognition of acquired skills. A healthy working environment and a fair and rewarding salary for professional care workers as well as social and financial protection for carers are also of the utmost importance.

Purpose of the consultation

​With the aim of including a range of different positions and so enrich the opinion, encompassing the local and regional point of view and that of associations and organizations working in the field of care, the rapporteur would like to ask you a number of questions in the form of a written consultation facilitated by the European Committee of the Regions.

The consultation focuses on the following questions that Mr Heinrich Dorner would like you to answer, in English or German, in a separate e-mail to before 12 March 2021.

Structural differences in systems

  1. Is your organization/institution involved in institutional/formal or informal care? ​
  2. In your view, what are the general challenges in the care sector? ​

Shortage of care workers

  1. What are current conditions like for care sector workers and what should they be like?
  2. How can a shortage of staff at local and regional level be avoided in the future and a sufficient number of care workers be recruited for the formal/informal sector, making the profession more attractive?
  3. Are you aware of any initiatives, campaigns or programs to attract workers to the care sector?
  4. How can informal carers be socially protected or integrated into the labour market? What potential do they offer for the care sector?
  5. Are standard basic principles and framework conditions required at EU level, e.g. with regard to remuneration and social protection for relatives acting as carers?
  6. Are you aware of examples of best practices, novel approaches or innovative ideas to meet the requirements of the care sector in line with needs?

Resilience (COVID-19)

  1. What problems/challenges or opportunities have resulted from the COVID-19 pandemic with regard to the care sector?
  2. In your view and based on your experience, how can the care sector be made more resilient and future-proof?​

Organizer: Commission for Social Policy, Education, Employment, Research and Culture (SEDEC) 
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