Opinion of the Economic and Social Committee on "Hospice work - an example of voluntary activities in Europe"

(2002/C 125/07)

On 26 April 2001 the Economic and Social Committee, acting under Rule 26 of its Rules of Procedure, decided to instruct the Section for Employment, Social Affairs and Citizenship to draw up an information report on "Hospice work - an example of voluntary activities in Europe".

At the last plenary session on 20 and 21 February 2002, it was decided to transform the information report into an own-initiative opinion (Rule 23(3) of the Rules of Procedure).

The Section for Employment, Social Affairs and Citizenship, which was responsible for preparing the Committee's work on the subject, adopted its opinion unanimously on 27 February 2002. The rapporteur was Mrs zu Eulenburg.

At its 389th Plenary Session on 20 and 21 March 2002 (meeting of 20 March), the Economic and Social Committee adopted the following opinion by 80 votes to one, with three abstentions.

Preamble

Action and commitment by citizens are an essential part of political and social life and the basis of the Member States' system of organisation and values. For private individuals participation and involvement mean taking part in cultural, social and political life. Society is shaped and developed by voluntary involvement in intermediary organisations (action groups, societies, interest groups, trade unions, political parties). When ordinary people make a commitment to the common good, they create social cohesion and put flesh on the bones of democracy.

Voluntary activity is a higher form of citizen involvement and is based on a firm and steady determination to do something for the common good because we are all responsible for everyone.

This firm and steady determination to do something for the common good is based on a humanistic view of society and on the awareness that we all belong to the same "solidum", in which joint responsibility requires voluntary participation and high-minded action.

So, this commitment does not correspond to a mere feeling or a mood, but presupposes a degree of magnanimity and personal devotion, which gives honorary activities their essential aspect of being voluntary and gratuitous, without which there would be a danger of people blindly counting their "cost" simply on the basis of their "monetary value".

People have to be encouraged to extend their commitment. More commitment and individual responsibility will be possible only in a state whose actions are guided by the principle of subsidiarity and which takes its role as guardian and guarantor seriously. The state must create the conditions for ordinary citizens to play their part.

Civic involvement of the type described here is generally on an unpaid, voluntary basis. It extends to all areas of the life of society.

The discussion below does not aim to given a complete account of all areas of voluntary activity in the Member States. Rather, the purpose is to bring to light the roots and motives of voluntary work in general and to highlight the enormous importance of individual commitment for the social and political development of the Member States and the Community. The opinion focuses on hospice work as an example of voluntary commitment, in order to illustrate the kind of work volunteers do and the conditions necessary for this. Finally, on the basis of this specific illustration and of experience drawn from different countries, conclusions are drawn from the opinion's findings.

1. Voluntary work in Europe

1.1. International Year of Volunteers 2001

1.1.1. The Universal Declaration on Volunteering describes voluntary work as a fundamental building block of civil society. According to the declaration the right of all people to assemble freely and exercise their responsibilities is a basic principle of democracy, enabling people to engage in the pursuit of peace, freedom, safety, justice and personal learning and growth.

1.1.2. Voluntary work is performed by individuals - often far from the public gaze - or through groups, societies and associations. The civil-society organisations which make these voluntary activities possible and support them play an important role in society.

1.1.3. The Economic and Social Committee is the representative of civil society organisations in Europe. Within its ranks are representatives of many associations and organisations for which, on both a personal and an institutional level, voluntary commitment is an integral part of their work. For the Economic and Social Committee the International Year of Volunteers is an important and appropriate opportunity to stress the significance of voluntary work for the development of a social Europe.

1.2. Voluntary work as a component of European civil society

1.2.1. Voluntary work is a major force in shaping social solidarity and participative democracy. It is unpaid, creative, entailing commitment and personal involvement. It bears witness to man's strength and to his will to shape his own environment and to act on his own responsibility for the general good.

