PSI Social Services Conference June 1995
PSI Social Services Conference
SOCIAL SERVICES
PSI position paper for discussion
The politics of social services
Concepts of Social Services - like the Public Service as a whole - are many and various,
reflecting national structures and traditions. Not only is the line between "public" and "private"
drawn differently between countries, it is also a line which has changed over time. Aspects of
economic, social and political activity which over the decades were strategic or whose initiation
or continuation was seen as being essential to progress, have often been taken under the wing of
the public authorities. The reason was that, under a system of private enterprise, these activities
were either ignored because they were financially unattractive or, conversely, were too attractive
(and lucrative) to be left in private hands and thus rendered vulnerable to speculation.
The growth of the public sector can be interpreted in different ways. Over the centuries, the State
sector has tended to grow because economic and social life has become more complex and
because democracy, as an ideal and a process, has been widely seen as the right path to take.
Collective decision making, collective accountability and collective responsibility are an integral
part of democracy, and this collective activity is most equitably carried out by properly
accountable public bodies.
Neo-liberalism
But there is another view, one which has been prevalent in many countries over the past two
decades, which takes a quite contrary stand, namely that collective action does not empower, but
stifles personal freedom and restricts economic growth. This view advocates a neo-liberal
approach of monetarism, privatisation, deregulation, contracting out and the diminution of the
State; one of its chief spokespersons and executors, Margaret Thatcher, went as far as to insist
that "there is no such thing as society, there are just individuals".
Neo-liberalism has caused immense harm and continues to do so; it encourages a fatally shortterm perspective, and, on the economic front, makes short-term speculative profit its foremost
objective, ignoring long-term growth. Some individuals and companies have made fortunes on
the back of privatisation, but the majority of people have had to pay for that, not just in direct
financial terms, but also in the destruction of the jobs and services which have fallen victim. The
climate that it has created, with break-neck competition based on sub-standard employment
conditions, is difficult to escape from. Companies which try to take a longer-term view and
maintain decent working conditions are at a short-term disadvantage which, in recession, could
lead to insolvency.
The consequences for social services are broadly threefold. Firstly, Reaganism, Thatcherism and
their hybrids were to a large extent social and political objectives cloaked in economic terms, and
this can be seen by the sort of sloganeering that they engendered, particularly "get big
government off my back". The "nanny state" was also an expression to get across the idea that
public services encouraged dependence, even idleness. In focusing on individual attainment, it
also sought to apportion individual blame, so the implication was clearly made that
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unemployment was the fault of the unemployed, that unemployment was caused by workers
"pricing themselves out of the market", that social security encouraged unemployment and, by
extension, that those who received state help were basically parasitic.
Neo-liberals set out to devalue the State and the agencies that work on its behalf, especially
social services, which have been widely portrayed as creating and perpetuating social problems
rather than solving them.
Secondly, right-wing politicians have set about restructuring and demolishing social services,
and cutting back the resources available to them. Alongside privatisation and contracting out has
been the tendency to insinuate private sector methods and attitudes into social services.
A third aspect of the impact of neo-liberalism on social services is simply that the social services
have been called on to take care of the casualties of unemployment, poverty, underdevelopment,
as well as cope with demographic changes, structural adjustment and disease patterns. So, at the
same time that resources were going down, the demands on social services and, consequently,
the scale of individual workloads, have gone up. With services stretched beyond their limits, it is
imperative that a concerted international offensive be mounted to promote and restore
fundamental ideals of collective social action. No organisation is better placed to initiate this
campaign than PSI.
Role of PSI
PSI's role has evolved over the years. As the public sector spread, so did PSI's membership and
function, and it now encompasses a vast spectrum of employment and services. The common
factor is not simply that the members are paid from the public purse or employed by a public or
analogous body, but that they are employed in carrying out a service to the public. In other
words, PSI has grown from being just a defender of public employees (although that is still a
necessary function) and is now also a principal defender and promoter of the public service ethic.
PSI's principles on the public service have remained consistent with time, although at every
Congress they have been refined to keep pace with events. In 1972, PSI set up a Health and
Social Services Section which has met regularly since, and over the course of these meetings a
World Policy Programme for the Health Service was adopted, first by a World Health Seminar in
1982, and then formally by the World Congress in 1985. In 1991 the Health and Social Services
Committee decided to integrate social services into the Policy Programme, and the World
Congress in 1993 adopted three relevant resolutions (see Appendices):
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PSI World Wide Policy Programme for the Health & Social Services (Resolution No. 41)
Health and Social Services (Resolution No. 42)
World Wide Policy Programme for the Health and Social Services (Resolution No. 43).
To some extent, the debate had tended to focus on health services, possibly because the
institutions and jobs that are part of the health care system are more easily identifiable than in
social services, especially in an international context. However, these resolutions recognised that
there must be close linkages between health services and social services so that both are geared
towards prevailing needs, and involve an important preventative approach, so turning away from
social control and towards poverty reduction and the elimination of misery. Not only does it
make sense to tackle the root causes of social and health problems, but it also has wide
implications for the sort of structures that are needed. Together with complementary trends in
thinking about health care, the role of institutions has also been reviewed. Far more emphasis is
put on a policy of community care than in preceding decades, albeit for different reasons.
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Unfortunately one of the major political motives for encouraging the decentralisation of care to
the community has been to save money, and many breakdowns in community care can be clearly
attributed to lack of resources.
This broad view of health and social services is important as it underlines their true role of
providing security. Health and social services are not simply services to deal with the sick and
the disadvantaged; they are the means through which many social objectives can be realised:
equality of opportunity, the provision of financial security for periods of sickness, unemployment
old age and child-rearing, housing, and employment services.
There are many areas of overlap between health services and social services, and these overlaps
are very important. Social services, in particular, have a complex function of "networking", in
that they act as a conduit of communication between individuals and the different services that
those individuals need at a particular time.
Social services therefore have capacity to maximise the effectiveness of other services as well as
to humanise them.
The Issues
Definitions
For the purposes of the present Conference, social services have been defined to include:
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social work services;
accommodation/housing services
labour market and employment/unemployment services
retirement schemes
income maintenance schemes
social security
social insurance
community services.
How these are structured will differ from place to place, particularly according to local, regional
and national government structures. Social services will also tend to differ because they aim to
respond to local needs, and these needs themselves vary with time and place. However, with so
many countries in a process of transition - to market economies, to industrialisation, to postindustrial societies etc - concepts and definitions of social services have become confused and
their role and function in the future are still largely undecided.
International issues.
Given that the focus of the majority of social services is on meeting the needs of individuals and
community groups, it would follow that the problems confronting services would be similarly
local and individual, but this is not always the case. Whilst local conditions and situations are
important, there are very major international issues which are impacting on social services and
having a decisive effect on the lives of individual people.
