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| 3.5.2023 | EN | Official Journal of the European Union | C 157/28 |

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Opinion of the European Committee of the Regions on the European care strategy

(2023/C 157/06)

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| | | | | --- | --- | | Rapporteur: | Heinrich DORNER (AT/PES), Member of the State Government of Burgenland | | Reference document: | Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions on the European care strategy COM(2022) 440 final | |

POLICY RECOMMENDATIONS

THE EUROPEAN COMMITTEE OF THE REGIONS (CoR),

Policy priorities

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| | 1. | recognises the need for high-quality care services in the field of early childhood education and care so that children can develop their cognitive, language and physical abilities and skills, maintain a healthy and active lifestyle and avoid poverty and social exclusion, as well as in the field of long-term care to help older people and/or people with disabilities maintain their autonomy and their dignity. They are also a way of addressing demographic change and the exponentially increasing demand for care services. Intervening at an early stage, promoting health and preventing disease can help people lead independent, healthy and active lives for longer and delay the need for care; |

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| | 2. | thinks that high-quality care services must be affordable, accessible and available in order to meet the ever-increasing demand for early childhood education and care and to enable older people and/or people with disabilities to live independently, while at the same time supporting and easing the burden on their families; |

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| | 3. | observes that care workers are not always properly appreciated, which in some areas is often reflected in low pay, low educational attainment, little prospect of career progression, a lack of training opportunities, a lack of psychological support and care, and sometimes job insecurity; |

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| | 4. | stresses that women are disproportionately affected by the lack of care services, as they still carry out the lion’s share of additional or informal care responsibilities, affecting their ability to balance work and private life and take up paid work. Women make up 90 % of formal care workers, with jobs still all too often poorly paid and insecure. In the EU, 92 % of women carry out unpaid care work regularly, i.e. more than one day a week, and 81 % do so daily. Moreover, 7,7 million women in Europe are not gainfully employed due to care responsibilities [(1)](#ntr1-C_2023157EN.01002801-E0001); |

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| | 5. | notes that care systems in many countries were able to adapt quickly and to continue providing good care during the COVID-19 crisis. At the same time, the pandemic revealed a certain lack of resilience in care systems, and the CoR stresses that both jobs and continuity of care can be safeguarded by establishing crisis-resilient employer structures, particularly with regard to ownership structures and use of the profits generated; |

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| | 6. | draws attention to the Europe-wide shortage of skilled care workers and its far-reaching social impact, particularly in areas affected by depopulation or regions lagging behind, where care for older and dependent people is less accessible, the enormous potential of the care sector for the labour market and, in this connection, the fact that there will potentially be 8 million jobs available in the health and social care sector over the next decade [(2)](#ntr2-C_2023157EN.01002801-E0002); |

Principles

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| | 7. | acknowledges principle 9 of the European Pillar of Social Rights, which includes the right of parents and people with caring responsibilities to suitable leave, flexible working arrangements and access to care services; |

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| | 8. | acknowledges principle 11 of the European Pillar of Social Rights, which includes children’s right to affordable early childhood education and care of good quality; |

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| | 9. | is committed to principle 17 of the European Pillar of Social Rights and the right enshrined therein to inclusion for people with disabilities and their right to income support, a work environment adapted to their needs, and services that enable them to participate in the labour market and in society; |

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| | 10. | acknowledges principle 18 of the European Pillar of Social Rights, which includes the right to affordable long-term care services of good quality, in particular home-care and community-based services; |

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| | 11. | acknowledges the EU Charter of Fundamental Rights, which lays down older people’s right to live independently and with dignity and to take part in social and cultural life; |

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| | 12. | acknowledges the EU Charter of Fundamental Rights [(3)](#ntr3-C_2023157EN.01002801-E0003), which lays down 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; |

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| | 13. | calls on the EU Member States, that have not yet done so to ratify and implement the relevant ILO conventions, particularly No. 189 concerning decent work for domestic workers, No. 190 on violence and harassment in the world of work and No. 149 on nursing personnel; |

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| | 14. | supports the UN Convention on the Rights of Persons with Disabilities and the obligation enshrined therein to promote the training of professionals and staff working with persons with disabilities in the rights recognised in the Convention so as to better provide the assistance and services guaranteed by those rights; |

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| | 15. | is committed to Article 19 of the UN Convention on the Rights of Persons with Disabilities and the right enshrined therein for persons with disabilities to have access to a range of in-home, residential and other services to support their way of life and inclusion in the community; |

General observations

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| | 16. | is pleased that the Commission Communication on the European care strategy also refers to issues identified in a previous CoR own-initiative opinion [(4)](#ntr4-C_2023157EN.01002801-E0004) on care and partly addresses the solutions proposed therein, such as the establishment of an efficient system of comprehensive data collection and analysis; signals an urgent need to activate an interoperability system between sectors (in particular between the health and social sectors); |