1.2.2. In undertaking voluntary work and serving the common good, volunteers' horizons extend beyond themselves, their families and their jobs. They are more than just workers, parents, consumers and/or voters. Volunteers embody in the truest sense the threefold role of professional, citizen and human being. Civil society, in which people are to take on more responsibility for themselves and others, is rightly much talked about today.

1.2.3. Working together with others - as well as individual commitment - form a counterweight to an increasingly self-centred society. They also counterbalance the tendency to reduce social, human and cultural issues to market economics.

1.2.4. Voluntary work in the Member States extends to all areas of society, from political involvement (political parties, trade unions, action groups, etc.) via sport and culture, social involvement (young people, family, women's issues, marginal groups) to disaster and emergency relief work.

1.2.5. Voluntary work is the ideal environment for the expression of attachment to one's fellow man, values and a sense of responsibility to oneself and to others. There are a variety of underlying motives, such as:

- the need for company and human contact;

- the need to do something worthwhile and organise one's own life;

- the wish to right a personally experienced wrong;

- a decision to take on social responsibility;

- the need for social recognition or the need to acquire and maintain personal skills;

- the need for help with solving one's own problems and

- religious or humanitarian motives.

1.2.6. The traditional image of "helping out" (implying availability, willingness to make sacrifices, commitment) is just as important as an understanding of voluntary work geared more to personal development, involving modest, manageable tasks, limited in time, options and the ability to choose one's area of involvement.

1.2.7. Increasing individualisation and personal mobility and the proliferation of lifestyles contribute to the increasing breakdown of traditional social environments for which there are no durable substitutes. As a result people often do not find their place in the group, they do not feel involved and needed and they do not commit themselves despite an underlying willingness to do so. There are however signs that organisations and bodies are beginning to open themselves up and that local authorities and government bodies are setting up structures to bring people interested in doing voluntary work together with providers of social and community services. Examples of this are voluntary work agencies, forums, exchanges, citizens' advice bureaux etc. Voluntary work on a temporary basis requires the institutional backup of associations and societies. It has to be organised and coordinated. Structures created in this way make it possible to take account of personal interests and needs as well as of the demands of the work.

1.2.8. Voluntary work requires encouragement and support structures. Government bodies at transnational, national and regional level, local authorities, industry and associations can ensure the maintenance and development of social capital by ongoing investment (see the ESC opinions on Cooperation with charitable associations as economic and social partners in the field of social welfare(1)) and private not-for-profit social services in the context of services of general interest in Europe(2). Firms and associations prove themselves to be good citizens and social players through "corporate citizenship" and by supporting employees who make a personal and financial commitment (e.g. by giving them time off or through top-up donations). Voluntary work is thus a link between government, market and society.

1.2.9. Voluntary work has a quality of its own. Volunteers can set about their tasks spontaneously, passionately, with little "red tape". Budgeting for their own time and providing a broad range of skills, they can be used in a great variety of ways.

1.3. The importance of social voluntary work

1.3.1. Voluntary work in social services, institutions and action groups makes a special contribution to social cohesion. It is geared directly to people in a particular situation and makes it possible to integrate them into society.

1.3.2. The opinion shows how social voluntary work can develop and how it can shape and change political conditions, using the hospice movement as an example. A short introduction is therefore needed to the variety of social voluntary work and to its political dimension.

1.3.3. Social voluntary work provides society with an insight into the problems of disadvantaged and marginalised groups, and highlights society's responsibility for them, at the same time as frequently providing these people with a bridge to the everyday life of society. In working for these people's interests citizens become their advocates and ensure that their needs and aspirations are aired in the world of politics and in society. Voluntary work can prevent these people experiencing society almost exclusively in terms of professional care systems.

1.3.4. Social voluntary work embraces participation in established societies, associations, organisations and projects. Often volunteers are the driving force behind new activities.

