A human rights approach to long-term and social care: crucial in - PDF document

A human rights approach to long-term and social care: crucial in times of financial turmoil. Some remarks alongside the Social Platform’s 2011 document on care Frits Tjadens, Health and Social Care Associates, the Netherlands i First of all, let me thank you for inviting me. Second, thank you for efforts and outcomes related to the Social Platform document Recommendations on care, which is both extremely relevant and comprehensive. As a person who keeps getting involved in issues about family carers and long-term and social care, I am especially happy that the document fully includes family carers and their human rights. When we discuss social care or long-term care and basic rights we often tend to focus on clients’ rights and tend to forget family carers’ situations and rights. In that perspective I would like to stress that carers not only need support, in the shape of information and training, to be better able to care for the caree, but also need to have their own (social protection) rights protected and ensured. The document further mentions care w orkers, who will be the main ‘bearer’ of the message and who have to be empowered to do so within the context of their organizations, but who also need to have their own rights protected and secured. For the risk exists that they caught between conflicting demands of management and caree . I was asked to provide some comments on the first part of the recommendations. I will do so by making some observations. The document by the Social Platform comes in a time of extreme and ongoing crisis and the required results may be easily get squeezed between the forces of financial markets. This can be seen as ‘wrong document, wrong time’. My view, however, is that the document is, especially now , incredibly relevant. For guaranteeing fundamental human rights in care often is a continuous challenge in times of prosperity and will be much more so in case of lacking funding. However in a time when serious cutbacks challenge the very fabric of social protection and social care in many Member States, efforts to guarantee fundamental human rights and to enhance the full implementation thereof in social care are not only more difficult but even more important as tendencies may well exist to ‘cut corners’ in all layers of societies that influence and impact on social services. Governments may, for instance, tend to – further - outsource services that were once within the public sphere. Without adequate regulation private service provision may easily lead to non- adherence to human rights as examples in the United States show. Therefore perhaps a relevant addition to the document were to be to stimulate the Commission to endorse Member State Frits Tjadens, HASCA, Presentation during Social Platform Conference We care, how can EU care? December 9, 2011.

activities that regulate private social care provision, including clear enforcement thereof and to include providers that work on the completely privately paid service markets, in order to guarantee adherence to basic human rights. Moreover, care provider management is often not educated or trained to – on a professional level - deal with issues such as client-, family carer or worker rights and voice. Thus, while the latter can be stimulated and may require empowerment policies, it is also required to develop – preferably on an EU-level where mutual learning and exchange can be endorsed – programs that support social care managers to not only stimulate, endorse and practice a human rights based approach in their management style, but also to teach by example. Examples of such programs exist in England and are organized by their umbrella organization. Such programs, which could include the whole of the organization in a business re-design from the bottom up, are even more urgently required now that many social care managers feel pressed to re-target their services as a consequence of cutbacks. Thus, while many may feel urged to first answer the call of lack of money, a continuous quest for quality and human rights is required that, indeed, could even lead to new inspiration in the sector. EU-funding, for instance from the available types of Research and Innovation funding, including specific DG EMPL programs such as PROGRESS, could provide good support here. Ideally such a program would include management, worker and client representatives, closely working together towards joint goals and perspectives. However, developing and implementing an integral human rights based approach to care may well require a fundamental cultural change in the way thinking about care develops and subsequently how care is provided to whom, under what circumstances and what care actually implies. As a consequence, such a change may well require a longer lasting, if not enduring, approach, stretching out over a number of years and with focus on not only development, dissemination and first-stage implementation, but perhaps even more important, focus on second and even third stage implementation. This is, however, often not how funding programs work. A second remark relates to the consequences of the financial crisis. It is generally thought that it will cause the fabric of solidarity to crack. To some extent this is correct as services will be re-targeted and solidarity may become redefined in terms of ‘who’s in’ and ‘who’s out’ . In as far we think about solidarity as cash-transfers by means of taxes or risk-pooling, the risk is there that this hard solidarity will suffer from already mentioned cutbacks. Indeed, social protection is among the first issues targeted (OECD, 2011). The implicit assumption in these cutbacks, though, is often that societies will find other means to fill the voids. T hus other forms of, what I would like to call ‘soft solidarity’ will need to be (re-)developed and supported. Social care providers can play a role here, but will have to find the inspiration and know-how to do so. Guidance and support may be welcome, also in terms of supportive programs. It is furthermore generally thought that care at home is better geared to deliver required support and care with often better dignity for the caree, certainly better able to prevent hospitalization tendencies and sometimes ‘learned helplessness’ . Moreover care at home is often considered to be better able to deliver value for money and cheaper on a macro basis than institutional provisions. With the aid of modern tools there are also more possibilities to provide more care at home. One should realize, though, that by implication, two of the reasons why care at home may be considered both cheaper and better are: Frits Tjadens, HASCA, Presentation during Social Platform Conference We care, how can EU care? December 9, 2011.