Explanatory Memorandum to COM(2022)441 - Access to affordable high-quality long-term care - Main contents
Please note
This page contains a limited version of this dossier in the EU Monitor.
| dossier | COM(2022)441 - Access to affordable high-quality long-term care. |
|---|---|
| source | COM(2022)441  |
| date | 07-09-2022 |
Contents
- CONTEXT OF THE PROPOSAL
- BUDGETARY IMPLICATIONS
- The value of long-term care
- Long-term care needs
- Long-term care challenges
- Affordability challenge
- Availability and accessibility challenge
- Quality challenge
- Workforce challenge
- Funding challenge
- Governance challenge
- Objectives of the proposal
- 2. LEGAL BASIS, SUBSIDIARITY AND PROPORTIONALITY
- 3. RESULTS OF EX POST EVALUATIONS, STAKEHOLDER CONSULTATIONS AND IMPACT ASSESSMENTS
- 5. OTHER ELEMENTS
• Reasons for and objectives of the proposal
Long-term care 1 has an important social and economic role. It contributes to ensuring life in dignity and well-being of those in need of care, and to protecting their fundamental rights. It also reduces inequalities, thereby improving social fairness and intergenerational solidarity. Investing in long-term care has economic returns: it creates jobs and unlocks labour resources for other sectors by alleviating the family care burden. A strong long-term care sector can help foster gender equality, as care responsibilities keep millions of women out of the labour market and/or in part-time work with a negative impact on overall labour supply and, thus, potential growth. Care responsibilities may also have a negative impact on women’s pay and old-age pensions, meaning many older women are less able to afford the care they need. The lack of adequate formal long-term care means that the care burden sometimes falls on family members, which can negatively affect their health and well-being.
Population ageing will increase the demand for long-term care which is already high. The number of all people across the Union potentially in need of long-term care is expected to rise from about 30.8 million in 2019 to 33.7 million in 2030 and 38.1 million in 2050, corresponding to an overall increase of 23.5% 2 . The pool of informal carers is diminishing, as women who have traditionally carried out most of the informal care burden are increasingly employed more and retiring later. At the same time, demographic ageing also implies that the EU’s working-age population is projected to continue to decrease. Along with an increased labour demand across different economic sectors, this risks further reducing the supply of formal carers due to them moving to more attractive sectors.
Long-term care systems differ in terms of their design and maturity across the Union but they face common challenges. Those challenges are related to affordability, availability, accessibility and quality, all in the context of labour shortages, pressures on public funding, and complex governance. The structural weaknesses of long-term care systems have been put into the spotlight by the COVID-19 pandemic. It highlighted the need to strengthen the resilience of care systems to external shocks and the pressing need for structural reforms and investments in long-term care.
Financial reasons and the lack of adequate social protection represent significant barriers to accessing long-term care. The risk that arises from having long-term care needs is generally less covered by existing social protection systems than other common risks (e.g. old-age income and healthcare) and social protection arrangements vary across the Union. In some countries, public support is available only to a small proportion of people with long-term care needs. When available, social protection is often inadequate. Even after receiving support, on average, nearly half of older people with long-term care needs are estimated to be below the poverty threshold after meeting the out-of-pocket costs of home care 3 .
Access to and the variety of long-term care options are insufficient, raising equity concerns. The traditional choice of care options has been between informal care (usually provided by family members or friends, mainly women) and residential facilities (usually for severe long-term care needs or the poorest). Other options, which are more person-centred, such as home care and community-based care, have started to expand, though not evenly, across the Union 4 . There are geographical and socio-economic barriers to access, which remains especially difficult in rural and depopulating areas 5 . Older people with lower levels of income are more likely to need long-term care than those with higher incomes. Furthermore, persons with disabilities, who represent a large proportion of those in need of long-term care, are also confronted with accessibility challenges.
Long-term care quality standards and their assurance mechanisms are often weak. Many Member States traditionally have a robust set of regulations and standards applicable to residential care. By contrast, such standards are often less well developed for home and community-based care. Even when in place, quality standards are often limited to basic nutrition and hygiene requirements. They do not consider the well-being and quality of life of people receiving care. Furthermore, compliance by all long-term care providers, both public and private, is uneven and many Member States lack appropriate quality assurance mechanisms.
