Nearly 31 million people need long-term care in the European Union

DIPLOCAT and the Third Sector Platform of Catalonia hold a joint debate to address the challenge of integrated social and health care

The Third Sector Platform of Catalonia and DIPLOCAT, in collaboration with the Pere Tarrés Faculty of Social Education and Social Work (Ramon Llull University), held a new debate today in Barcelona on the 'Social Europe' cycle, created to reflect and discover experiences regarding shared social challenges in different European territories. 

This third debate focused on integrated social and health care, a model of care that provides a comprehensive and coordinated response from the social and health system that is being developed in Catalonia. Currently, the Departments of Social Rights and Health of the Catalan Government are designing the future Comprehensive Social and Health Agency, a body intended to improve care, especially for those people who have more complex needs, such as the elderly, people with disabilities or people with mental health issues.  "This whole process is a lever of change to help us rethink and redesign the system with the priority of ensuring that the individual can decide how and where they want to live.  For this reason, we are committed to prevention, community intervention and support for home care", explained Aina Plaza, Director General of Health Planning of the Government of Catalonia.

Integrated social and health care is a priority for the European Union, which recently presented the European Care Strategy, which aims to ensure affordable and accessible quality care services, and to improve the situation for both those who receive this support and those who offer it, be they professionals or informal caregivers.  "It is a priority because everyone receives care and everyone will have to give it. It is a matter of concern that needs are growing and that there are needs that are not being met. There is a lack of long-term care services, a lack of common quality standards, territorial inequalities and the work of professionals is being undervalued," said Susanna Ulinski, technical manager of the European Commission's Directorate-General for Employment, Social Affairs and Inclusion.

Ullinski presented data that provides a clear example of the extent of the challenge. The number of people potentially in need of long-term care in the European Union is 30.8 million and is expected to increase to 38.1 million by 2050. In the EU, 52 million people are informally providing long-term care, while an estimated 1.6 million long-term caregivers will be needed to maintain the current level of care, according to data from the European Care Strategy (September 2022).

"It is a priority because we are increasingly facing an impoverished and unequal society that is growing older; with more labour-intensive households, which makes it difficult for family care tasks, which continue to fall mostly on women and with people who have more support needs and for a longer period of time because these situations of dependency, chronicity and disability are becoming more frequent and complex," said Francina Alsina, president of the Catalan Third Social Sector Platform.

DIPLOCAT Secretary General Laura Foraster said that "debates like today's make it possible to bring to the focus in Catalonia those social issues that concern us as Europeans and help us put people at the centre of the debate."  She also noted that the social rights action plan presented last year by the European Commission, after extensive consultation with state, regional and local authorities, social partners and civil society, states that "a strong, just, inclusive social Europe with opportunities for all must be based on people and their well-being".

The round table heard about the experiences of Catalonia, Scotland and the Netherlands. The latter two have a model of care for people that integrates the social and the health systems. "This transformation can only be built on trust between those who receive these services and those who provide them. We need social and health professionals, but also an alliance with the community, the third social sector and volunteering," said Anne Hendry, director of the International Foundation for Integrated Care in Scotland.  Trust, as an indispensable element in the backbone of this social and health integration, was also highlighted by Mirella Minkman, president of the Vilans board of directors (National Centre of Expertise in Long-term Care in the Netherlands):  "Values and trust are the key element. It is not only important to establish connections and common goals, but also to know what each actor (person or organization) is thinking, and take this diversity into account in decision-making".

The governance model has also been a much debated issue among the Catalan speakers, who are directly involved in the design of the Integrated Social and Health Agency.  "We are working with all the actors involved, not only the Departments [Health and Social Rights] but also the local governments. We must organize this governance not only through the macro lens, but, also counting on a territorial version", said Joan Carles Contel, Integrated Care Technician, and Directorate General of Planning and Health Research of the Department of Health. "This macro governance model will have to be adapted to the reality of each territory, which each have needs that we understand are not identical," added Anna Vila, a technician in the General Directorate of Personal Autonomy and Disability of the Department of Social Rights, who also highlighted the work being done to raise awareness among professionals in the two systems. "If we don't know each other, we won't be able to work together and that's essential for the whole thing to work." 

Anne Hendry has taken advantage of the trip to Catalonia to make a series of visits and professional meetings, organized by the Third Sector Platform and DIPLOCAT, with the collaboration of the Northern Metropolitan Territorial Management of the Catalan Health Institute (ICS). On the agenda are meetings with those responsible for Integrated Social and Health Care of the Catalan Ministry of Health, a visit to a primary care center in Ocata and another visit to the Hospital Germans Trias i Pujol, where she will meet with those responsible of the Complex Chronic Patients Unity (ProPCC Unit).

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