A deeper look into the EU Social Fund and how to make it just and fair
Roger Steer is a Management Consultant working in the Healthcare sector as well as an Advisor to Local authorities scrutinising NHS plans. He is based in France but active in the UK
In my last article I drew attention to the EU Social Fund priorities for 2021-27 that came into force from 1 July 2021. What struck me was that I had read nothing about this before publication or since. I only came across it as a footnote to the ongoing social care crisis in the UK, to which it is no longer directly relevant. It turns out even if the UK had remained in the EU it would not have been immediately relevant to the UK’s social care crisis.
Why? Because the priorities of the EU Social Fund ignore social care (or long-term care), which was surprising, to me at least. It shouldn’t have been, but it’s a long story.
1 EU policy-making
To understand why this should be the case, we need to understand the policy-making framework and processes of the EU, something that successive UK governments were not very attuned to and even friends of the EU have struggled with. There is EU law which provides the framework, the Commission which proposes changes to EU law, the Council of Ministers which sets priorities and takes decisions, and the EU Parliament which has powers over the Commission and acts as a democratic back stop.
The law itself is voluminous and sets rules for its interpretation and implementation. In effect it defines the key concepts of conferral, subsidiarity and proportionality: these govern how issues are managed between the EU and its member states. These rules and practices in my view provide ways for member states to keep the EU at arm’s length, and at the same time allow the EU to palm off responsibility for expensive social programmes. The net result is that states look to prioritise their demands made on the EU according to a narrow (although widening) range of appropriately approved topics, and the EU seeks to minimise the demands made of its funds. Social Care drops out as both potentially expensive and low priority.
If ever proof was needed that the inverse care law applies in the EU then we need only look at the priority provided in the EU to social care.
2 Long-term care in the EU
It is not that long-term care fails to be recognised as a problem and this report from the European Commission, which came out in July, the 2021 Long-Term Care Report: Trends, challenges and opportunities in an ageing society is very useful. It identifies for example that only a relatively few countries limit the proportion of old people living at home in severe difficulty.
It estimates that the size of the problem in EU covered around 31million individuals across Europe in 2019. This is expected to rise to 34million by 2030 and 38million by 2050. Data is drawn from the separate 2021 Ageing Report published by the EU in May 2021.
Long-term care appears as item 18 in The European Pillar of Social Rights in 20 principles which reads as follows:
18. Long-term care
Everyone has the right to affordable long-term care services of good quality, in particular home-care and community-based services.
But the plan to bring this about becomes murky. There is indeed a plan. In May 2021 the European Council supported the Porto declaration on social rights and published in July 2021 an action plan with three main targets for 2030. On Long term care the plan is:
The Commission will:
Propose an initiative on Long-Term Care in 2022 to set a framework for policy reforms to guide the development of sustainable long-term care that ensures better access to quality services for those in need.
Propose new tools to better measure barriers and gaps in access to healthcare (2021- 2022).
Propose in Q4 2021 the European Health Data Space to promote access to health data for better healthcare, research and policy-making, and to foster the development, deployment and application of digital services for the provision of healthcare.
The Commission encourages:
Member States to invest in health and care workforce, improving their working conditions and access to training
Member States to boost the digitalisation of their health systems and tackling health inequalities.
Overall though, member states have been allowed to devise their own plans to achieve targets and to apply for the trillion + euros package of support in the EU’s long-term budget for 2021-2027 to do so; albeit the door has been left open to a different approach following whatever the 2022 initiative says.
The problem, common both to healthcare and long-term care, is that the subsidiarity principle means that EU leaders are delegating responsibility onto local politicians who tend to allocate funds to their most powerful lobby. The inverse care law applies and despite the identification of a huge care problem that is set to increase, the expectation is that not enough will be done to stop the problem getting worse, and the opportunity to apply lessons from the most successful member states to create jobs, relieve suffering, grow the economy and provide a fairer distribution of resources will be lost, particularly in the most backward parts of the EU.
3 Social Europe
This means that paradoxically a disproportionately low level of both investment and initiative is likely to be taken in the areas that need it most. Social Europe continues to be an attractive banner for many, and some sense of urgency is provided in this Policy Brief. The author, Daniel Seikel, concludes:
The strengthening of the social dimension of the EU is back on the agenda of European politics. The European Pillar of Social Rights, the revision of the Posted Workers Directive (Directive 96/71/EC), and the initiative for a European minimum wage are interpreted by some as a turning point. However, the European Pillar of Social Rights is not legally binding, the revision of the Posted Workers Directive (Directive 96/71/EC) basically only repairs the damage caused by the CJEU’s jurisprudence, and the future of the European minimum wage is completely open. The road to a more social Europe is still very long.
Against this background, this Policy Brief asks what a formula for a social Europe could look like. Based on the assessment that European social policy is limited by structural boundaries, I present a concept that takes these limitations into account. The formula for strengthening the social dimension of the EU can be formulated as follows: social minimum standards plus a reconfiguration of the internal market and EMU in a way that is compatible with the pillars of the European Social Model.
The goal of the programme is the strengthening of the European Social Model which is based on national institutions that have evolved over time and that are to be protected and developed further.
My own view is that permissiveness towards structural obstacles is an obstacle in itself; pious statements from the EU about the need for countries to develop better long-term care are lost amongst a sea of other things to do: this is not the way to do it. It may be that the 2022 initiative has been timed so as to come after the key national elections in Germany and France and a more proactive policy may follow a change in leadership. Otherwise it is all too easy to conclude that the recent Porto Declaration amounts to nothing more than the EU washing its hands of responsibility to member states who are all too eager to exploit their most vulnerable sections of society.
Perhaps this bleak assessment is borne of too close a contact with the UK health and care systems and of local politicians who reminded me that, “there are no votes in the mentally handicapped”. But, allowing politicians too much scope in deciding priorities, and relying on them knowing enough to invest in the best way a pot of over 1 trillion euros smacks of a recipe for corruption and misallocation of resources away from the people who need them most.
I propose that the EU directs a social dividend to the most in need within member states as a means of retaining loyalty and support, together with other incentive payments for progress toward the 20 pillars. Without a dividend, other electorates than the UK, may be tempted by local politicians looking to spend the membership fee in other directions. With member states over a Covid barrel this may not be the time for undue meekness.
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