AVAILABILITY AND QUALITY OF SOCIAL AND HEALTHCARE SERVICES
COUNTRY REPORTS FROM GERMANY, THE NETHERLANDS, SPAIN, AND THE UNITED KINGDOM
The austerity measures promoted by the European institution over the past years have had a negative impact on the access to and quality of social and healthcare services in several member states.
Rather than investing in these services as a prerequisite for upward social convergence and inclusive economic growth, the Country Specific Recommendations of the European Semester evaluate them from a budgetary and fiscal perspective, i.e. urging EU member states to increase the cost-effectiveness of their health and social services. In several member states it is reported that the EU recommendations to increase cost-efficiency create a downward pressure on the availability and quality of these services, thereby straining their capacity to act as social safeguards.
As regards to health and social services, the European Commission has recommended Germany to make additional efforts to increase the cost effectiveness of public spending on healthcare and long‐term care. Conversely, our members Arbeiter Wohlfahrt and Arbeiter-Samariter-Bund call for greater investments to ‘future-proof’ the access to, and quality of, health and social services, especially in rural and structurally weak regions. Reporting on a growing shortage of specialist staff and increasing gaps in coverage, our members deplore the cuts that are being made in local investments precisely at a time when oncoming demographic and social changes are starting to put pressure on the existing infrastructure. To make matters worse, these issues are even more acute in rural and structurally weak regions, where, unlike in the booming cities, access to and quality of health and social services are faltering.
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In 2015, a substantial reform of the long term care system has been implemented in the
Netherlands, notably introducing a bigger role for local government and increasing the use of informal care with the hope of making the system more cost-effective and sustainable. Our Dutch member, Humanitas has expressed concerns and questions whether these reforms will improve access to healthcare and ensure the affordability of quality social services for all. While healthy and high income segments of the Dutch population can opt for low cost and high risk insurance policies, the sick and low-income segments are faced with rising costs, and increasingly limited access to health and social services. Our Strategy Group in the Netherlands warns that the combination of severe budget cuts and an ambitious timeframe is already straining the access to, and quality of, health and social services in the Netherlands. As the reforms to this system are further implemented, it will be crucial to closely monitor and correct these negative effects.
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A number of recent reforms have helped to reduce costs in the healthcare sector in Spain. The SOLIDAR EU Strategy Group in Spain – led by our member Movimiento por la Paz (MPDL) – emphasises the negative consequences of the cuts in health and social services, which have been implemented precisely at a time when the effects of the financial crisis have caused an increase in demand for these services. Specifically, our Spanish Strategy Group deplores that these cuts have targeted the local level, thereby impacting basic services and their proximity to those in need, and that they have been implemented without much differentiation, thereby impacting people with a lower income and migrants more than others. Together, the negative consequences of the reforms are gradually increasing the inequalities in access to, and quality of, health and social services in Spain.
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The SOLIDAR EU Strategy Group in the United Kingdom – led by our member Volunteering Matters – points to the dangers and pitfalls in the ongoing process of modernising the country’s healthcare system. This process seeks to overhaul how health services are currently organised and provided by the National Health Service (NHS), which has so far resulted in the May 2014 Care Act and the significant publication of the ‘Five Year Forward View report’ by the NHS that was published in October 2014. While even the NHS itself accepts that certain changes are necessary to future-proof the healthcare system, the focus on bringing down costs is putting the process onto a risky trajectory. For example, volunteering is put forward as a cost-effective way to ensure that the access to, and quality of, health services is not negatively affected, even though this type of work by its very nature is not sufficiently reliable to take over from the public sector.
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Against this background, SOLIDAR promotes the idea of access to social services as a pre-requisite to combating poverty and achieving equality and social cohesion. In recent years, health and social services have served as effective social safeguards against the worst effects of the economic crisis. Furthermore, we support the creation of sustainable quality employment and decent work conditions that would also have the effect of attracting people to the sector and thereby better exploit its employment potential. Therefore we call on the European Commission to take the analysis of the Social Progress Watch into account when developing the upcoming Pillar of Social Rights. An increased investment in the social and healthcare services is a pre-condition for social inclusion and sustainable economic prosperity.
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