Workforce shortages and non-standard forms of employment are widespread in long-term care. Most Member States report or expect significant numbers of unfilled vacancies, especially for skilled care personnel, such as nurses. Unfilled job positions are particularly high in the sub-sector of services for older people. Attracting and retaining care workers is difficult due to often poor working conditions and low wages, which could be alleviated through social dialogue. However, social dialogue plays a mixed role in long-term care. Only in few Member States are almost all long-term care workers covered by collective agreements. In other Member States, social dialogue is almost absent from the long-term care sector 6 . Another challenge is addressing the specific situation of live-in carers, who are usually mobile or migrant workers 7 , being particularly vulnerable, especially if engaged in undeclared work 8 . Such workers may earn extremely low wages and their working-time arrangements, including adequate rest periods and other working conditions, may be blurry 9 and even not compliant with labour law. Furthermore, the care sector is one of the most gender-segregated sectors. Women make up 90% of the care workforce and gender stereotypes related to care provision are pervasive.
Informal care represents most care provision, but comes with its own costs. Around 52 million Europeans, that is to say 14.4% of the population aged 18 to 74, provide informal long-term care to family members or friends on a weekly basis, accounting for close to 80% of people providing long-term care at EU level 10 . However, caring can be difficult, especially for older carers, affecting their own health and well-being. Informal care also comes with (hidden) costs to the economy and the individual. Informal carers (who are usually women) are more likely to take career breaks, opt for part-time work or withdraw from the labour market, which adds to gender gaps, and labour and skills shortages.
Public expenditure on long-term care is expected to further increase significantly, requiring sustainable financing. It is projected to increase from 1.7% of GDP in 2019 to 2.5% of GDP in 2050, with marked variations across Member States 11 . This projected increase, furthermore, may be largely underestimated. It does not take into account that the current substantial contribution of informal carers, estimated currently at 2.4% of the Union’s GDP 12 ), is unlikely to remain at the same level in future, due to changing family structures and rising female employment. Fiscal sustainability can be improved by ensuring cost-effectiveness of long-term care, for example, through a coherent and integrated governance framework, support for independent living and better targeting of long-term care to personal needs to make sure, for example, that people with low care needs are not being cared for in more expensive settings for severe needs. Furthermore, more ambitious actions on health promotion and disease prevention are needed to ensure that people remain in good mental and physical health, that a strong workforce is ensured and that health care systems remain sustainable and resilient.
In many Member States, long-term care provision is often fragmented, being organised in a complex system of services across healthcare and social care and other types of support, and subject to a national, regional or local distribution of responsibilities. This contributes to differences in the availability and quality of long-term care services and reduces cost-effectiveness. Indicators for monitoring long-term care vary and administrative data tends to be fragmented at national level and is often not available or comparable at the Union level. This hampers efficiency and limits also the possibility for effective monitoring and mutual learning. Long-term care involves a variety of players, including those in need of long-term care, their family members and organisations representing them, relevant authorities (national, regional, local), social partners, civil society organisations, social economy organisations, long-term care providers, and bodies responsible for promoting social inclusion and integration and protection of fundamental rights, including national equality bodies. Sound policy governance is needed to ensure that all the available resources are well targeted, including by collecting evidence, conducting a mapping of available infrastructure and services, individual needs assessment and gap analysis, while taking into account territorial inequalities and demographic challenges.
The European Pillar of Social Rights Action Plan 13 announced an initiative in 2022 on long-term care. In the 2021 State of the Union speech , the President of the European Commission, Ursula von der Leyen, announced a new European Care Strategy to support men and women in finding the best care and the best life balance for them. The present proposal for a Council recommendation aims to support Member States in their efforts to improve access to affordable high-quality long-term care. It will provide guidelines on the direction of reforms to address the shared challenges of affordability, availability, quality, and the care workforce, and on sound policy governance in long-term care. That will further structure Union cooperation on long-term care, while striving for upward convergence.
• Consistency with existing policy provisions in the policy area
The proposal supports the implementation of the European Pillar of Social Rights 14 , which states, in its Principle 18, that everyone has the right to affordable long-term care services of good quality, in particular home care and community-based services. It also contributes to the implementation of Principle 9 on work-life balance for people with care responsibilities and Principle 17 on the rights of persons with disabilities.
