European trends and tendencies in social services

1. European trends and tendencies in social services Jan Spooren, General Secretary EPR

2. Social economic • challenges • Ageing • Gender equality • Social integration • Labour market flexibility • Increasing and diversifying demand • Adapt • to changing needs • Understand needs • Flexible responses • New target groups • New services • Sophisticated and complex services Modernisation The context (1) 2

3. The context (2) THE EC BIENNIAL REPORT ON SSGI – July 2008 Modernization • Response to new challenges and needs • Combine universality, sustainability and quality • Adapt to new paradigms (social model / market-based regulation) • Need to change sector • Pathways to modernization Significance • Employment • Contribute to social cohesion and creating equal opportunities for all • Part of ‘Social Agenda’ and ‘Social Europe’ • Justify allocation of finances to HSS • Defend policy impact of stakeholders Application EC Law • Procurement • State aid • Internal market • HSS is ‘economic’ activity • State regulator/guarantor and financer (but less provider)

4. Characteristics of social services Based on solidarity Characteristics of social services Asymmetric relationship providers-beneficiaries Comprehensive & personalised Rooted in (local) cultural traditions Not-for-profit Involvement of voluntary workers 4

5. The social services paradox UNIVERSALITY QUALITY FINANCIAL RESOURCES SUSTAINABILITY

6. Increasing Social Expenditure UNIVERSALITY QUALITY FINANCIAL RESOURCES SUSTAINABILITY

7. Strategic alliances with service-users organisations to lobby towards public authorities Ensure that people with complex and severe disabilities still get opportunities for inclusion Most impacted by increasing unemployment Tendering with only focus on price, and outcome measurement with only focus on hard outcomes include risks that SSPs are obliged to concentrate on more easy target groups Stress relevance and importance of Social Services in times of economic crisis Substantial part of economy and generator of employment Contribute to Lisbon Strategy and European Social Agenda of ‘active inclusion’ and ‘social cohesion’ Request to invest sufficient resources in SS

8. Re-thinking Core Elements UNIVERSALITY QUALITY FINANCIAL RESOURCES SUSTAINABILITY

9. MODERNISATION “Doing more and better with the same resources” “Increase efficiency and quality via innovation” Reconciling basic concepts of social services UNIVERSALITY QUALITY SUSTAINABILITY

10. Elements of modernisation Paradigm shift in health and social services From public programming regulation to market-based regulation Positive & proactive approach High level expertise Modernisation • Mainstreaming/partnership • Inclusion / maximise potential • Empowerment • Decentralization • Demonstrate added value • Quality assurance • Competition: tendering • Market analysis and orientation Paradigm shift in disability field From medical model to social model

11. Habilitation persons with disability from birth Rehabilitation individuals with acquired disability UNCRDP Article 26 - Habilitation & Rehabilitation HEALTH EMPLOYMENT EDUCATION SOCIAL SERVICES • Proximity and decentralisation • Training of professionals • Promote assistive technology • Early intervention • Multi-disciplinary assessment • Individual assessment To enable persons with disabilities to attain maximum independence, ability and participation

12. Advance mainstreaming • Definition • All policies, programmes and activities should incorporate a disability perspective, so no specific measures/actions are needed. • All actors/groups in society should be aware of disability issues and prepared to take them into account in all activities and attitudes • Benefits • In line with social model • Equality of opportunities • Partnership + participation • Risks • Some people with severe and complex disabilities still need specific interventions • Public authorities abuse concept to reduce resources for disability sector Mainstream of disability policies should be complemented with specific actions/programmes fostering the development of disability-specific expertise and solutions

13. Prejudices from general population about disability Mostly problem in initial phase Resistance from PwD and their families Insecurity / over-protection Difficulties to accept negative consequences of ‘mainstream’ Mainstream services lack resources to involve specialised support Offering specialised support to mainstream providers requires active marketing Economic crisis reduces employment for PwD Challenges in advancing mainstreaming

14. Client involvement Individual: about own integration plan Balance between rights and duties Participation Collective: about design, management and evaluation of a service Organise representation Informed choice Availability and proximity of services Information on quality, results and costs of services Empowerment as pre-condition Concretise, measure and improve empowerment Double side of empowerment Empower service-user as customer

15. From centre based to out-patient services Changed mentality Adapted internal organisation (HR / logistics / …) Decentralisation/fragmentation of services Case management Need for partnerships Maintain sufficient interface with client Departmentalisation of policies & funding Need for marketing and sales strategies Decentralisation of service-delivery Challenges for service providers • Need for flexibility

16. Demonstrate added value and cost-effectiveness • Analysis and comparison of perceived values • Methodologies for outcome measurement • Benchmarking on pricing + quality • Lobbying towards stakeholders Prove cost-effectiveness Demonstrate added value • Economic terms • Social benefits • Well-being • Meet expectations • Price/quality ratio • Benchmarking • Do more and better with available resources JUSTIFY Social services must meet needs and expectations Best use of limited available resources Exigent clients + funders + society

17. EU Disability Strategy 2010 – 2020 10 Thematic areas

18. EU Disability Strategy - Employment • Rationale • Economic independence and personal realisation • Economic growth • Sustainable social protection systems • Actions at MS level • Report on labour market situation of PwD • Active labour market policies (mainstream) • Specialised services - job placement - on the job training • Move PwD from sheltered work to open labour market • Awareness raising • Actions at EU level • Work with PES • Work with social partners

19. EU Disability Strategy – Education & Training • Definition • Provide required support for PwD within general education system • Effective and individualised support measures • Actions at MS level • Remove legal and organisational barriers from mainstream education • Effective and individualised support: - Timely support - Early identification of special needs - Well-coordinated services • Disability training of teachers/staff • Ensure availability of (financial) resources for support of teachers • Actions at EU level • Promote transition from education to employment • Promote inclusive education • Promote accessibility and reasonable accommodation in education • European Agency for Development in Special Needs Education

20. EU Disability Strategy – Independent Living • Definition • PwD should have choice of place of residence • Support de-institutionalisation and provision of CBS • Actions at MS level • Close residential institutions and development of CBS • Good working conditions for professional carers and support to informal carers • Use European Structural Funds to support CBS - (Re)Training of professionals - Building infrastructures • Actions at EU level • Mutual learning on de-institutionalisation • Quality framework for CBS • Use European Structural Funds • Promote personal assistance schemes • Data collection on PwD in institutions

21. EU Disability Strategy – Rehabilitation • Definition • Provision of quality and affordable specific services • Actions at MS level • Modernise long-term care services • Modernise mental health services • Provide adequate rehabilitation services • Actions at EU level • Address quality of services, including users-perspective