Volunteers are for example involved in:

- support groups for immigrants and asylum seekers aimed at alleviating problems of racism;

- activities aimed at promoting the social integration of disadvantaged, sick, disabled or marginalised groups such as, for example, prisoners, drug addicts, the elderly, the sick, those in need of nursing care, the terminally ill, children and families;

- poverty relief projects aimed at alleviating the consequences of social and economic imbalances;

- self-help groups;

- youth work, schools, kindergartens and school exchange programmes etc.

Volunteers also make a major contribution to general social activities geared to the common good (e.g. volunteer fire brigades, rescue and emergency services) or to the hospice movement, where they work for a more humane approach to the seriously or terminally ill and the bereaved.

1.3.5. Without voluntary work many health and social initiatives would be unthinkable. It is often personal commitment and the willingness to offer help where it is needed that has made it possible to provide new forms of social assistance and support. Although the range of voluntary work is greater today, and although many innovative measures being developed in all European countries deserve more detailed treatment and broader public acknowledgement, this opinion will concentrate mainly on one aspect: the hospice movement. This movement is of exemplary importance to the extent that work in this area deals with the basic issues of human existence, such as our attitude to death. Moreover, it is a new, very new field which has influenced the actions of the Member States in relation to their social security arrangements.

2. The example of hospice work

2.1. General

2.1.1. The driving force behind the hospice movement

The hospice movement is not the result of government planning or initiatives. Hospices exist thanks to the voluntary commitment of family members and friends of the terminally ill, as well as of individuals with a professional interest, whose commitment often went far beyond the purely professional. These individuals who were unwilling to tolerate shortcomings in the treatment and care of the dying started to work for a more humane approach. Death, dying and grief are not to be hidden, but rather brought to people's attention as part of life. This means creating a space in which the dying can live and feel part of life.

2.1.2. Tenets of the hospice movement

2.1.2.1. Underlying the hospice movement is a concern for the terminally ill and their relatives. Through a holistic approach the seriously and terminally ill are acknowledged and accepted in physical, psychological, socio-economic and spiritual terms.

2.1.2.2. The hospice movement is based on the following basic tenets:

- Hospices should be open to all the terminally ill and their relatives, regardless of social or financial status, cultural or religious affiliation.

- The hospice concept is based on an image of humanity which has the sanctity of human life as its centre point.

- The action arising from these beliefs can take place anywhere where there are people who take the needs of the dying and their personal integrity and autonomy seriously. However, it has to be realised that no counselling or holistic care can take away the suffering inherent in death and dying.

2.1.2.3. There is a social impetus behind the hospice movement.

- People should be encouraged to come to terms with life, dying, death and grief, and dying and death should become an integral part of life and be brought to people's attention.

- People from different walks of life who are willing to engage in voluntary work should be encouraged and empowered to assist the dying.

- Voluntary work is an integral part of support for the dying. It assists and complements the work of hospital in- and outpatient departments, old people's and nursing homes, doctors and spiritual counsellors.

- The existing institutions for the care and support of the elderly should be encouraged to rethink their approaches to support for the dying and, where necessary, to develop new ideas.

2.1.3. Hospice tasks

2.1.3.1. Hospices, whether catering for inpatients or outpatients or a combination of both, provide a wide range of services. Some of the main tasks are:

- psycho-social counselling and care of the seriously ill and dying (e.g. support with psychological problems, helping individuals take stock of their lives, helping overcome crises, relieving the pressure on those close to the dying, assistance with everyday tasks);

- advice (e.g. on social issues, care, putting affairs in order);

- provision of palliative assistance up to and including comprehensive palliative care;

- therapy; spiritual counselling;

- round-the-clock availability of support;

- counselling for the bereaved and relatives;

- intensive preparation, support and further training of volunteers and professionals;

- educational and publicity work;

- fund raising from donations and sponsorship.

2.1.3.2. All the above tasks are, depending on facilities and staffing, provided by the hospice itself or by third parties. They are necessary for the holistic care of the dying and their relatives.

