Lethbridge, Jane ORCID: https://orcid.org/0000-0002-0094-9967 (2005) Childcare services in Europe. Discussion Paper. Public Services International, London, UK.

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Abstract

There are several changes taking place in care services in Europe. Many national policy changes in financing and delivery of social care services have been triggered by the perceived view that the increasing size of the older population will cause an expansion in demand for social care services for older people. Although services are still funded by taxation in many countries, some countries have introduced new systems of long term care insurance and co-payments. More details of national policies are set out in Table 1.

There has been a transfer of services from the public sector to the private and voluntary sectors although municipal and local state authorities remain responsible for commissioning and purchasing social care services. There has also been a decline in the number of care homes in many countries with a corresponding rise in home care services. The trend is for people to remain in their own homes for as long as possible. This is also contributing to the development of the “assisted living” concept where companies or public-private partnerships build residential developments, which also provide some care services.

A new type of funding provision involves the government giving money directly to service users so that they can purchase services to meet their own care needs individually. The impact of these arrangements on the care workforce is only just beginning to be understood. There are some indications that individually purchased care in some countries leads to increased insecurity for care workers in both employment and income. In a few countries it is leading to an increased professionalisation of care work. The impact of individual purchasing of care services will have to be monitored in future.

National care markets are dominated by a small group of large companies as well as many smaller companies running small scale care homes and homes care services. Markets are fragmented although some consolidation is taking place. To what extent this process of national consolidation will lead to regional consolidation is unclear. Multinational company presence in the social care sector is still relatively limited.

The development of childcare services is slightly different to social care services. Childcare provision is closely linked to employment policies, which are trying to expand the participation of women and single parents into the labour force. Government support for childcare is through direct service provision in some countries but through private and voluntary provision in others. The move towards integrating childcare services with education services in several countries is helping to improve the status of childcare workers.

Private provision of childcare services is done through small and medium sized companies mostly operating at regional or national levels. Multinational company activity in childcare is still relatively small.

In countries of Central and Eastern Europe, the development of a social care model of provision is relatively new. Much care for older people or people who are chronically ill, still takes place in institutions. There are often long waiting lists for the care homes that exist. In several countries, acute care beds are used for long term care for older people. These institutions are publicly owned and still publicly run. The beds are funded usually by state or local government funding.

There are also signs that a new social care system is being introduced in several countries that will be less controlled by the public sector. This is being driven partly by policy changes following health sector reform but also by a shortage of different types of social care for older people.

Multinational company presence in the social care sector is still relatively limited. This means that there are relatively few companies that operate in more than one country in Europe. The companies that are technically eligible for a European Works Council are: Attendo, Bridgepoint Capital, BUPA, Carema, Medidep and Orpea.

Item Type:	Monograph (Discussion Paper)
Uncontrolled Keywords:	childcare, Europe, public services, training
Subjects:	H Social Sciences > H Social Sciences (General)
Faculty / School / Research Centre / Research Group:	Faculty of Business > Centre for Work and Employment Research (CREW) > Public Services International Research Unit (PSIRU)
Related URLs:	Publisher
Last Modified:	17 May 2019 14:00
URI:	http://gala.gre.ac.uk/id/eprint/5012

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