This proposal is a key action under the Commission Communication European care strategy 15 . It contributes to the lifelong approach to care promoted therein and focuses on social protection for long-term care and the enabling conditions for its effective provision
Policy developments and challenges in long-term care are monitored through the European Semester. In past years, several Member States received country-specific recommendations on various aspects of long-term care, including access, quality, affordability, increasing women’s participation in the labour market, and sustainability. The Employment Guidelines call for adequate and inclusive social protection systems. They also state that timely and equal access to affordable long-term care and healthcare services, including prevention and healthcare promotion, is particularly relevant, in light of the COVID-19 crisis and in a context of ageing societies. The 2022 Joint Employment Report highlights the importance of long-term care services to increase the labour market participation of women. It also underscores the fact that population ageing is expected to lead to a great increase in the demand for long-term care. The Report calls on Member States to increase the provision of quality, affordable and sustainable long-term care services.
The proposal is consistent with and builds upon existing social protection policies. In particular, in the context of the Social Open Method of Coordination, Member States have agreed common objectives related to long-term care, as follows:
·to guarantee access for all to adequate health and long-term care and ensure that the need for care does not lead to poverty and financial dependency, address inequities in access to care and in health outcomes;
·to promote quality in health and long-term care and adapt care to the changing needs and preferences of society and individuals, notably by establishing quality standards reflecting best international practice and by strengthening the responsibility of health professionals and of patients and care recipients;
·to ensure that adequate and high-quality health and long-term care remains affordable and sustainable, by promoting healthy and active lifestyles, good human resources for the care sector and a rational use of resources, notably through appropriate incentives for users and providers, good governance, and coordination between care systems and institutions.
The proposed Council recommendation on long-term care addresses key challenges identified in the 2021 Report on long-term care , prepared jointly by the European Commission and the Social Protection Committee. It will therefore deepen the ongoing EU-level cooperation on social protection and, more specifically, on long-term care, by establishing a shared understanding on the direction of the reforms.
While there are no previous EU legislative initiatives specifically focusing on long-term care, some are of relevance to long-term care and thus complement the proposal. The Work-Life Balance Directive 16 introduces the possibility for the employed to use a carers’ leave and promotes flexible forms of employment, which are of relevance to informal carers of working age. The current proposal refers in the recitals to the Directive as being relevant EU law.
The Commission proposal 17 to revise Regulation (EC) No 883/2004 of the European Parliament and of the Council 18 aims to bring legal clarity and transparency regarding access to long-term care benefits when residing in another Member State. The proposal for a Council recommendation on long-term care does not as such address the free movement of people in need of long-term care or the transferability of long-term care benefits. Rather, it focuses on the coverage of long-term care by national social protection in general and on the key enabling conditions for its effective functioning, i.e. the existence of appropriate and high-quality, long-term care services and carers.
This proposal is consistent with and without prejudice to Union law on working conditions as far as it applies to long-term care workers.
The European accessibility act 19 aims to improve the functioning of the single market for accessible products and services. It covers products and services that have been identified as being most important for persons with disabilities while being most likely to have diverging accessibility requirements across EU countries. Furthermore, the Web Accessibility Directive 20 already requires websites and mobile applications of public sector bodies, including information, online contact and applications forms, to be accessible to users, in particular persons with disabilities. This proposal calls on Member States to ensure that long-term care information, services and facilities are accessible to persons with disabilities.
• Consistency with other Union policies
The proposal follows up the debate launched under the Green Paper on Ageing . This highlighted the need for an integrated approach to long-term care that is accessible, affordable and of high quality, that is centred around the care recipient’s needs, and that aims at supporting every individual’s independence as long as possible. Respondents considered focusing on increasing the provision of home- and community-based care as key to enable ‘ageing-in-place’. Such person-centred care services were said to be best created through co-development with all stakeholders. In addition, new technologies and digital solutions were said to improve care delivery, in particular in rural and remote areas.