2.1.4. Hospice networks

Hospice work builds new networks based on (voluntary) civic commitment aimed at improving the quality of the final stage of life. Here the accent is on the physical and emotional, as well as the social and spiritual needs of the individuals concerned and those close to them.

The establishment of such a network requires an interaction of nursing, medical, therapeutic, spiritual and social counselling support, as well as the voluntary contribution, in the framework of a multidisciplinary team.

Networks of this kind need ongoing support from policy-makers and society at large.

2.2. Voluntary hospice work

2.2.1. The basic concept

2.2.1.1. The contribution of volunteers is an essential feature of hospices. Volunteer workers help, care for and support the dying. They form a bridge with the outside world, and complement, and relieve the pressure on, family/caregivers. It is thanks to volunteers that the dying are not exclusively cared for by professionals. This is all the more important if there is no support from family/friends.

The presence of volunteers, indeed the very knowledge that voluntary hospice workers exist, can encourage family members and friends to maintain contact with the dying person.

2.2.1.2. Volunteers working in capacities not bringing them into direct contact with patients (e.g. publicity, fund raising, planning - in the sense of expert advice) also make a major contribution to raising the public profile of hospices.

2.2.1.3. Hospices' outpatient work is entirely in keeping with the principles of networking and building a basis of support in society. The work of volunteers on patients' behalf is particularly tangible here. Care dispensed in patients' own homes makes it clear that it is always at patients' own request that they receive support and visits from hospice workers. Volunteers are welcome guests.

2.2.1.4. The volunteer contribution is based on:

- neighbourly, human solidarity which allows the dying and the bereaved to participate in the life of society;

- solidarity which encourages and relieves the pressure on relatives/friends and professionals;

- listening, sympathetic solidarity which actively and genuinely seeks contact and builds up a relationship of trust;

- solidarity inspired by hope, open to ideas about the meaning of living and dying and the individual's attitude to the fundamental questions of human existence.

2.2.1.5. The support and complementary services provided by volunteers are a challenge to government and society to improve the working conditions of full-time professionals, so that the dying and the bereaved can receive the expert help which they need.

2.2.2. Conditions of voluntary hospice work

2.2.2.1. Volunteers contribute their work and their time. In view of the scale of the commitment and the pressures involved, conditions need to be created to make such commitment possible and to keep the load to manageable proportions. A number of aspects have to be considered here:

- Suitable, high-quality preparation and regular basic and further training are essential to ensure that volunteers are able to approach the task and assume their responsibilities with confidence.

- Cooperation with, and support by, the multidisciplinary team help volunteers to cope with difficulties. The contribution of voluntary work must be recognised and valued, but also clearly defined.

- Coordinated use of volunteers is necessary to make the most of their availability (in terms of personal commitment and time).

- Support and supervision guarantee the quality of volunteer work and help safeguard volunteers' psychological stability.

2.2.2.2. Voluntary work means commitment for a given period. Hospice volunteers perform their duties with a high degree of reliability and commitment. Professional support is needed to ensure the long-term continuity of services, particularly with regard to organisation and coordination. Thus, expert advice is often needed, as is support specifically geared to volunteers and to patients.

2.3. Situation in some Member States and applicant states

2.3.1. Basis for the use of volunteers

2.3.1.1. The same principles applying in other areas of voluntary work to the recruitment, training and coordination of volunteers applies to a particularly high degree in the case of hospice work. The example of hospice work should make it clear that the conditions for the successful ongoing use of volunteers are to a great extent universal.

2.3.1.2. Volunteers come to hospice work through personal experience, word of mouth, direct approaches, newspaper advertisements, hospice open days, conferences and targeted information campaigns.

2.3.1.3. Volunteers are given a thorough preparation for their work.

The aim of the preparation is to enable volunteers:

- to provide support with self-confidence and a sense of responsibility;

- to assess their own abilities and limitations;

- to develop new communication skills in dealing with the seriously and terminally ill.