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| | 17. | stresses the need for a joint strategy shared by all EU local and regional authorities responsible for health, care and education, and Member States, as well as the EU institutions, to provide accessible long-term care that meets the needs of both people in need of care and care workers, and to ensure high-quality, affordable and accessible childcare throughout the EU. This strategy must therefore also be integrated into the European Semester process. In accordance with the principle of subsidiarity, such a strategy must start from the principle that care and early childhood education are organised differently in different Member States; |

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| | 18. | considers the European care strategy to be an important and positive first step towards achieving the European Pillar of Social Rights and improving the care system in Europe, with the potential to help improve long-term care and early childhood education and to boost gender equality and social fairness in care systems; |

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| | 19. | recognises that social services such as early childhood education and care and long-term care are part of an important economic sector that meets care needs, creates jobs, helps reduce healthcare costs and thus has multiple benefits for society; |

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| | 20. | welcomes the Commission’s proposals to coordinate and take joint action on matters of long-term care and childcare, with supportive measures (such as drawing up joint analyses, exchanging best practices and supporting reforms and investments using EU funds) at EU level and policy frameworks for reforms and investments at national, regional and local level, in line with the principle of subsidiarity. The CoR also calls on the Commission to guide public investments in long term care services in the use of the EU’s programmes and financial instruments; complementarity between the EU funds of the various programmes is also becoming necessary, in order to ensure maximum impact; |

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| | 21. | considers that complementary to the green taxonomy as a contribution to the implementation of the Green Deal, the Commission should urgently make a proposal to establish a social taxonomy. A social taxonomy would provide potential investors and enterprises with a clear guidance as to what can be understood as ‘social investment’. The absence of a social taxonomy currently impedes possible private investments into healthcare and social services; |

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| | 22. | stresses that under the Recovery and Resilience Facility (RRF), 33 % of the social expenditure planned in the 25 National RRPs endorsed by the Commission and approved by the Council so far is dedicated to health and long-term care (around EUR 45 billion), another 33 % to education and childcare (EUR 45,7 billion), and 14 % to social policies (EUR 19,7 billion); |

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| | 23. | considers the creation of affordable, more accessible, available and high-quality care services to be an important step towards ensuring women’s participation in the labour market and thus gender equality; it is important to carry out analyses of existing services, identify complementarities, and reduce overlap or duplication in order to direct resources and boost the added value of multiprofessionalism; |

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| | 24. | stresses the importance of local and regional SMEs and non-profit organisations as care service providers. Points out to this effect that the local and regional markets for care services should allow for SMEs and non-profit organisations to compete with larger service providers on equal terms. EU institutions, Member States and LRAs should work to empower the multitude of service providers and foster well-functioning local and regional markets on care services. Within the framework of socially responsible public procurement, the Committee calls on LRAs to consider, in their capacity as public buyers, the local/regional social impact of how the services are produced, sourced and delivered; |

Observations on early childhood education and care

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| | 25. | thinks that the proposed revision of the Barcelona targets will be useful in extending access to childcare even further and that it complements the Council Recommendation establishing a European Child Guarantee [(5)](#ntr5-C_2023157EN.01002801-E0005). With regard to children’s future prospects, it is in their best interest to encourage their participation in early childhood education and care in order to promote social inclusion; |

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| | 26. | believes that including the time-intensity of participation in early childhood education and care when assessing the progress of early childhood education and care provision in the Member States is a useful addition as it enables a more accurate assessment of each Member State’s progress; |

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| | 27. | recognises how important the working conditions, prestige and pay of workers, as well as their continuous vocational training and education in the early childhood education and care sector are in ensuring that care is as good as possible and provided by qualified staff and thus in achieving better development outcomes for all children; |

Observations on long-term care

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| | 28. | stresses that the attractiveness of care professions is inextricably linked to better working conditions, adequate wages, education, vocational training, and upskilling and reskilling opportunities; in this regard, welcomes the fact that 2023 will be the European Year of Skills; |

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| | 29. | recognises the importance of strong employee representation both in the continuous improvement of working conditions in the care sector and in social dialogue as a fundamental component of the European social model. Welcomes in this context that the European Commission has announced in January 2023 the setting up of a new sectoral social dialogue for social services at EU level, including the sub-sector of care services, in which the representation of local and regional authorities in their capacity of public sector employers will also be guaranteed; |

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| | 30. | welcomes the quality principles for all long-term care providers set out in the proposal for a Council Recommendation on access to affordable and high-quality long-term care and stresses that, in the future, the long-term care sector must not revolve around achieving profits but around regularly investing in quality-enhancing measures and highly skilled staff. Against this background, the CoR supports the European Parliament call on the Commission to present a framework directive on long-term, formal and informal, care that would lay down fundamental principles and provide evidence-based criteria for accessible and integrated quality long-term care and support services across the EU [(6)](#ntr6-C_2023157EN.01002801-E0006); |