The proposal has close links with the Strategy for the Rights of Persons with Disabilities , as there is a strong correlation between disability and the need for long-term care. There are also links with the European Skills Agenda , which contributes to upskilling and reskilling across the Union, including in the long-term care sector. There are also links with the New Pact on Migration and Asylum , notably the Skills and Talent package , which includes a focus on attracting workers for the long-term care sector.
The proposal is also of relevance for the Gender Equality Strategy , as most caregivers and people in need of long-term care are women. The strategy frames the European Commission’s work on gender equality. The key objectives are among other things challenging gender stereotypes, addressing the gender pay and pension gaps and closing the gender care gap. The proposal is complementary to policies promoting work-life balance, as access to long-term care and affordable quality long-term care is seen as one of the tools to help reconcile work and family life. The Work-Life Balance Communication acknowledged the need to provide access to affordable, good quality, formal care services across the EU to remove obstacles to employment, especially for women.
Social economy bodies, including cooperatives, mutual benefits societies, associations and foundations, and social enterprises are major partners for public authorities in the provision of long-term care. The proposal, therefore, has connections with the Social Economy Action Plan . It can help boost the care economy and improve working conditions in the care sector, thereby helping to address the challenges of social economy players as well.
The proposal complements EU initiatives in the area of health prevention. In particular, it builds on the Healthier Together initiative and Europe’s Beating Cancer Plan , which address the prevention, treatment and care of non-communicable diseases. One of the pillars of the Cancer Plan addresses the quality of life for patients and survivors and has several actions to ensure that they live long, fulfilling lives.
This proposal also supports the green and digital transitions, as it promotes the use of digital technologies in long-term care and compliance of long-term care provision with environmental and energy-saving requirements. Thus, it is also aligned with the EU Communication on Enabling the Digital transformation of Health and Care in the Digital Single Market ; empowering citizens and building a healthier society.
The proposal also responds to the Conference on the Future of Europe proposal on demographic transition (proposal No. 15). This calls for appropriate care for older people that takes into account the needs of both care receivers and caregivers.
The funding at Union level is available to support investments in accessible, affordable and quality long-term care, in particular in home and community-based care settings, including for older people, persons with disabilities and geographically remote populations and to support to social economy players offering these services. Union funds include the European Regional Development Fund , the European Social Fund plus , including its Employment and Social Innovation strand , the European Agricultural Fund for Rural Development , the Just Transition Fund , Horizon Europe , the Digital Europe Programme , and the Recovery and Resilience Facility for eligible reforms and investments in the context of the recovery from the COVID-19 pandemic. Technical support is available from the Technical Support Instrument . The Union funds have different investment priorities. For example, the European Regional Development Fund has as priority focus supporting non-residential family- and community-based services.
• Legal basis
The proposal will support the Union's aims set out in Article 3 of the Treaty of the Functioning of European Union (TFEU) to promote the well-being of its peoples, the sustainable development of Europe aiming at full employment and social progress, and also to promote social justice and protection, equality between women and men and solidarity between generations. Pursuant to Article 9 TFEU, the Union, in defining and implementing its policies and activities, ‘shall take into account requirements linked to the promotion of a high level of employment, the guarantee of adequate social protection, the fight against social exclusion, and a high level of education, training and protection of human health.’
The proposed Council recommendation is based on Article 292 TFEU in combination with Article 153(1)(k) TFEU, which allows the Union to act with regard to ‘the modernisation of social protection systems’. In this field, the Union can only adopt measures designed to encourage cooperation between Member States.
‘Modernisation’ is commonly understood to refer to the process of adjusting something to updated needs or habits or to recent techniques, methods, or ideas. Recent examples of EU acts explicitly claiming to aim at modernisation appear also to understand the concept in this way 21 . The proposed recommendation will promote the modernisation of social protection systems by using innovative approaches and actions to improve coverage, adequacy and quality of long-term care in order to face the needs in a rapidly ageing society, while taking into account budgetary constraints and ensuring the overall sustainability of public finances.
The proposal focuses on social protection for long-term care for all population groups, irrespective of their current or former employment status and their presence or not on the labour market. Furthermore, the proposal also addresses the key enabling conditions for the effective functioning of social protection for long-term care, including services, the workforce and policy governance.