2.3.1.4. The training of volunteers differs from hospice to hospice and from Member State to Member State. The duration of training varies from 2 to 3 months to 10 to 12 months. In many hospices on-the-job training is part of the preparatory stage. Basic training may be followed by more specific training geared to the volunteer's future field of activity. This applies particularly to volunteers who will be working as bereavement counsellors.

2.3.1.5. Training is generally provided by a multi-disciplinary team and the progress of training is monitored by management. Apart from basic knowledge (dying, death, grieving, hospice work and palliative care and medicine), the accent is on the role of counselling, the individual volunteer, the basic idea underlying the concept of the hospice, communication and caring skills.

2.3.1.6. During their work with the dying and the bereaved volunteers have access to the coordinator or manager as well as to members of the team. Supervision is regularly offered. Volunteers are expected to attend regular further training courses and lectures. One-to-one spiritual counselling can often also be arranged on request. Some hospices also offer memorial services for volunteer and professional staff and family and friends. Events such as summer or pre-Christmas parties form an important part of the hospice's programme.

2.3.2. Volunteers' areas of work

2.3.2.1. Volunteers are involved in all areas of hospice work. The extent of their duties is often determined by their professional skills. Hospices ensure that the duties of volunteer workers are clearly defined in advance. These may vary from one individual or hospice to another.

2.3.2.2. The following are examples of areas in which volunteers provide additional and complementary services.

- psycho-social counselling (e.g. conversation, reading aloud);

- spiritual counselling (e.g. prayer, reading aloud, accompanying patients to church services);

- psycho-social counselling of relatives and the bereaved;

- transport;

- complementary therapy;

- helping patients with personal hygiene;

- assisting with meals;

- hair care;

- looking after plants;

- gardening;

- telephone calls;

- administrative work;

- publicity work (press relations, manning stands at fairs, information events, newsletters etc.);

- fund raising (benefit concerts, jumble sales, raffles etc.).

Volunteers have more time and opportunity than professionals to focus on the individual needs of the seriously and terminally ill. This considerably enhances patients' sense of well-being.

2.3.2.3. Volunteers also make an essential contribution to supporting hospice work financially, morally and professionally through their work in the management of support associations, and work on committees and boards. In countries such as Poland, where social security systems do not finance basic (palliative) care in hospices, doctors and nurses often work voluntarily.

2.3.3. Cooperation between volunteers and professionals

2.3.3.1. Experience of cooperation between volunteers and full-time professionals in hospice work varies. Where the tasks and areas of responsibility of volunteers and full-time professionals respectively are demarcated, experience of cooperation is generally positive. Regular joint and separate supervisory sessions and guided discussions strengthen the respective identities and provide an opportunity to discuss day-to-day cooperation and solve any problems arising. The essential thing is the basic underlying attitude which stresses partnership and cooperation in the interests of terminally ill patients. Based on this understanding, every staff member, whether voluntary or professional, has his place in the team, even if areas of responsibility differ according to the individual's skills.

2.3.3.2. As so often in voluntary work, the emerging need for institutionalisation of volunteer hospice work is at odds with a creative grass-roots movement which is constantly taking on new challenges. The important thing is that the structure within which volunteers choose to work leaves scope for, and encourages, voluntary commitment.

2.3.4. Integration into health services

2.3.4.1. The Member States' hospice movements have generally developed independently and on their own responsibility, outside the framework of state planning. They owe their existence to a high degree of personal initiative and creativity, particularly with regard to funding. In some Member States hospices are financed mainly by socially orientated associations, charities and religious orders.

2.3.4.2. In the course of the 1990s government involvement increased. With the creation of tumour networks (Great Britain), a development plan for the promotion of hospice work (Poland) and laws underpinning in and outpatient hospice work (Germany, Italy) politicians have been doing more to create the framework conditions for hospice and palliative care, particularly in terms of supporting voluntary work.