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| | 31. | stresses that, in relation to the call made on Member States to develop a quality framework for long-term care services (paragraph 6 of the respective Council Recommendation [(7)](#ntr7-C_2023157EN.01002801-E0007)), systems to secure the quality of care already often already exist at national or regional level and should therefore be duly considered, also in view of meeting the principles of subsidiarity and proportionality; |

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| | 32. | believes that investment in care is part of a comprehensive approach that not only pursues social policy objectives, but also sees such investment as a positive economic incentive; |

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| | 33. | draws attention to the importance of paying special attention to the psychological training of those providing care services; |

Recommendations for early childhood education and care

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| | 34. | encourages standardised data collection at local and regional level and sustaining mutual learning practices to provide a basis for targeted support for regions, enable comparisons to be made across Europe at local and regional level and support national and regional authorities through indicators used to monitor the quality of childcare; |

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| | 35. | recommends increasing and expanding financial support for the establishment and maintenance or modernisation of childcare facilities in order to address the different speeds at which EU regions and cities are developing; |

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| | 36. | recommends expanding the range of personalised services available to include those that are most in demand and that facilitate independent living, such as personal assistance and home help; |

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| | 37. | believes that improving working conditions and prestige, and ensuring adequate pay, for early childhood education and care staff is an integral part of the implementation of the care strategy; |

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| | 38. | underlines the importance of closing gaps between the end of adequately paid or compensated maternity, paternity or parental leave and the start of early childhood education and care; to that end, recommends that Member States consider introducing a legal entitlement to early childhood education and care; |

Recommendations for long-term care

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| | 39. | suggests considering whether there is a need for binding instruments and/or legislation and, accordingly, for increased cohesion funding to ensure universal, equal and effective access to high-quality care services for all people in need across Europe and to provide decent and healthy working conditions, professional support and decent wages for all care workers, safeguard high-quality jobs and make working in the care sector more attractive, reflecting the social and societal value of their work; |

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| | 40. | recommends increasing and expanding financial support for the establishment and maintenance or modernisation of eldercare facilities in order to address the different speeds at which EU regions and cities are developing; |

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| | 41. | recommends drawing up a comprehensive strategy on the future demand for skilled workers in the EU, particularly with a view to reducing brain drain in the bloc to a level that is manageable for the regions concerned, and laying down uniform conditions for the work of care workers and domestic workers from third countries; |

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| | 42. | suggests setting targets and indicators similar to the Barcelona targets in the field of long-term care too and accordingly collecting data at local and regional level to provide a basis for targeted support for regions and enable comparisons across Europe at local and regional level; |

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| | 43. | advocates the appointment of national long-term care coordinators or, depending on national circumstances, another suitable coordination mechanism to serve as a single point of contact to support the implementation of measures; |

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| | 44. | considers it important to recognise the role that local and regional authorities play in active ageing in other areas of life, such as social inclusion, belonging to a community, and access to culture, education and housing; building on the Partnership on Active and Healthy Ageing, it is important to strengthen local and regional ecosystems that ensure input from all key policies and sectors; |

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| | 45. | calls for a Europe-wide campaign to make care professions more attractive and achieve a gender balance in the relevant occupational sectors. |

Brussels, 9 February 2023.

The President of the European Committee of the Regions

Vasco ALVES CORDEIRO

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[(1)](#ntc1-C_2023157EN.01002801-E0001)  COM(2022) 440 final.

[(2)](#ntc2-C_2023157EN.01002801-E0002)  COM(2021) 50 final.

[(3)](#ntc3-C_2023157EN.01002801-E0003)  Charter of Fundamental Rights of the European Union ([OJ C 202, 7.6.2016, p. 389](http://publications.europa.eu/resource/oj/JOC_2016_202_R_TOC)).

[(4)](#ntc4-C_2023157EN.01002801-E0004)  CoR opinion on a Future plan for care workers and care services — local and regional opportunities in the context of a European challenge ([OJ C 440, 29.10.2021, p. 56](http://publications.europa.eu/resource/oj/JOC_2021_440_R_TOC)).

[(5)](#ntc5-C_2023157EN.01002801-E0005)  Council Recommendation (EU) 2021/1004 of 14 June 2021 establishing a European Child Guarantee ([OJ L 223, 22.6.2021, p. 14](http://publications.europa.eu/resource/oj/JOL_2021_223_R_TOC)).

[(6)](#ntc6-C_2023157EN.01002801-E0006)  European Parliament resolution of 5 July 2022 towards a common European action on care (2021/2253(INI)) ([OJ C 47, 7.2.2023, p. 30](http://publications.europa.eu/resource/oj/JOC_2023_047_R_TOC)), point 61.

[(7)](#ntc7-C_2023157EN.01002801-E0007)  Council Recommendation of 8 December 2022 on access to affordable high-quality long-term care ([OJ C 476, 15.12.2022, p. 1](http://publications.europa.eu/resource/oj/JOC_2022_476_R_TOC)).

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