• Subsidiarity (for non-exclusive competence)
While long-term care falls under the responsibility of Member States, the Union has the competence to support and complement their actions. The proposal ensures the added value of action at EU level. It will uphold a political commitment to ensure access to affordable, high-quality, long-term care set out in the European Pillar of Social Rights .
The COVID-19 pandemic especially highlighted the need for a dedicated EU-level instrument to support Member States in addressing the structural challenges of their long-term care systems. The recommendation will provide guidance and set key principles for improving national long-term care systems, which will also help to better target the significant EU funding and improve the quality of investments. Progress in this area across the EU will help to ensure that, no matter where one lives in the EU, one has access to affordable, high-quality, long-term care. It will also contribute to enhancing upward convergence for robust social protection systems and for formal long-term care that is accessible, affordable and of quality. It will contribute to upholding the key values of safeguarding human rights, reducing inequalities, and strengthening social cohesion.
• Proportionality
The proposal complements Member State efforts on long-term care. It respects Member State practices and the diversity of systems. It recognises that different national, regional or local situations could lead to differences in how the recommendation is implemented. The proposal does not propose any extension of EU regulatory power or binding commitments on Member States. Member States will decide, according to their national circumstances, how they can make best use of the Council recommendation. Proportionality also played a key role in guiding the choice of the instrument.
• Choice of the instrument
The instrument is a proposal for a Council recommendation, which abides by the principles of subsidiarity and proportionality. It builds on the existing body of the Union law and conforms with the type of instruments available for EU actions in the area of social policy. As a legal instrument, the proposal for a Council recommendation signals the commitment of Member States to the measures laid down in this recommendation and provides a strong political basis for cooperation at Union level in long-term care, while fully respecting the remit of Member States.
• Ex post evaluations/fitness checks of existing legislation
Not applicable.
• Stakeholder consultations
The call for evidence on the European care strategy was published on the Have your say web page and was open for public feedback from 1 to 29 March 2022. The Commission received 123 contributions, most from NGOs (64). The most recurrent topics raised during the consultations were access to and availability of care services, social protection and affordability of care services, quality of care services, care workers and informal carers, socio-economic and territorial inequalities, gender dimension, active and healthy ageing and prevention policies, financing of care services, governance/coordination aspects, potential of digitalisation and innovation for the care sector, and the COVID-19 pandemic and its impact.
The targeted consultations included exploratory debates with the high-level group on gender mainstreaming (28 January 2022) and with Member State representatives in both the Social Protection Committee (17 March 2022) and the Employment Committee (1 April 2022). There was also a strategic dialogue with civil society organisations (11 March 2022), a joint hearing of the Committees of the European Parliament on Employment and Social Affairs and Women’s Rights and Gender Equality (24 March 2022) and a dedicated hearing with social partners at Union level (7 April 2022).
The role of robust social protection and its impact on access to and affordability of high-quality long-term care services was highlighted by many respondents, including Member States, social partners and civil society. The importance of person-centred approaches and the need for greater integration between care and healthcare services was highlighted, especially by civil society organisations. Appropriate public funding and investment in care services, including by using all available Union instruments, were deemed crucial to that end. The need to use the Recovery and Resilience Facility for care was echoed by social partners.
Improvement of working conditions in the long-term care sector was a key topic in all consultation events and written contributions. MEPs highlighted underfunding and understaffing in the care sector and its high potential for job creation and innovation. They called for addressing the low unionisation in the sector and highlighted the role of education and training in ensuring qualified workers and professionalisation. Social partners also mentioned the role of social dialogue and the importance of sufficient staffing levels to ensure quality and person-centred delivery. Social partners stressed that migrant workers, domestic workers and people in personal household services should benefit from the same social and labour rights as workers in the mainstream care sector. Member States are aware of worker shortages and some are developing strategies to attract more workers, including men, to the care sector. Several civil society organisations called for a definition of the legal status for informal carers.
Regarding implementation, civil society organisations supported monitoring based on indicators and targets, and called for national action plans for implementation to be developed by Member States. Social partners considered it important to monitor progress in addressing challenges in the long-term care sector by building on European Semester framework arrangements. In the Social Protection Committee (SPC) and Employment Committee (EMCO), Member States also stressed the need to improve the evidence base and supported a continued exchange of good practices. Some Member States shared concerns regarding potentially increased administrative burden and highlighted the importance of consistency and synergies with related policy initiatives at EU and international level. During the exploratory debates with these two committees, several Member States pointed out that the initiative should be developed in full respect of national responsibilities and the principles of subsidiarity and proportionality, also taking into account the different national circumstances and set-up of care systems.