Enormous changes are taking place in the world. Current estimates put the world population at
around 5.6 billion, 4.2 billion of whom live in the developing parts of the world. It is estimated
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that world population will exceed 8 billion by 2020, and that the proportion in developing
countries will continue to increase, with the least developed countries growing fastest.
About 30 per cent of the world's workers cannot find productive employment; 125 million have
no work at all. They and their families make up the vast bulk of the 1.1 billion poor who have to
try and survive on less than $1 a day.
Right-wing, neo-liberal, monetarist, ideology has increasingly established itself not only as
government policy in major industrialised countries, but also in the institutions - both national
and international - that those governments control, notably the International Monetary Fund and
the World Bank. In this way, those governments with economic influence have been able to
apply monetarist policies right across the globe, as they were made part of the conditionality of
structural adjustment programmes.
Structural adjustment programmes have specifically targeted cuts on social services, which have
increased poverty and removed the means by which it could be alleviated. Despite their
devastating effects, these programmes have been claimed as a success by the International
Monetary Fund and the World Bank.
A large proportion of the global population is effectively excluded from development because
they lack adequate nutrition, education, health and employment opportunities. For the long term
alleviation of poverty, alternative development models have to be introduced which address
human problems, not just those of the financial markets.
The State and Social Services
Laws are enacted to protect, and regulations to control and supervise, but in order to do so they
must also restrict. Generally, the reason they were adopted in modern democratic states was to
safeguard society from the abuse of power.
The law must strike an acceptable balance, protecting both the individual and society as a whole.
Of all the reasons for the demise of ‘communist’ regimes in Central and Eastern Europe, one was
certainly that the State apparatus had extended too far and the laws which it adopted and
enforced were too restrictive and ultimately unacceptable to the majority. The presence of
extensive State machinery does not automatically signify that government is either oppressive
one the one hand, or empowering on the other. State machinery can be used to defend or to
attack individual freedom and choice.
The initial optimism over the end of the Cold War has very quickly turned to disillusionment for
many. Those in Central and Eastern Europe who expected swift prosperity have been
disappointed, whilst those in the West have been dismayed at the upsurge of nationalist conflicts
and crime. Developing countries which hoped that the end of the Cold War would bring a new
economic and political order in which they could make up lost ground have been largely
frustrated.
Tragically, the response of intergovernmental institutions has not done much to inspire
confidence, especially the failure of the UN to resolve the conflicts in the former Yugoslavia and
Somalia.
Proponents of neo-liberalism not only see the State as too big in terms of institutions and
expenditure, but also in its coverage. With economic recession affecting all economies over
much of the last decade and powerful forces calling for cuts in public expenditure, the roles and
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duty of the State are being fundamentally re-examined. Nowhere is this debate more profound
than in Central and Eastern Europe, but the ideas that are emerging in those countries are
undoubtedly influencing policy in other parts of the world, especially in developing countries.
It is easy to get bogged down in polemics when arguing for or against the public sector, and what
is acceptable to the people of one country may well be unacceptable to those in another. Social
services come under particular scrutiny because they are concerned with individual needs and
circumstances, and therefore are open to allegations of being intrusive.
But what is important in the current political climate is to reaffirm that there is a basic need for
the State to protect and promote the rights and interests of all members of society. "Rolling back
the State" does not spell greater general prosperity or freedom, but it does entail removing the
strictures on corruption, crime, lawlessness and exploitation. Trade unions do not support
oppressive State machinery; neither do they support the anarchy and deprivation that results from
dismantling social welfare mechanisms.
Global Dimension
An important aspect of re-evaluating the role of the State is the direction that society as a whole
is going in, and thus what sort of social welfare system is going to be most appropriate in the
coming decades. With ever extending communications, and the imminence of what some call the
"information super-highway", the concept of the "global village" is fast turning into an everyday
reality. The things that ordinary citizens use are often made in other countries - often in other
continents. They are constantly told that they have to compete for their jobs, and that the
competitors are foreign. Much of the information and entertainment they get is from other
countries. At the same time, awareness of environmental damage has shown people that their
lives are affected by pollution that stems from other parts of the world and that even the climate
itself may be changed as a result. In short, people are becoming more aware of the global
dimension of the world around them.
It will take time for people to adapt to this new perspective, and to work out what it means for
them and what their response should be. One reaction is likely to be fatalistic, where the
magnitude of the forces at work on their lives seems so great that individuals feel powerless to do
anything about them. However, that sort of reaction tends to be short-term, for if people perceive
that the quality of their lives is continuing to deteriorate, helplessness can turn to frustration and
anger, and eventually to action. This reaction should be channelled positively into reinforcing
democratic institutions and processes, but there is a serious danger that it will manifest itself as
violence, nationalism, racism and xenophobia.
Basic Principles
In a world of uncertainty, many people are looking for the reassertion of basic principles which
they can support. The fragmentation of their immediate environment - with unemployment,
disintegration of family structures and uncertainty about the future - is compounded by the
confusion that is apparent at the global level. This makes the role of the State very important;
people who realise that, individually, they are limited, need and expect the State to protect them
and to create a stable environment. The need for stability has also been echoed by industry, so
that it can take a longer-term view of investment.
Yet in broad terms, the trend over recent years has been for State provisions to be diminished and
for more emphasis to be put on individuals to take a greater share of responsibility for their own
welfare (and that of their dependants). This has been manifest in pensions, housing, health care,
social insurance, employment schemes etc. Those political forces (including governments) which
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publicly decry "social engineering" have in many instances carried out the most blatant
restructuring in society, for example through the creation of a massive pool of unemployed and
people in insecure employment, as well as by channelling social services away from those who
do not fit their stereotypes, e.g. one parent families and cohabiting couples.
This is one example of where new lines have been drawn in social services, but they can be
found everywhere. Certainly there is need for reform, but not with the sole aim of diminishing
social security so as to promote economic development. Privatisation of services is not a more
efficient way of serving the client or society - far from it - but it is a way of producing a shortterm cash inflow from the sale of public assets, as well as generating profits for the associates
and friends of government. Not surprisingly, multinational companies have been quick to seize
the opportunity of buying into the more profitable areas of social service provision, for example
residential homes for the elderly.
Change and Reform
The way that social services are developed in the future will be an important - possibly the most
important - deciding factor determining the future shape of society; social services are a
barometer both of society's problems and its commitment towards solving those problems.
Fundamental statements need to be made about the role of social services. To begin with, people
must be clear about what they expect from the State in terms of social services and to do that
they need unbiased information about the current situation and where it leaves them now and in
the future; they must also be clear about the implications of present decisions for future
generations. This must include reliable information on demographics, changes in the global
location of production, economic and employment trends, opportunities for education and
training, and changes in disease patterns. If the individual is really going to play a greater role in
decisions about social services, then the individual must be properly informed and offered a full
spectrum of choices, not just "sold" a political ideology. Individual choice must include the right
to participate in collective action as citizens and not just as customers.
