Robert Anderson

EUROFOUND, Dublin

Employment in home care services

Human resources for care

• EU Green Paper on the European Workforce for Health (and social care)

• Formal providers + Informal carers – should be coordinated and mutually supportive – high commitment to care

• Dominance of family and informal care in most Member States, e.g. EU – 80% of care hours are provided by informal care

But concerns (e.g. in 2009 Communication on Alzheimer’sDisease) about shortages of carers, lack of support for informalcarers, and risk of social exclusion for carers.

Care workers in the EU policy debate

• Role and contribution of home carers begins to be visible

• Recruiting and retaining an adequately qualified and skilled care workforce

• Training and social protection and reconciliation of work with life

• Sustainability and quality of the care workforce (Commissions in Finland, NRW)

Comparative data on home care workersDifficult exercise because:• Variable definitions of which professions work in LTC and job

categories vary between countries• Systems cover health and social care• Inclusion of non-formal/paid workersAvailable international data on:• Budgets/expenditure on long-term care• Numbers of paid care workers• Some characteristics of the paid workforce and their working

conditions• Users of care services• Quality and affordability of care services

Economic and employment significance of workers in long-term care

OECD 2006 estimates of LTC workers

Formal Informal Family assistance

Italy 125,000 4m 800,000

Netherlands 100,000 1.2m Not known

Spain 11,000 2.7m 500,000

Projections:

OECD LTC expenditure: 1% of GDP in 2005 to 2%-4% by 2050

EU population aged 80+: 5% in 2010 to 8% in 2030 to 12% in 2050

European Commission estimates: Shortage of 2m LTC workers by 2020

Working conditions in home care: example of Belgium (Proxima project) 2006

1000+ workers completed written questionnaire:• 99% women, among whom 38% report experience of sexual

harassment• 14% report worked in unhygienic houses• 52% report regular physical health problems, especially

backache• Most are satisfied with their job and level of managerial

support; enjoy wide variety of tasks in their job and working time flexibility

• Criticise low societal recognition and low pay

Characteristics of paid care work

• Predominantly undervalued; low prestige• Mainly done by women• Poor visibility of the sector• Not regarded as high skill• Low pay although above average for low-skilled• Lack of career prospects• High staff turnover; part-time and atypical contracts• Tasks often intimate attention to personal needs

Measures to improve image and attractiveness of care work

• Promote public debate on societal significance of care; job recognition

• Emphasise meaningful work and job enrichment• Enable flexible employment and work-life balance• Opportunities to gain qualifications through training• Promote retention, with active ageing policies• Employ technologies to assist carer and dependent

person• Increase rates of pay