The Commission received contributions or held exchanges of views with the European Economic and Social Committee (EESC) and the Committee of the Regions (CoR):
·The EESC is concerned about the precarious situation of live-in carers, who are often migrant or mobile women, and has made recommendations to improve it, including via regularisation of their situation and supporting their professionalisation 22 . The EESC welcomes the Commission's initiative to establish a new European care strategy and calls for its swift implementation 23 . It urges the European Commission and Member States to develop, in the short term, principles relating to care for older people within the European Pillar of Social Rights Action Plan.
·In July 2021, the CoR adopted an opinion on the Future plan for care workers and care services – local and regional opportunities in the context of a European challenge 24 . The opinion calls on the Commission to publish a European quality framework for long-term care and for an efficient system of comprehensive data collection and analysis.
The European Parliament called on the Commission to present a plan to ensure the mental health, dignity and well-being of people, including older people 25 , and underlined the key role of adequately funded social protection schemes in making care affordable and truly accessible 26 . It also called on Member States to ensure equal access to health and care services and on the Commission to put forward a ‘care deal for Europe’ 27 . In its most recent own initiative report ‘Towards a Common European action on care’ 28 , it called for the Commission to present an ambitious, robust and future-proof European care strategy that builds on everyone’s right to affordable, accessible and high-quality care and the individual rights and needs of both care recipients and carers, and that encompasses the entire life course, targeting and responding to the needs of people at critical periods throughout their lifetime, laying the ground for continuity of care services throughout the lifespan and fostering solidarity between generations.
The Council invited Member States and the Commission to improve the availability of high-quality long-term care and the sustainability and adequacy of social protection systems 29 , to use digitalisation to make health, social and long-term care services easily accessible and user-friendly 30 , and to develop services that provide person-centred and integrated care, including for persons with disabilities 31 .
• Collection and use of expertise
The proposal is underpinned by a Commission staff working document 32 and is based on the most recent relevant studies and reports, including:
· 2021 Long-term care report , jointly prepared by the Social Protection Committee and the European Commission (DG EMPL);
·Estimating the Effects of Social Protection for Long-Term Care in Old Age in Europe, Organisation for Economic Cooperation and Development (OECD) (forthcoming);
· Challenges in long-term care in Europe , European Social Policy Network (2018);
· Mapping long-term care quality practices in the EU , European Social Policy Network (2020);
· Study on exploring the incidence and costs of informal long-term care in the European Union , Ecorys (2021);
· Study on the long-term care supply and market in EU Member States , KPMG (2021);
· www.eurofound.europa.eu/publications/report/2022">COVID-19 and older people: Impact on their lives, support and care , Eurofound (2021);
· www.oecd.org/fr/publications">Who Cares? Attracting and Retaining Care Workers , OECD (2020);
· www.eurofound.europa.eu/publications">Long-term care workforce: employment and working conditions , Eurofound (2021);
· The 2021 Ageing Report: Economic and Budgetary Projections for the EU Member States (2019-2070), European Commission (DG ECFIN), Economic Policy Committee (Ageing Working Group).
• Impact assessment
The proposed instrument offers guidance to Member States on how to improve access to affordable, high-quality, long-term care, allowing Member States the flexibility to design and implement measures according to their national practices. Consequently, no impact assessment is needed. Furthermore, the impact of this recommendation will depend not only on how Member States implement the measures, but also on country-specific circumstances, such as the macroeconomic situation, the design of social protection systems and social services, and the structure and functioning of the labour market. Those circumstances make it difficult to disentangle the specific impact of the proposal from other factors. The proposal is accompanied by a staff working document, which takes stock of the long-term care challenges and explores possible avenues for action.
• Regulatory fitness and simplification
Not applicable.