As a basic principle, social services policies must set out to prevent poverty rather than just treat
its symptoms; policies be comprehensive and universal, aiming to provide all those social
services to all those people who need them. Provision should not be limited to providing the
minimum, and systematically diminishing eligibility, access and range of services. Social
services must be available as a fundamental right, not as the result of discretionary administrative
decision.
Social services should be closely linked with other services, and where possible be
interdisciplinary.
Independence
Social services should be aimed at providing sufficient and appropriate support to encourage self
reliance and independence. This is especially important with the physically and mentally
handicapped who wish to live as "normal" lives as their condition permits, including the
possibility of fulfilling employment and a satisfying social life. People place enormous value on
their independence and will place corresponding value on the help that they receive in being able
to remain independent.
Individual attention
In order to carry out their function effectively, social services must work with the individual, and
try to understand and identify their needs and concerns. Those needs and concerns differ greatly
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from person to person, depending not just on their physical or mental condition, but on their
education and training, the history of their condition, their family situation, their financial
position, and their previous experience. It is completely inappropriate to classify people solely
according to a registered disability or condition; this is just as true for those who are, for
example, visually impaired, as it is for the elderly. One person may seek to share experiences
with others in a similar condition, whilst others will want to get away from being grouped like
this and want to enjoy the company of a wider range of people; others may simply want privacy,
to have some time away from day-centres and be able to read or watch television on their own
for a while. Some may want to look after themselves to the greatest extent possible, including
looking after their own home and finances, whilst others would prefer these burdens taken off
their shoulders, at least for a while.
Carers
Social services must also be attentive to the needs of "carers" in society, that is to say, those who
look after dependent friends or relatives, often without much outside support or understanding.
They, too, need their independence and the possibility to have a social life, take holidays and
enjoy social interaction. Overwhelmingly these carers are women who in many societies spend
as much of their life caring for dependent parents as they did caring for their children. They are
often ‘invisible’ and are rarely included in the list of people who have a need for social services.
Of course, they also need more equal relationships with the men who also have these children
and parents.
Information and communications
Needs and concerns also vary with time and circumstances, and social services must be prepared
to be flexible in providing for those changes. Given the diversity of needs, it is likely that the
services or support that a person needs may involve more than one department or provider. This
could involve assistance with housing, transport, education, employment and so on. Clear lines
of communication between different departments or providers of social services, as well as
between social services and other agencies, must be in place. Experience has shown that people
get a good deal of informal information about social service-related matters, so social service
providers should make sure that reliable information on approaching social services is available
through other bodies and groups; for example, clubs and associations, charities, public libraries,
the media - and increasingly through computer networking. With the increasing multi-cultural
nature of many societies, it is important that information should be available in a form which is
readily understood by non-dominant groups, including in other language versions.
Resource Problems
As with many other public services, there is frequently a problem of balancing quality and
quantity of social services, which is exacerbated by lack of resources. A lot of emphasis must be
put on spending sufficient time with individuals to assess their needs and to work out with them
the kind of support that is appropriate and this is clearly resource-intensive. Furthermore, those
whose needs are the greatest are frequently those who cost the most to support in the community.
It is not impossible to do a great deal with few resources, as those who work in social services
have amply demonstrated, but this cannot be considered an ideal situation or one which should
be tolerated as a permanent situation. The "temporary slow down" of social services very easily
becomes a permanent decline which, once started, is virtually impossible to reverse, as the gap
between what is and what should be becomes ever greater. It is very important, therefore, that
resourcing social services is not seen just as a short-term cost, but as a long-term investment,
avoiding the economic, political and social consequences that inevitably erupt from an uncaring
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and brutalising society. Those who live in hardship can very soon find themselves sliding into
abject poverty, and eventually marginalised from society. Social services must aim to build
social cohesion rather than to exacerbate social divisions.
Disincentives
It may seem futile to identify needs if there are not sufficient resources to provide the
appropriate facilities to match them, or if there are inadequate planning mechanisms to take
account of changes in needs. In fact, it can create disincentives within social services, as staff
may feel that there is no point making the public aware of their rights to services if there is
insufficient resourcing to provide those services when they are sought. This can encourage
providers to conceal rather than reveal what services are - in principle - available, in case the
resulting demand over-stretches resources. It can also mean that services are provided strictly
in accordance with current resource limits, causing waiting lists which impede access, and in
practice taking away people's basic right to services and creating the impression that public
services are incompetent.
Another result of under-resourcing is that staff are forced into prioritising, which in itself is not
necessarily bad, but it should not be allowed to deteriorate into a situation of permanent crisismanagement, nor should it try to shift the responsibility for shortcomings on to individual social
service staff, when the real responsibility lies with those who set overall targets and budgets,
particularly politicians.
Volunteers
The role of volunteers and voluntary organisations has to be carefully evaluated. In many
countries they play an important role in helping particular groups, both directly and through
fund-raising, and they can sometimes act as a special interest lobby and as a raiser of public
awareness. Some organisations may even receive public funding to carry out some of their
activities, and enjoy special fiscal status.
However, this must raise questions. The essentially voluntary nature of these organisations
means that their continuity is not secure and their public accountability is doubtful. They are
selective in the groups that they assist and this inevitably leads to some groups being left
uncatered for. For these reasons, they should not be allowed or encouraged to replace formally
accountable, publicly funded providers.
On the other hand, those who are desperate for help and assistance will understandably welcome
it, irrespective of whether it comes from a voluntary or a statutory body. Additionally, raising
public awareness of the needs of others, encouraging them to see that they can do something to
help and especially motivating them into collective action, is important. Ways have to be found
to harness the altruistic potential of volunteerism to the needs for social equity and democratic
accountability.
Privatisation
In doing so, a clear distinction must be drawn between those organisations which operate out of
charitable motives and those which operate for profit. Increasingly, shortages in social services
are becoming institutionalised, with the gap being met by private bodies. This can include user
fees, contracting out and privatisation.
There is no justification for hiving off public responsibilities for the provision of social services
to private companies, especially when so many are only able to compete because they pay low
wages, offer little job security and frequently use part-time, temporary or casual staff who do not
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have the proper training or experience. These workers are also much more difficult for unions to
organise, service and defend.
Monitoring
Private service companies which are out to make profit have very little incentive to carry out
services other than those which are closely defined within the terms of their contract, and often
manage to negotiate let-out clauses to allow them to avoid serving difficult or expensive clients;
these people are liable to fall through the safety net as a result. This, combined with mistakes and
poor quality work, means that there has to be careful monitoring of the performance of private
companies, which adds to their cost and to the frustrations of both clients and staff. However, in
the drive to reduce costs, all too often there is inadequate provision left for proper monitoring
and it is frequently devolved to clients to fulfil the monitoring function by standing up for their
rights and complaining.