2.3.5. Funding and costs

The fundamental principle of voluntary work is that it is unpaid. Expenses may however be reimbursed.

Although volunteers are generally (e.g. in Germany, Great Britain and Poland) insured through their organisations and associations (third party and accident insurance), the risks actually covered by insurance and the adequacy of cover need to be studied.

Costs also arise in connection with preparation, further training, supervision and coordination provided by qualified staff. Such activities are also conducted on a voluntary basis or in return for charitable donations.

2.3.6. Encouragement of and hindrances to voluntary hospice work

2.3.6.1. The following have proved conducive to social voluntary commitment:

- encouragement and recognition of social voluntary work by society;

- open discussion of death and the process of dying;

- local/regional networks embracing and linking the healthcare, social security and hospice systems;

- high-quality standards in hospices;

- thorough preparation of volunteers;

- good working environment;

- acceptance and recognition of volunteers;

- opportunities to use personal experience from hospice work in other areas of an individual's life;

- spiritual motivation or membership of a religious community;

- family support.

2.3.6.2. The following have proved a hindrance to voluntary hospice work:

- a society in which discussion of death and dying is taboo;

- lack of recognition and feedback;

- lack of knowledge of opportunities in hospice work;

- competition between hospices for funding;

- inadequate preparation and support;

- unclear demarcation of tasks and responsibilities;

- lack of recognition from family and friends;

- lack of leisure time;

- feelings of social isolation.

2.3.6.3. The above positive and negative factors depend mainly on the volunteers' personal situation, social and political recognition and the way in which voluntary work in hospices is organised. Long experience in countries where voluntary work plays a significant role has highlighted the value of professional support for volunteers to ensure continuity.

2.4. Summary and conclusions based on the example of hospice work

2.4.1. The following can be deduced from the example of voluntary hospice work:

- Volunteers see their work as worthwhile and carrying responsibility.

- Thorough and well-planned preparation, supervision and further training are seen as something of value, a source of assistance and personally enriching, strengthening the individual's self-confidence and self-esteem and contributing directly to the effective performance of duties.

- New and lasting bonds are formed between like-minded people working as an increasingly cohesive group. Open discussion of existential issues normally considered taboo promotes mutual trust and cohesion.

- Features of voluntary work are a high degree of commitment and enthusiasm, sustained over an extended period, and willingness to undergo further training.

- Voluntary work enjoys a high level of recognition in society, the world of politics and the volunteers' immediate environment.

- Volunteers identify to a high degree with the objectives of the hospice movement and hospices themselves as the embodiment of this idea. This feeling is significantly promoted by identification with a region. There is a great willingness and potential for voluntary hospice work.

2.4.2. As preconditions for the above:

- The maintenance of motivation and enthusiasm depends directly on good management and a good working atmosphere.

- Volunteers' tasks are generally clearly described. They should be clearly identifiable and diverse.

- Organisation and coordination are needed to ensure that volunteers' needs are as far as possible catered for.

- Voluntary work is in principle limited in time. The duration of the period of voluntary work should be regularly confirmed (e.g. annually).

- A permanent point of contact, such as a hospice office or in-patient hospice provides orientation and identification.

- A permanent contact person providing coordination, guidance, practical supervision etc. provides continuity for the purposes of networking and contacts with volunteers.

- Clear consultation and a high degree of mutual commitment, taking account of responsibilities towards volunteers as well as to the seriously or terminally ill patients and bereaved persons entrusted to the volunteers, are a precondition for a reliable service.

- The hospices' public relations work keeps the importance of voluntary work in the spotlight. This makes it easier to recruit volunteers, contributes to a sense of identification with the hospice idea and communicates an additional sense of recognition.

2.4.3. On the basis of an analysis of voluntary work and experience in hospices, thought needs to be given to ways in which society can specifically promote voluntary work. In the process it should be borne in mind that the variety and combination of motives displayed by volunteers shows that they are increasingly looking for meaning and opportunities for personal development in their voluntary work. It may be assumed that political and cultural factors at regional and national level will strongly influence people's willingness to engage in voluntary work.

