Quality and access to social services – a European issue? Context for change in social services in Europe Institutional interest – links to EU policy User involvement in service developments Strengthening the focus upon quality In conclusion 02/07/2019

Social Situation Report 2002 Ageing of the EU15 population – from 34 million aged 65+ in 1960 to 61 million in 2000 Numbers of people aged 80+ will increase by almost 50% over the next 15 years (and two thirds will be women) Estimate that in 2010 around one third of those 65+ will live alone, and 45% of people aged 80+ 02/07/2019

Families and households Fewer and later marriages and more marital breakdowns (40% in DK, FIN, S, UK) Trend to smaller household size (avg. 2.4 in 2000 cf. 2.8 in 1981, but 2.9 in Ireland in 2000) Rise in single-parent households (representing 6% of children in Greece but 25% in UK) 02/07/2019

Social Situation Report 2003 – life expectancy From 1960 to 2001 average life expectancy for the EU15 rose from 70 to 78 years For people aged 65 expectation of life is about 20 years for women and 16 years for men Life expectancy (without severe disability) is 66 years for women and 63 years for men 47% of people in the EU aged 65+ report chronic illness or disability 02/07/2019

Expenditure on social protection as a % of GDP (1999 data) 02/07/2019

Institutional aspects – links to EU policy Services of general interest – competition Employment – job creation and equal opportunities Social protection – social inclusion and access to care 02/07/2019

The context for change Increased demand for services From client-dependency to active user involvement and empowerment Focus on quality of performance and results Changing needs, demnds and preferences 02/07/2019

Services of general interest Quality of life depends to a large extent on provisions – transport, energy, telecommunications; but also health, education, social services Affected by rules on competition and state aid Raise issues of quality, price and accessibility Rights to access services of general interest are central to the European social model 02/07/2019

Social services as services of general interest Services provided directly to citizens, by paid workers, to meet general social needs Regulated, funded or provided by governments Health, education, social protection, personal social services, employment Usually excluded from general interest provisions in the Treaty on European Union And social services have specific characteristics e.g. user-provider relationship 02/07/2019

Report to the Spring European Council 2004 Employment - Overall rates are too low (64% in 2002 compared with 62% in 1999) – 57% in AC10 - Rate of female employment rose from 53% in 1999 to 56% in 2002 (50% in AC10) – with target of 60% in 2010 - Older workers (55-64) rose from 37% in 1999 to 40% in 2002 (30% in AC10) – but target is 50% in 2010 02/07/2019

Employment in social services Key area for job creation (1995-2001 annual growth rate of 2.4%) Employment policy guidelines – reconciliation of work and family life (17% of all women in employment and in health and social services) Future labour supply issues 02/07/2019

Social protection issues Draft joint report on social inclusion Joint report on health care and care for elderly Open method of coordination 02/07/2019

Key dimensions of reform and modernisation New models of public sector management Decentralisation and de-institutionalisation Targeting of services Emphasis on coordination and integration Mixed economy of provision Cost containment Quality initiatives linked to improved services 02/07/2019

User involvement in service developments Direct users, indirect users, potential users and excluded users Needs and demands related to demographic, socio-economic and political change Generalised increase in consumer expectations (continued on next slide) 02/07/2019

User involvement in service developments (continued) Different methods: user panels, user involvement in service provision, user involvement in assessment of needs, quality groups and circles, user surveys, users as volunteers, users’ rights, user advocacy schemes, user advice centres Different levels: information, consultation, partnership, delegation and control 02/07/2019

Strengthening the focus upon quality of service Growth of activity from simple quality statements to sophisticated performance evaluation Formal and informal mechanisms of quality assurance Variation between stakeholders in perceptions of quality Development of internal quality improvement procedures 02/07/2019

Mechanisms for service quality improvement Innovation and experimentation Partnership in service provision Improved coordination between agencies and services Participation of users – feedback, needs assessment 02/07/2019

In conclusion Quantity + quality No one quality model for social services Quality frameworks need to allow local adaptability Need participative approaches to quality standards for staff and management, users and citizens 02/07/2019

Key indicators for quality outcomes User involvement and empowerment Participation of users and workers in design of quality systems Relevant and adaptable quality frameworks Meaningful systems of evaluation Training and qualification of staff 02/07/2019