Whilst an efficient complaints and review mechanism is important, the emphasis should be
placed on preventing poor service rather than reacting to service failures after they have
occurred.
One of the most important ways by which unions can fight to regain public social services is to
insist on effective monitoring and, indeed, to monitor private contractors themselves, drawing
attention to contractor failures and insisting that public agencies impose the proper sanctions.
Wherever possible, privatised social services should be taken back into public hands and carried
out by direct labour.
Inefficiency
Studies of privatisation have shown that savings which were initially targeted have failed to
materialise over time, and that the recipients of services, as well as those involved in the delivery
of services, have suffered; some of them have been pushed out of the system altogether, and the
community as a whole is poorer as a result. Yet the private provision of elements of social
services is increasing and will probably continue to do so, at least in the short term, as political
and economic circumstances have been created which make a variety of forms of privatisation
more possible, for example, through compulsory tendering.
Fighting contracting out
In order to protect social service workers, unions have taken different forms of action, including
negotiating no-contracting-out agreements, guarantees of no job-loss, advance notice of
contracting out plans, and the right for staff to put in their own bid to keep the work in-house.
Having a say in the terms of the contract is also important, so as to ensure that private bidders are
having to provide at least the same level of access, eligibility and service, and that private bids
include the cost of monitoring and supervision - and, where necessary, rectifying mistakes.
Unions should also insist that terms and conditions of employment, including social welfare
benefits, are maintained, and that all those who work for the potential contractor would have the
right to join, or remain members of, a union; unions should cooperate to see that, whatever
happens, workers are organised. When contracts are put out to tender on this basis, it will often
be very difficult to find private sector bidders and it will slow down, if not prevent, the
privatisation taking place.
Principles of Funding
The State and public agencies not only have a role have a role in budgeting and monitoring
expenditure, but also in how the revenue for funding is raised; voluntary organisations do not
have the same degree of control over their funding, which is, by definition, not compulsory and
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is dependent on the largesse of individuals, companies and others. There is no equity built into
voluntary financing, so a relatively poor individual may contribute, whilst a rich company may
choose not to.
Social services work best when their system of financing is compulsory, and the level of
contribution takes into account the wealth and income of individuals and commercial
undertakings. In other words, an important aspect of social service provision is the maintenance
of an equitable and effective taxation system.
As well as being socially desirable, there are sound practical reasons for putting the financial
emphasis on setting up and providing services, rather than on pricing services and regulating
them according to market forces.
People turn to social services when they need assistance, so obviously they are not in the best
position to be able to pay for them at the point of need. This is not only true of groups within
society, but also of individuals. It makes sense for an individual to contribute to the financing of
social services when s/he is in employment rather than in retirement, unemployed, disabled,
homeless or destitute.
At some point in their lives, everyone will have need of social services, but it is wholly
unrealistic to promote the idea that the individual should be responsible for making their own
personal provisions. Firstly, many people would not do it and so the State's role of being the final
"safety-net" is certain. In any case, no one's life goes according to plan and it would be
impossible for all but the very rich to make personal provision for every eventuality based on
accurate risk assessment. One of the many virtues of a publicly, collectively financed system is
that the risk is spread as widely as possible, and so the risk to the individual is minimised. It also
means that, where there are fundamental demographic changes - such as that now being faced
because of the general ageing of the population, both the financing and the planning of social
services can be reviewed.
Ageing population
In the present situation of social services, it is inevitable that a lot of attention is focused on the
short-term. But it is crucial to the continued relevance of social services that sight is not lost of
the long-term horizons.
Even those countries which are economically powerful have fears for the future; to begin with,
not all of them have comprehensive social services - most notably the USA - and those that do
are concerned that the ageing of the population will impose a huge financial burden, as older
people have more need of social services (retirement pensions, appropriate housing, community
medical care, domestic help etc) but at the same time the funding base will be smaller, firstly as
the proportion of people of working age will be less and secondly because, if present trends
continue, many people of working age could be either unemployed or in part-time or temporary
employment.
The ageing of the population is not something that has been suddenly discovered; birth and
morbidity rates give decades of advance notice of a process like this, and the increased
disintegration of the three-generation family has been steadily charted. So, whilst this is not a
new problem, it is still not one which is easy to resolve and little has been forthcoming in the
way of viable solutions. Proposals have been put forward to raise the age at which people are
entitled to retirement benefits and pensions, to extend minimum qualification periods for
pensions and to reduce the real value of pensions. None of these options are acceptable, as they
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treat ageing as though it were socially undesirable. In fact, applied in any other context, they
would be seen as disincentives. The fact remains that few countries have introduced any major
changes to the way in which their pension systems are financed.
Employment-related benefits
Some governments are hoping to supplement state pensions by encouraging occupational and
vocational pensions, but linking pensions to employment will only help those who are employed;
those who are unemployed will not benefit.
Employment-related benefit systems also tend to put women at a disadvantage, as they are more
often in forms of employment which do not qualify them for social security or have spent, not
always by choice, many years out of the paid workforce to care for children. Employers
deliberately try to exclude staff from pension and other social insurance rights by diminishing
job security.
Furthermore, the days when a person could expect to stay in one job for the whole of their
working lives are gone, and existing pension arrangements do not perform well where
employment is not continuous. A major difference would be made to older workers and to the
job flexibility which employers say they want if it was made possible (or compulsory) for these
employment-related benefits to be portable from job to job.
Trade union demands for full employment and job security are therefore central to the issue of
funding future social services, particularly retirement pensions.
Unions and Social Services
Unions are critical of the shortcomings of social services, and many support reform. However,
they do not agree that the answer lies in making social services behave more like private sector
businesses, which is the direction that neo-liberal policies are taking. Cut backs and
fragmentation are not going to take away the problems, still less are they going to promote the
solutions.
In conformity with the approach of seeking to engage preventative rather than simply curative
measures, unions want to take part in an in-depth analysis of the problems which social services
are called upon to tackle so that their root causes can be identified and dealt with. A serious
attack on poverty and unemployment are central in this process as, without doubt, many social
problems are compounded, and often caused, by poverty and unemployment. In recent years,
economic policy has accepted, and sometimes even promoted, unemployment as a consequence
of fighting inflation. Unions have consistently warned of the dangers, but both national and
international financial institutions have been intent on strict monetarist measures being
introduced, even in the poorest countries of the world. Tackling the root causes of social
problems demands a strong political will; a sense of collective responsibility must be engendered
if tax payers are going to support fiscal measures which would put the concept of social
solidarity into practice.