3. General conclusions and recommendations

3.1. The example of hospice work provides convincing proof of the power of voluntary work to help change political conditions and social realities. The tenacity and persistence of individuals in translating their ideas and convictions into action and in persuading (and inspiring) others to follow their example are an important driving force behind the development and continuity of civic commitment. Volunteers' advocacy on behalf of people in need and the resulting pressure for political action can be seen to bring about change in laws and regulations. Volunteers' impact on social conditions and realities is an excellent example of a properly functioning civil society.

3.2. Cooperation is developing in the European Union. Enlargement is coming. The processes associated with this need to be harnessed and consolidated if social cohesion is to be promoted in the applicant countries and in the Community. Making voluntary work possible and promoting it in the European Community will help ensure that individuals can participate in the development of society and in solving problems and tackling tasks of a social nature. Establishing a network of organised civic commitment can make a major contribution to the development of a national understanding of the concept of "Europeans".

3.3. A possible basis for further development is Declaration 38, appended to the Treaty of Amsterdam, which recognises "the important contribution made by voluntary service activities to developing social solidarity. The Community will encourage the European dimension of voluntary organisations with particular emphasis on the exchange of information and experiences as well as on the participation of the young and the elderly in voluntary work".

3.4. The Committee makes the following proposals:

1) Policy to promote voluntary work must, building on the International Year of Volunteers, give lasting recognition to voluntary work and promote dialogue between the supporting associations, authorities and social facilities.

2) Forums and/or exchanges for volunteers must be established providing detailed information on the many opportunities and areas of voluntary work at regional, national and European level. The new media should be used to this end. Suitable measures to tackle mobility problems should also be considered.

3) As a basis for successful voluntary work financial and staffing provision must be made for the basic and further training and supervision of volunteers during their service.

4) Research should be carried out into the basic conditions for voluntary work, such as motives, the effects of prevailing conditions, the differences and similarities between the various areas of voluntary work, and the differences and similarities between regional, national and European voluntary work, as well as into the positive effects of a society based on solidarity. To this end regional, national and European projects will need to be coordinated and promoted by the European Community.

5) Research must be carried out into the development of voluntary work from a grass-roots movement to a self-managing network, using the example of hospice work, with consideration for the opportunities and risks involved for social voluntary work. Studies should concentrate more than hitherto on common criteria underlying the different trends in the various European countries.

6) Continuity of organisation, administration and basic counselling of volunteers must be ensured by a minimum presence of full-time professional staff. The support of volunteer workers by full-time professionals should be an important measure of the extent to which responsibilities towards volunteer workers are being met.

7) Voluntary work must not be disadvantageous to the volunteers. Statutory cover for risks to life and limb should be available to protect the livelihoods of the volunteers themselves and their families. Legal framework conditions should be laid down at European level.

8) Greater use should be made of existing dialogue arrangements in the Member States, e.g. in the economic and social councils or in connection with the discussion of the national action plans, to promote the development of voluntary work.

Experience of existing programmes e.g. youth programmes, should also be exploited.

3.5. Finally, the Committee recommends that the visibility and wide distribution of the hospice movement in the Member States be exploited for further own-initiative work (for example the holding of hearings involving practitioners). This opinion should be disseminated and discussed in all the Member States and applicant countries. Suggestions and feedback should be absorbed into a further discussion process and used as a basis for new initiatives. In this way it will be demonstrated that the widespread application of provisions to promote voluntary work and the willingness to put these on record can be harnessed for the task of developing ways of promoting voluntary work and establishing conditions conducive to it.

Brussels, 20 March 2002.

The President

of the Economic and Social Committee

Göke Frerichs

(1) OJ C 73, 9.3.1998.

(2) OJ C 311, 7.11.2001.