1. 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
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2. 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+
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3. 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)
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4. 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
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5. Expenditure on social protection as a % of GDP (1999 data)
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6. 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
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7. 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
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8. 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
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9. 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
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10. Report to the Spring European Council 2004
Employment - Overall rates are too low (64% in 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
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11. Employment in social services
Key area for job creation ( 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
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12. Social protection issues
Draft joint report on social inclusion
Joint report on health care and care for elderly
Open method of coordination
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13. 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
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14. 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)
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15. 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
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16. 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
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17. Mechanisms for service quality improvement
Innovation and experimentation
Partnership in service provision
Improved coordination between agencies and services
Participation of users – feedback, needs assessment
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18. 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
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19. 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
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