Coalition building
As with the provision of social services themselves, good participatory relationships must be
built up so as to achieve the necessary consensus. Diverse groups in the community, often
representing interests which at first sight are conflicting, or at least in competition, need to be
brought together to identify problems and solutions and to campaign to secure the means to
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PSI Social Services Conference June 1995
support them. Unions can play a very important part in coalition building, as they tend to have a
broader social view than many single-interest groups, and they represent experts: the workers in
the services themselves. These workers must not only campaign for increased funding, but must
demonstrate that they know how funding can be most effectively deployed and where potential
savings are located. Political support is important, and focusing on issues of quality is essential in
building up coalitions, as it is most likely to respond to the particular needs of their constituents.
Not only must social service unions work with community groups, they must not neglect the rest
of the labour movement, for if other organised workers - who are also citizens, tax-payers and
recipients of social services - do not support their demands, they are unlikely to have enough
backing to win. This is important at a local level, but crucial at a national level, where changes in
government policies are needed and where division in the labour movement are most likely to be
exploited.
Neither should social services management be excluded. Although there has been a growth of
anti-union management attitudes, including even union-busting in some instances, some
managers are in an unenviable position of having to implement cuts against their own better
judgement, and their cooperation should be sought. Where restructuring has been introduced
without union involvement, the effects have often been lost jobs, contracting out and service
reductions. But, where cooperation is possible between unions and management, there is a better
chance of identifying savings whilst protecting jobs and services, as well as promoting more
cohesive labour relations in general.
Workers and quality of services
The main asset of social services is the people who work in them. Improving quality in social
services depends to a large extent on investing in human resources, in terms of pay, conditions of
work and employment, training and qualifications and the promotion of equal opportunities.
Caseloads
The number of clients of social services has increased dramatically in many countries since the
onset of economic recession, whilst the number of jobs in public services has tended to decrease.
That said, given the diverse nature of social services, it is sometimes difficult to quantify
caseload on a comparative basis as for one worker a "case" may be one person, for another a
family and for another a claim form or payment transfer. Additionally, individual needs vary
greatly, so it is misleading to compare caseloads on a wholly quantitative basis.
Experience has shown that, because of the commitment of social service workers and the nature
of their work, there may well be overload that is not immediately apparent, as staff may be using
their own time and resources, taking work home, not registering overtime, etc. so as to work
within the prescribed budgets. Some may also be overworking so as to avoid losing their jobs.
Thus the first indications of overload may be the deterioration of the health and/or morale of the
worker. The effects on social service workers have been serious, and the incidence of overwork,
burn-out and disillusionment are increasing. Many know that they are not doing the job that
needs doing and that they have been trained to do. Furthermore, as so many aspects of social
services involve referring clients to other services, they find that this is an ever more difficult
exercise, as other public services have also been subject to cuts. So, in addition, social service
workers may well find that they are getting the blame for cuts or overwork in other services.
Putting in place controls on caseload levels is therefore important for the workers as well as for
the client. The legal position of workers can also be affected if they are doing unauthorised work
which exposes them - or their client - to a hazardous situation. Understaffing causes long delays
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PSI Social Services Conference June 1995
or impersonal treatment or, where workers are having to implement cutbacks, by denying
benefits; clients may well become angry or even violent. Injuries and even death inflicted by
clients are becoming more common among social service workers, in all kinds of work, and
security of staff is becoming a pressing issue in many countries.
Comparability
Unions must work steadily to improve the situation of social service workers. Some of the means
to do so have already been referred to, such as building coalitions, but in mounting a successful
campaign, the importance of getting across to the public the inextricable link between good
working conditions and high quality, cost-effective social services cannot be overstated. There is
no reason why social services workers should be remunerated at a lower level than workers in
other sectors of the economy with similar training and responsibilities.
Pay and conditions
Negotiators should ensure that they have up to date information on the composition of social
service employment, particularly the numbers in each job and grade and the breakdown by
gender, race and disability. They should know the proportion of union members in each group
and the history of previous claims and settlements. Unions must be able to demonstrate to the
public and to the employer that pay and conditions must be good enough to attract and retain
staff with the right qualifications, experience and commitment.
Where morale amongst workers is a particular problem, it is important to establish the key
factors that are important to them. Whilst pay is important in denoting the value that is placed on
their work, it is not the only factor. Working conditions and unsympathetic management attitudes
may be just as important in terms of morale.
Training and Qualifications
Given the enormous and increasing scope of the problems that social services have to handle, it
is important that employees have the appropriate qualifications and training. Excessive case load,
staff shortages, and use of private contractors or temporary staff should not result in clients being
handled by people who have not been adequately trained.
Training must be organised to permit refresher courses and further training as a basis for career
development, so that valuable knowledge and experience gained over the years is not lost. Initial
training must prepare employees for this type of lifelong learning and enable them to work both
independently and as part of teams, including cooperating with staff from other agencies. In
order to promote coordination between different parts of social services, as well as to maximise
career development, there should be uniform initial training for similar professions, with
specialisation occurring later on; this would more easily enable workers to retrain and move
between professions, without having to start from the beginning. It is very important that training
should equip employees with the skills they will need for dealing personally with clients, to be
able to help them express their concerns and, where possible, identify their needs. The social
service worker can then help the client to solve her/his problems either directly or by referral to
other agencies. The employee should be able to inform the client of the services that could be
made available in their circumstances and how they can be obtained. Staff should be able to help
clients to take preventative actions to avoid new or further problems. This should include passing
information about services so that they can make those services better respond to their needs.
Social service staff must be given full training to help people who have been marginalised,
people in crisis, children getting a raw deal, to work on change and to acquire knowledge of the
structures and laws of society.
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The increasing prevalence of community care and de-institutionalisation places greater
concentration on social services. Staff must receive training which is appropriate for the sort of
situations they will have to deal with. They are increasingly the first contact with clients who
would previously have been in hospitals or residential care and so communications must be
established whereby they can participate to a much greater degree in decision making. The
employer must have a clear policy on matters such as the administration of medicines and home
helps and carers should know the tasks that they should not undertake. Staff should be informed
of the procedures to take when clients have adverse reactions to medication, or when they refuse
to take their medication. They should know how to report suspicious circumstances (e.g., health
hazards in the home, signs of abuse, special concerns of clients etc).
Working environment
Many social service workers are involved in "processing" clients' information; as already stated,
this can be seen by some as potentially intrusive, and some people will find it demeaning,
especially if it is dealt with "over the counter" in front of others. Managers of social services
must be trained to structure reception and interview areas so that clients' feelings and dignity are
respected; at the same time, staff safety must also be promoted. Local social service offices
themselves should be based in, and accessible to, the local community, providing a full range of
information and services. Good working conditions for social service workers should translate
into a more user friendly environment and better service quality.
