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European
trends and tendencies
in social services
Jan Spooren, General Secretary
EPR
The context (1)
• Ageing
• Gender equality
• Social integration
• Labour market flexibility
Increasing and diversifying
demand
Adapt
to changing needs
Modernisation
Social economic
challenges
• Understand needs
• Flexible responses
• New target groups
• New services
Sophisticated and complex
services
2
The context (2)
THE EC BIENNIAL REPORT ON SSGI – July 2008
Modernization
Significance
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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
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Response to new
challenges and needs
Combine universality,
sustainability and quality
Adapt to new paradigms
(social model / marketbased regulation)
Need to change sector
Pathways to
modernization
Application EC Law
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Procurement
State aid
Internal market
HSS is ‘economic’ activity
State regulator/guarantor
and financer
(but less provider)
Characteristics of social services
Based on solidarity
Asymmetric relationship
providers-beneficiaries
Comprehensive &
personalised
Not-for-profit
Characteristics
of
social services
Rooted in (local) cultural
traditions
Involvement of
voluntary workers
4
The social services paradox
QUALITY
UNIVERSALITY
FINANCIAL
RESOURCES
SUSTAINABILITY
Increasing Social Expenditure
QUALITY
UNIVERSALITY
FINANCIAL
RESOURCES
SUSTAINABILITY
Request to invest sufficient resources in SS
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Strategic alliances with service-users organisations
to lobby towards public authorities
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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
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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’
Re-thinking Core Elements
QUALITY
UNIVERSALITY
FINANCIAL
RESOURCES
SUSTAINABILITY
Reconciling basic concepts of social services
MODERNISATION
UNIVERSALITY
QUALITY
SUSTAINABILITY
“Doing more and better with the same resources”
“Increase efficiency and quality via innovation”
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
UNCRDP Article 26 - Habilitation & Rehabilitation
Rehabilitation
Habilitation
persons with disability from birth
individuals with acquired disability
HEALTH
EMPLOYMENT
EDUCATION
SOCIAL SERVICES
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Proximity and decentralisation
Training of professionals
Promote assistive technology
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Early intervention
Multi-disciplinary assessment
Individual assessment
To enable persons with disabilities to attain maximum
independence, ability and participation
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
Challenges in advancing mainstreaming
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Prejudices from general population about disability
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Mostly problem in initial phase
Resistance from PwD and their families
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Insecurity / over-protection
Difficulties to accept negative consequences of ‘mainstream’
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Mainstream services lack resources to involve
specialised support
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Offering specialised support to mainstream
providers requires active marketing
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Economic crisis reduces employment for PwD
Empower service-user as customer
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Client involvement
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Participation
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Individual: about own integration plan
Balance between rights and duties
Collective: about design, management and evaluation of a service
Organise representation
Informed choice
 Availability and proximity of services
 Information on quality, results and costs
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of services
Empowerment as pre-condition
 Concretise, measure and improve
 Double side of empowerment
empowerment
Decentralisation of service-delivery
Challenges for service providers
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From centre based to out-patient services
 Changed
mentality
 Adapted internal organisation (HR / logistics / …)
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Decentralisation/fragmentation of services
Case management
Need for partnerships
Maintain sufficient interface with client
Departmentalisation of policies & funding
Need for marketing and sales strategies
Need for flexibility
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
JUSTIFY
• Benchmarking
• Do more and better
with available
resources
Social services must meet needs and expectations
Best use of limited available resources
Exigent clients + funders + society
EU Disability Strategy 2010 – 2020
10 Thematic areas
No services required
Special services required
Non discrimination
Employment
Accessibility
Education and training
Citizenship and free movement
Independent Living and deinstitutionalisation
Social protection and income
Health, rehabilitation and
prevention
Participation
EU external action
EU Disability Strategy - Employment
Rationale
• Economic independence and personal realisation
• Economic growth
• Sustainable social protection systems
Actions at MS level
Actions at EU level
 Work with PES
 Work with social partners
 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
EU Disability Strategy – Education & Training
Definition
• Provide required support for PwD within general education system
• Effective and individualised support measures
Actions at EU level
Actions at MS level
 Promote transition from
education to employment
 Remove legal and organisational
barriers from mainstream education
 Promote inclusive education
 Effective and individualised support:
- Timely support
- Early identification of special needs
- Well-coordinated services
 Promote accessibility and
reasonable accommodation in
education
 European Agency for
Development in Special
Needs Education
 Disability training of teachers/staff
 Ensure availability of (financial)
resources for support of teachers
EU Disability Strategy – Independent Living
Definition
• PwD should have choice of place of residence
• Support de-institutionalisation and provision of CBS
Actions at EU level
Actions at MS level
 Mutual learning on
de-institutionalisation
 Close residential institutions and
development of CBS
 Quality framework for CBS
 Good working conditions for
professional carers and support to
informal carers
 Use European Structural
Funds
 Promote personal assistance
schemes
 Data collection on PwD in
institutions
 Use European Structural Funds to
support CBS
- (Re)Training of professionals
- Building infrastructures
EU Disability Strategy – Rehabilitation
Definition
• Provision of quality and affordable specific services
Actions at EU level
 Address quality of services,
including users-perspective
Actions at MS level
 Modernise long-term care services
 Modernise mental health services
 Provide adequate rehabilitation
services