Demographic and labour market changes in Europe are creating new demands for care work, for both children and dependent adults. The well-established trend to ageing in all EU Member States, albeit at varying pace, will ultimately create larger numbers of people in need of long-term care.At the same time, the low fertility rates in most Member States have generated increasing demand for accessible, affordable and high-quality childcare. Meanwhile the increasing labour force participation of women, at both younger and older ages, is raising challenges to maintain the supply of care workers — both family carers and formally paid carers.
Across the EU most care has been organised and provided by family or informal networks; in most countries, it is only in recent decades that the social care workforce has become a key factor in social protection budgets — and the formal care sector has been financed and developed in very different ways in the different Member States. These trends and societal challenges have ignited a wide-ranging debate at European level on the care challenges associated with demographic change, but debates on the future of care have been muted in many Member States — perhaps especially where care is regarded as largely a family matter. Actions to support carers and to strengthen the care resource, both in the family and more formal arrangements, are developing unevenly across the EU countries.
2. Demographic Perspectives
The key demographic trends are captured in the recent population projections from Eurostat (2008); the dominant trend is one of ageing. The median age of the population of the EU27 is projected to rise from 40.4 years in 2008 to 47.9 years in 2060; the number of people aged 65 years and over is projected to nearly double from 84 million in 2008 to 151 million in 2060; and the corresponding number of people aged 80 years or over is expected to treble from 21.8 million to 61.4 million. These population changes are often presented in terms of ‘dependency ratios’ as in Figure 1.
Fig. 1: Projected age dependency ratios for selected years, EU27
Source: Eurostat, EUROPOP 2008 convergence scenario.
This clearly expresses development in numerical relations: whereas in 2008 in the EU27 there are 4 persons of working age (15-64 years) for every person aged 65 years or over, in 2060 the ratio is expected to be 2 to 1 — and in many countries this doubling of the old age dependency ratio will be in place by 2040. However, individual countries are affected differently and it is particularly the new Member States of Central and Eastern Europe that are expected to experience higher increases in old-age dependency ratios than in the EU27 as a whole. These are countries that, in general, appear particularly poorly prepared for rapidly increasing demands for long-term care (Österle and Meichenitsch, 2008).
The presentation of ‘dependency ratios’ is intended to give an indication of the level of support of the older population by the working population, but this may be misleading. Such figures may not represent the burden of ill-health or care needs of the older population or the numbers of economically active persons in the working age population; they certainly give no indication of the care provided by spouses and others in the older population or the caring capacity of informal networks and family in the younger age groups.
3. Policy Developments at European Union level
Family carers of dependent adults and older people have been almost invisible in policy documents of the European institutions until the last five years. A real upswing in attention to care workers has taken place with growing attention to the policy challenges of an ageing population and workforce, specifically in relation to the costs and coverage of long-term care for the dependent population. Now, reference, at least, to care workers and family carers is evident in documents related to policy areas of Employment, Social Protection and Equal Opportunities. Even so, the main Communication from the European Commission in October 2006, on ‘The demographic future of Europe’ makes no reference to care workers as such (an omission that was rectified when the Commissioner for Social Affairs launched this document).
The current policy debate on long-term care acknowledges the different contributions of the state, market, family and community in meeting care needs. The most recent review of developments in Social Protection in the EU (European Commission, 2008) pays explicit attention to the role, burdens and needs of informal caregivers. Specifically, this report highlights care workforce shortages and inadequacies in the training of both formal and informal carers. It argues, as so many articles do, that the increased participation of women in the formal labour market is posing a serious challenge to the sustainability of the informal provision of long-term care. While there is no doubt that this is an issue (taken up in a later section on working carers), it should also be acknowledged that historically only one woman in each family has typically borne the main responsibilities for care, and that there are still many women — and men — outside the labour market who are among the pool of potential carers. Nevertheless, it is clear that the probability that a person of working age will have family care responsibilities for adult relatives is increasing.
The Commission report argues that the main concern for policy-makers is recruiting and retaining an adequately qualified and skilled care workforce; training is presented as an issue for family carers as well as formally employed carers. Among measures to improve conditions for family carers, the report highlights incorporation of informal carers into social security schemes, protection of pensions and other social rights.
A second theme related to family carers who are also in employment relates to better reconciliation of work and care. A discussion paper from the Directorate-General for Employment (2008) asserts that ‘many women (and very few men) give up paid employment to provide care’, and this may cause financial hardship and social isolation. For most carers of working age the more common tension lies in trying to reconcile professional and care obligations. The authors of the EU discussion document see the way forward in terms of developing day-care centres for dependent older people, respite services and the introduction of new leave and working-time arrangements for informal carers; the social partners (organisations of employers and trade unions) are invited to develop this approach to enable workers to care for an elderly or dependent family member.
Care Work in the EU: Support Measures in a Context of Demographic Change: Paper for International Symposium on Social Support Measures for Care Work, Seoul, 9 October 2008.
Robert Anderson: European Foundation for the Improvement of Living and Working Conditions, Dublin.
Tags: Care Policy developments, Care Work Europe, Employment in care work