New forms of delivery
Amongst the new forms of delivery systems which are being introduced is that of "one stop
shopping" which means that a person has only to see one representative of social services to
explain their situation and all the necessary contacts with specific branches can be dealt with by
that one social services representative. Too often, where clients' situations necessitate action by
several services or providers, it has been necessary for the client to deal personally with each
aspect of the problem, involving visits to several offices. This is making the client fit the system
rather than the services adapting themselves to clients' needs, and such a procedure is not only
time-consuming and often expensive for the client, but it can also be demeaning and discourage
them from claiming all their benefits.
Equal Opportunities
In promoting equal opportunities for clients, social services should not lose sight of their own
responsibilities as employers in this respect. Gender stereotyping in recruitment and training, as
well as in career development and mobility should be vigorously opposed.
People with disabilities should not suffer discrimination and obstacles to recruiting, employing
and training workers with disabilities must be removed, including modification to buildings and
the provision of appropriate aids. Neither should race or sexual orientation present barriers to
employment in social services. Indeed, a multi-cultural service workforce can be a distinct
advantage when dealing with clients from particular sections of the community, for example,
minority language groups.
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Social Service Objectives
Social services should:












Prevent poverty rather than only relieving poverty once it has arisen;
Provide genuine security against contingencies such as unemployment, sickness, old age,
disability, and homelessness;
Meet the needs of everyone, on the basis of adequate benefits paid as of right;
Act as one of a number of means of sharing out resources more fairly by distributing
income both between social groups and over the life-cycle of individuals;
Be part of an overall social provision, combined with policies to tackle unemployment,
low pay, health care, education and housing;
Treat people as individuals, recognising and respecting their particular needs;
Recognise society's collective responsibility for children and others in need of care;
Allow equal access and provide equal treatment to everyone regardless of race, marital
status or sexual orientation.
Be administered efficiently and courteously;
Provide benefits which are easy to understand and to administer;
Be accountable to users and to those who work in them;
Act as model employers, treating their own staff fairly on the basis of the above
principles where relevant.
Trade unions in social services should:










Campaign for social service clients to be provided with a high quality delivery system;
Participate in decision-making on improvements needed in delivery systems;
Work with coalitions to generate public support for adequate governmental resources
targeted to social services programmes;
Oppose cuts in resourcing, including those imposed as part of structural adjustment,
which would have negative consequences for clients and for society as a whole;
Ensure that programmatic changes are made, and that social services staff are provided
with the opportunity to participate in training programmes;
Ensure that social service workers can participate in education and training programmes
which facilitate career development and mobility;
Work with management in developing innovative service delivery systems, such as "onestop shopping";
Secure terms and conditions of employment for social service employees which are at
least comparable with those in other sectors of the economy;
Campaign for working arrangements and a work environment which promote health and
safety, paying special attention to the increasing incidence of problems related to
violence;
Negotiate acceptable caseload levels which do not induce undue stress, overwork or
"burn-out";
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PSI Social Services Conference June 1995




Fight for equal opportunities in social services, both in terms of the services provided and
in terms of the social services in their role of employer;
Achieve the highest possible level of union organisation amongst social service workers,
with particular attention being paid to the needs of special groups, including the disabled;
Defend the fundamental trade union rights of workers in social services, in conformity
with ILO principles and standards;
Work with other unions, including those in other countries, and with PSI to promote
social services in public hands.
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PSI Social Services Conference June 1995
EQUALITY IN SOCIAL SECURITY
by Valerie Ellis, Assistant General Secretary,
Institution of Professionals, Managers and Specialists (IPMS) UK
and Vice Chair of the PSI Women’s Committee
According to the ILO, the two-fold aim of social security as it is generally understood today
is:

to maintain people’s livelihood by substituting benefits in the event of loss of income as a
result of illness, accident, disability, death of a breadwinner, or old age, or to cope with
the special expenses involved in family responsibilities such as child care;

to gain access to preventative and curative medical care, and also to rehabilitation.
Many social security systems date back to the first international labour standards which
followed the First World War and were primarily designed to provide individuals in paid
employment with protection against a defined set of circumstances. Although they take many
different forms, they are usually based on the concept of a ‘male breadwinner’ with dependent
family, where women who have no, or only intermittent work in the ‘formal economy’, have
to rely on ‘derived’ or indirect rights acquired through marriage-type relationships, or on
social assistance. Such a model neither reflects the social realities of today nor effectively
meets the needs for equality of treatment.
Many women have therefore been demanding individual social security rights for men and
women to take account of women’s changing position in society - usually called
“individualisation” - as the best way of achieving full equality. However, individual rights in
employment-related schemes pre-suppose that a high percentage of both sexes are in
continuous, full-time, reasonably paid employment. Whereas women are more likely than
men to combine paid work with unpaid caring work, they are concentrated in low paid
employment, often in the “informal” or unregulated sectors, and they work atypical patterns
of working hours. Thus, individualising contributory and insurance based schemes need to
take account of this, otherwise they will increase poverty rather than reduce it.
Not only is the traditional model of social security coming under increasing strain from
changing social structures and demands for equity between men and women, it is also under
pressure from:

rising unemployment and ageing populations which put increasing pressure on social
expenditure;

changing patterns of employment with atypical work patterns and casualisation
increasingly affecting men as well as women;

pressure from the Right and from the IMF and World Bank to reduce public expenditure
as evidenced in Structural Adjustment Programmes (SAPs);

increasing resistance to paying higher income tax to finance growing social needs.
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PSI Social Services Conference June 1995
In Europe, one of the results of these pressures has been a developing tendency for European
court judgements and other implementation procedures for equality legislation to reflect least
cost methods of security equality and, in some cases, to equalise ‘down’; as in the case of the
UK Government’s proposal to equalise state pensions at the current men’s age of 65, rather
than the current age for women which is 60.
There are, therefore, major problems in securing a social security system which achieves real
equality between the sexes and which is based on social models which reflect the working and
social patterns of today, while not giving reactionary forces the opportunity to impose their
preferred low-cost methods based on maximum private provision with a poverty level “safety
net”.
Within Europe, the White Paper on “Growth, Competitiveness and Employment” issued at the
end of 1993 promotes a model of European Society based on active solidarity between those
who have jobs and those who do not, between older and younger generations, between rich
and poorer regions and which is in support of marginalised groups. It also calls for coordinated action by the European Union to put this model in place, suggesting new ways of
raising extra finance for social provision (for example, through ‘green’ taxes) and proposing a
re-definition and redistribution of resources between paid and unpaid work. The White Paper
therefore offers an opportunity to integrate equality issues into the wider context of the
discussions on social and economic policy which are now taking place, and both the ETUC,
including its Women’s Committee, and the PSI will need to play a full part in that.