• Fundamental rights
This recommendation respects the fundamental rights and observes the principles recognised by the Charter of Fundamental Rights of the European Union . In particular, this recommendation respects the principle of non-discrimination (Article 21 of the Charter) and contributes to safeguard the rights of the child (Article 24 of the Charter), the rights of the elderly to lead a life of dignity and independence and to participate in social and cultural life (Article 25 of the Charter), the right of persons with disabilities to benefit from measures designed to ensure their independence, social and occupational integration and participation in the life of the community (Article 26 of the Charter), the right of a family to enjoy legal, economic and social protection (Article 33 of the Charter), and the entitlement to social security benefits and social services providing protection in cases such as maternity, illness, industrial accidents, dependency or old age, and in the case of loss of employment, in accordance with the rules laid down by Union law and national laws and practices (Article 34 of the Charter).
This proposal has no financial implications for the Union budget.
• Implementation plans and monitoring, evaluation and reporting arrangements
It is proposed that the Commission monitors the implementation of this recommendation in the context of the European Semester and with the Social Protection Committee and the Employment Committee. Monitoring should be based on national action plans to be submitted to the Commission by Member States within 1 year of the recommendation’s adoption and subsequent progress reports.
The proposal recommends that Member States nominate a national long-term care coordinator, equipped with adequate resources and mandate, who will effectively coordinate and monitor the implementation of this recommendation and act as a contact at Union level. The Commission will work jointly with the long-term care coordinators, the Social Protection Committee and the Employment Committee, as well as all other relevant stakeholders, to facilitate mutual learning, share experiences, and follow up on Member State actions taken to implement this recommendation.
It is proposed that the Commission takes stock of progress regularly with the Social Protection Committee and, where relevant, the Employment Committee, regarding the implementation of this recommendation based on national action plans and progress reports from Member States. The Commission will also engage with the Social Protection Committee to further develop the framework of indicators for long-term care to help monitor the recommendation’s implementation, and prepare joint reports to analyse common long-term care challenges.
Finally, after an initial period of its implementation, the Commission will take stock of progress made and report to the Council within 5 years after the adoption.
• Explanatory documents (for directives)
Not applicable.
• Detailed explanation of the specific provisions of the proposal
Paragraphs 1-2 define the objective of the recommendation and its personal scope (all people in need of long-term care and their carers) and material scope (all types of long-term care settings).
Paragraph 3 contains definitions that are applied for the purpose of the recommendation, building whenever available on definitions agreed in the context of the Social Protection Committee.
Paragraph 4 recommends that Member States improve the adequacy of their social protection for long-term care, so that long-term care is timely, comprehensive, and affordable to those who need it.
Paragraph 5 recommends that Member States increase the offer of long-term care services, while making sure that there is a balanced mix of services in all care settings, including by developing and/or improving home care and community-based care, closing territorial gaps, rolling out accessible innovative technology and digital solutions and ensuring accessibility for persons with disabilities.
Paragraph 6 recommends that Member States ensure that high-quality criteria and standards are established and strictly applied in all long-term care settings, tailored to their characteristics, by all long-term care providers irrespective of their legal status. To this effect, Member States are invited to establish a quality framework for long-term care guided by the quality principles set out in the annex to the recommendation and includes an appropriate quality assurance mecanism.
Paragraphs 7-8 recommend that Member States address skills needs and worker shortages and ensure fair working conditions.
Paragraph 9 recommends that Member States support informal carers, including by training, counselling, psychological support, respite care and financial support.
Paragraph 10 recommends that Member States ensure sound policy governance in long-term care by designating a national long-term care coordinator, involving all relevant stakeholders, increasing consistency with other policy areas, developing its forecasting of long-term care needs, improving contingency planning (e.g. for dealing with pandemics or other external shocks) and data collection, raising awareness, and mobilising available funding, including EU funds, for long-term care reforms.
Paragraph 11 recommmends that Member States prepare and submit to the Commission a national action plan presenting measures to implement this Recommendation, taking into account national, regional and local circumstances and, subsequently, regular progress reports.
Paragraph 12 sets out how the Commission intends to support the implementation of this recommendation, including by mobilising EU funding, monitoring progress in the context of the European Semester and with the Social Protection Committee and the Employment Committee, establishing a framework of indicators for monitoring, facilitating mutual exchanges, and reporting to the Council on progress within 5 years of the adoption.