human development, social justice and sustainable social systems

The carers in our homes are essential workers

On International Women's Day

Originally published on Euractiv

Social care workers deserve to be legally and financially protected as “essential workers,” on par with health care professionals, as this sector faces severe under-funding and informality, meaning many women work running multiple risks while facing high levels of precarity. The COVID-19 pandemic has further demonstrated just how fragile and unsustainable Europe’s current social and home care model is, revealing structural shortcomings due to the dependency of care work on cheap labour, open borders and the free movement of people within the EU. On the occasion of International Women’s Day, the social value of this female-dominated profession must finally be re-assessed across Europe.

Care workers have typically been underpaid (if paid at all) and undervalued far too long by comparison with the great social value their professions bring to families and whole communities. Having worked at a hospice and cared for people with terminal illnesses, I know first-hand the significant role care workers assume for patients and family members alike. The sensitivity required to handle different emotions and personalities and the technical skills required to provide professional care services cannot be understated.

It is thus vital to build a more sustainable social care system, especially given the increasing proportion of elderly. According to Eurostat data, “in 2019, more than one fifth (20.3 %) of the EU-27 population was aged 65 and over”, and “the share of people aged 80 years or above in the EU-27’s population is projected to nearly triple between 2019 and 2100, from 5.8 % to 14.6 %”.[1] In that time, most of us now reading will be entering that demographic ourselves, with a system under increasing pressure yet no real solutions at hand. In short, on the current trajectory, the quality of our own care, if needed, will have likely deteriorated when we need those services ourselves.

Clearly, stronger protection measures for women care workers, including full employment protection and access to unemployment insurance benefits are needed, since many home care workers are self- or informally employed. This has left them extremely vulnerable in the crisis, especially since most undocumented live-ins have no health insurance. Some care workers – without viable alternatives – have found themselves unable to say ‘no’ to unsafe and/or abusive working conditions.

According to the European Commission, personal care workers compose one of the five largest categories of key workers in the EU[2] and personal care work depicts one of six categories of key occupations.[3] The vast majority of the people playing this essential role are women and most  of them are also migrants. Thus, with border restrictions suddenly put in place under COVID-19 lockdowns, some care work came to a halt, with women unable to return to work if they were in their home countries, while others remained employed but at increased risk working in an employer’s home. Worse yet, some women found themselves released of duties out of fear of the spread of COVID-19. Their families, in turn, lose remittances and they themselves have little or no social safety net.

The pandemic has exposed problems that have been lying dormant, lingering beneath the surface for years, and now make clear the necessity to revamp the system to implement long-term solutions and emergency responses. Fortunately, the new Action Plan for the European Pillar of Social Rights  (principle 18)  acknowledges the need to better understand the challenges related to long-term care, such as the need to improve care access, affordability and quality and to ensure an adequate workforce while also providing clarity on the coordination of long-term care benefits in cross-border situations.

It is vital to ensure fair and dignified wages in accordance with local standards, training and professional nursing services support, as well as improved working conditions and the respect of labour rights. In addition, home care workers should obtain an “official” permanent status in the nursing sector with a recognised job title, such as “nursing assistants living in the household”, which could be reflected in all future relevant nursing agenda policymaking. Countries employing home care workers through employment placement agencies abroad or from neighbouring EU Member States should also recognise the negative impacts of “care drain” – when care workers are imported to other countries – on the communities left behind. Leaders should look for more sustainable solutions, such as investing in training or institutional care in sending countries and strive toward greater social convergence between European countries. Investment in the social care sector is clearly needed.

Considering the migratory component of ensuring fair care work in Europe, it is also vital to provide European solutions, not just national ones. Some standardisation of care work would likewise be beneficial – qualification requirements, e.g. diplomas recognised in all EU countries. And finally, considering the European Commission’s commitment to ensure greater equality between men and women, I dare it to ‘walk the talk’ and prioritise the revamping of the social care sector.

Notes:

[1] Eurostat: https://ec.europa.eu/eurostat/statistics-explained/index.php/Population_structure_and_ageing

[2] The others were teaching professionals (14.5%), skilled agricultural workers (11.9%), science and engineering associate professionals (11.1%), and cleaners and helpers (9.9%). (EC source)

[3] The others included personal care workers, cleaners and helpers, health associated professionals, teaching professionals, health professionals and personal service workers (Ibid.)