On the global front, the ILO held a tripartite meeting of experts on ‘Social Security and Social
Protection: Equality of treatment between men and women’ in November 1994 and has
produced a document which will have been considered by the ILO Governing Body in its
March-April 1995 session. The meeting took the view that the question of derived, as opposed
to individual rights, was a complex matter whose regulation was likely to vary both between
countries and over time. It instructed the ILO to make further studies of the impact of existing
ILO Conventions and Recommendations on the achievement of equal treatment of men and
women and to develop appropriate actions. Member States were encouraged to intensify their
own efforts to achieve equal treatment and to seek the help of the ILO office in doing so and
to ensure that equality of treatment was given special attention in the design and
implementation of the social aspects of SAPs.
The Workers’ Group were unable to make any progress in extending the scope of ILO
Conventions and Recommendations to include those people currently excluded from social
security systems either by type of work, or by unemployment or intermittent and precarious
working patterns. The employers were intransigently determined to prevent any progress and
to restrict the meaning of equality of treatment to matters internal to the social security
systems and not to use the social security system to redress inequalities in the labour market,
or to deal with the social support infrastructure.
V Ellis April 1995
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PSI Social Services Conference June 1995
INTEGRATING HEALTH AND SOCIAL SERVICES
FOR OLDER PEOPLE
Background Paper prepared by Anna L. Howe, Ph.D., Reader, School of Health Sciences,
La Trobe University, Melbourne, Australia
Acknowledgment
I am indebted to Public Services International for the opportunity to present a background paper
at its Asia-Pacific Regional Workshop held in Brisbane in October 1994. That paper and
discussion at the Workshop provided the basis for many of the themes and issues taken up in this
paper.
SOCIAL AND POLICY RESPONSES TO DEMOGRAPHIC TRENDS
Ageing should be seen as a positive outcome of development that indicates that many problems
of health, social support and employment have been overcome to a significant degree. Survival
of a greater proportion of the population to old age also provides an indicator of the spread of the
benefits of development across the whole of the population.
Whether rapid and on a large scale or at a slower and more modest pace, ageing brings a new set
of social issues to the policy agenda. The ways in which different societies define these issues
and respond to them depends much more on their social, cultural, economic and political systems
than on demographic trends. The importance of the social context is seen clearly in the contrast
between two countries separated only a line on the map, the USA and Canada, which have
similar age structures but very different social systems. Australia and New Zealand also have
similar age structures, but recent political events are seeing a growing divergence in social
policies and in the role of the public sector in the provision of health and welfare services.
The processes and outcomes of demographic ageing need to be understood as they present a
number of questions which policy makers and community groups must address, but they in no
way determine the nature of the response that are possible or probable in any set of
circumstances. There is no "Demographic Imperative".
Not only is there great diversity in the policy responses to population ageing between countries,
but within any country, there is considerable dynamism in aged care policies and programs.
Australia embarked on a major Aged Care Reform Strategy in the mid 1980s, with a series of
coherent policy measures to be implemented over a decade. The aim of the Reform Strategy was
to shift the balance of care from an overemphasis on residential care, especially nursing home
care, towards more community care. A Mid Term Review of the outcomes of these measures
was conducted in 1990-91, and while there were many indicators that considerable progress had
been achieved, a number of changes in other health and welfare areas were identified as likely to
have a growing impact on the aged care system in the coming years (1).
The Mid-Term Review was extended to a second stage that focused on these changing
boundaries. The report of the second stage of the Review (2) identified a number of opportunities
for improving the integration of aged care services and acute health care and promoting better
linkages with housing programs. Proposals regarding funding of aged care services that would
take account of changes occurring in retirement income arrangements were also advanced.
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This paper takes up two sets of issues canvassed in the Mid Term Review which have
implications for integration of health and social services for older people. It also considers some
ways in which the union movement in general and public sector unions in particular might take
an active part in responding to these developments.
AUSTRALIA IN AN INTERNATIONAL CONTEXT
Australia can be set in an international context by some brief comparisons of demographic trends
and social policy orientations.
Australia stands in the middle range of demographic ageing, with 11 per cent of its population
aged 65 years and over at the 1991 census. Even in 30 years time, when it is projected that
almost 18 per cent of the population will be aged, the age structure of Australia's population will
be similar to that of many European countries in the 1990s, and still younger than those countries
will be in 2020 when many will have at least 20 per cent of the population aged.
Demographic trends of ageing in Australia are similar to those of the US, Canada and New
Zealand, but the pace of ageing is slower than the in the rapidly ageing countries of the Asia
Pacific Region, most notably Japan. Other countries in this region, such as Korea and Taiwan,
will reach 10 per cent aged around the turn of the century. A similar level of ageing will be
reached in India and China over a somewhat longer period, and is made more significant by the
sheer numbers of their older populations. An ageing population, defined as 10 per cent of the
population aged 65 years and over, will not be reached by any of the other Asian or Pacific
countries, or most African countries, until well into next century. In many of these countries, the
concerns of older people may be more associated with their minority status and small numbers,
than with rapid growth of the elderly.
There is good reason to believe that the health status and causes of disability to which health
promotion and aged care services will have to respond in developing countries will be very
different to the "diseases of affluence" of the countries that now have large aged populations.
Social and cultural factors shaping care practices, including the role of family caregivers, and the
financial and human resources available for services will also differ. And within the older
countries, the coming cohorts of older people will have had very different health and social
experiences to those who are already old. These changes over time will be even greater for
ageing women than for men.
Turning to social policy orientations, three comments can be made in comparing Australia with
directions that are apparent in other countries. First, in Australia, as in almost all industrialised
countries, the main concern of current aged care policy is to strengthen community care and to
contain residential care. The goals of shifting the balance of care are concerned with developing
a wider range of more appropriate services in accord with the preferences of older people and
their carers as much as with cost containment. Notwithstanding this generally similar policy
orientation, a current OECD study (3) shows that systems of health and social services for older
people vary widely from country to country. The existing balances of residential and community
care thus present very different starting points for change, and while there may be broad
similarities in policies goals, strategies adopted to bring about change and progress towards
preferred outcomes also vary widely.
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Second, social policy debate on issues of ageing frequently draws on demographic trends, and
increases in the aged population in Australia have been the grounds for generating concerns over
the cost of retirement incomes and health and care services. Viewed in an international
perspective however, population ageing shows no consistent relationship to the proportion of
GDP spent on health care. OECD comparisons show that while the US is the highest spender on
health, at around 14 per cent of GDP, it is younger than most of the other European countries that
spend around 10 per cent of GDP on health. In the case of Australia, expenditure on health has
remained steady at around 8 per cent of GDP over the last 15 years while the proportion of the
population aged has risen by 27 per cent, from 8.9 per cent in 1976 to 11.3 per cent in 1991.
A third area of comparison, but one which has received relatively little attention in the policy
literature, is the extent to which the union movement is an active participant in the social policy
development process. This role is most formally and widely recognised in Australia in areas of
economic policy, and is growing in social policy areas, most notably in retirement incomes
policy. While unions are widely involved in consultations that occur in the course of aged care
policy development and retired union groups also represent the interests of older people in
various policy forums, there seems to be considerable potential to further this role in Australia
and internationally.
THE CHANGING SCOPE OF AGED CARE
The scope of aged care policy and programs is very much influenced by the context of other
health and social services policies in which aged care programs operate. For example, the
existence of a sound retirement incomes system, universal health care provision and adequate
housing achieved well before retirement, present a very different context to a minimal social
security system, residual public health services and poor housing.
From the perspective of older people, only a minority need care at any one time. The need for
aged care services is far more limited than the need for health care, income support and housing.
All older people require these general services for the duration of their retirement, whereas the
need for aged care arises only for some, usually at a relatively late stage of life. The provision of
adequate support in the broader areas, together with attention to health promotion and the
prevention of disability during working life and through retirement, can do much to limit the
need for aged care.
In Australia, the scope of aged care programs can be reasonably well defined in relation to the
flanking policy areas of income support, health and housing programs, as set out
diagrammatically below, and the Federal Government's Social Justice Strategy sets some
common principles of equity and access across these different policy areas. However, several
changes that are occurring at the boundaries of aged care and other policy areas mean that
previously discrete program areas are breaking down, and new opportunities for integrating
service delivery and funding arrangements are arising. Attention here focuses first on the
implications of increasing interaction between acute and long term care; these changes in turn
have implications for funding of long term care in relation to changes occurring in the retirement
income system.
Increasing interaction between acute health care services and long term care services is coming
about due to changes in three areas. First, advances in medical technology and other aspects of
patient management are reducing length of stays in acute hospitals, with post acute care being
provided in the community. Second, the settings in which rehabilitation is being provided are
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diversifying, with extensions into community care again being evident. Both these trends raise
questions of access and payment when services are no longer covered by Medicare and are
subject to different funding arrangements. A third area of interaction which has received less
attention is the scope for public health intervention in promoting the health of older people; this
area is taken up further below.
Medicare is Australia's universal health insurance system that covers the costs of medical
services and public hospital care. Private health insurance is available only for private hospital
services; there is no private insurance for primary medical care, or for long term residential or
community care. Medications are covered by the Pharmaceutical Benefits Scheme. Both
Medicare and the PBS limit co-payments to be met by the individual.
In residential care, charges are limited to a fixed proportion of the Age Pension; those who have
other income, hence a total income in excess of the Age Pension, pay only the same amount from
their private income. The resident payment amounts to some 25 per cent of the total cost of
nursing home care. Access to home and community care services is protected by the requirement
that service providers cannot exclude any individual in need of care because of inability to pay.
Beyond this general proviso, charging policies are left to provider agencies and there are
concerns about the equity of these arrangements, and the development of clearer national
guidelines has been a topic of policy debate for some time.
To date, these different funding arrangements have applied to largely discrete types of services,
but with increasing interaction between acute care and long term care, equivalent services are
becoming available in different settings. There is an increasing likelihood of inconsistencies and
inequities arising as individuals move between these settings. Rehabilitation services, for
example, can be obtained in public hospitals, in day hospitals, through Community Health
Centres, through domiciliary nursing services and through private practitioners. Transfer from
rehabilitation in a public hospital, covered by Medicare, to another setting where a charge may
be incurred is likely to meet with client resistance and possible non-use of services, comprising
recovery. The Mid Term Review recommended that to avoid these problems, attention to
integration of funding was required.
The nature of the retirement income support system has a significant bearing on the level of
payment for aged care services to be met by the individual vis-a-vis that met through social
provision by way of benefits and subsidies. In Australia, a high proportion of the clients of aged
care services are very elderly, aged 80 years and over, and are reliant on the Age Pension for
their income.
Developments in retirement income arrangements in Australia are seeing a rapid spread of
occupational superannuation, with contributions made by employers and workers. These
developments have considerable implications for the way that aged care services are paid for.
The likelihood of needing aged care services tends to be underestimated in the eyes of the
community. At any one time, less than 10 per cent of older Australians are resident in nursing
homes and hostels, and about another 15 per cent receive support from community care services.
Over a lifetime however, the probability of needing support is much higher. Almost one in two
older Australians will use an aged care service at some time before they die, making aged care a
very likely experience in later life.
The Mid Term Review Report argued that provision for financing of aged care should be
integrated with provision for retirement income generally. As Australia moves away from
retirement income financed from the general tax base to a contributory scheme, there is an
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opportunity to develop a social insurance based scheme for financing aged care. Devising such a
scheme would involve significant policy development in Australia and would take some time,
but its serious consideration is prompted by several advantages identified by the Review. A
review of the international experience of private long term care insurance found it to have little to
offer. The advantages seen in a social insurance scheme included:

it would increase transfers over an individual's lifetime relative to intergenerational
transfers; potential for intergenerational competition for public resources would be
reduced.

a universal system would provide some protection against reduction of retirement income
in the event of needing care by ensuring that provision for this eventuality was made in
an overall retirement support package.

the main redistributive effect would be similar to that of superannuation, namely,
between men who had more sustained involvement in the paid workforce and so accrued
large retirement benefits, and women who had less sustained involvement and
consequently limited benefits.

in containing public outlays and achieving universal coverage, such an integrated scheme
could address problems emerging with continuation of the present funding arrangements.
Integration of work and family caring roles
The place of family care giving in community care has received increasing recognition and
attention in aged care policy in recent years, and was a focus of discussion in the United Nations
International Year of the Family in 1994. Family care giving remains the basis of care of the
aged in industrialised countries, with the main part being played by elderly spouses and then by
middle-aged daughters.
Surveys conducted by the Australian Bureau of Statistics (4) show that care giving is widespread
in the community. Using a broad definition based on providing assistance to a handicapped
person in any task, some one in five households were found to be involved in providing care to a
frail aged or disabled person; most care-recipients were living in the same household. Focusing
on provision of assistance with personal care, one in five households was involved. These
findings suggest that care giving is a social norm, not an exceptional circumstance, and that
social policy needs to view support for care giving accordingly.
Providing support for family caregivers is now an important part of community care in many
countries. Family caregivers are recognised as clients in their own right in Australia's Home and
Community Care Program. Carers have identified respite care as the service that is the greatest
help, and the HACC program provides a range of respite services, in day centres and through inhome respite, and short term respite admissions to nursing home or hostel care are also available.
HACC also supports a number of carers' groups that provide information and advice to carers
and that take an advocacy role in program and policy development.
ILO Convention 156 which is concerned with responding to the needs of workers with family
care responsibilities provides a mechanism for developing carer support services and flexible
employment arrangements to assist these workers. Australia is a signatory to this Convention and
measures taken to date include an expansion of respite care services, an information package and
training strategies for carers seeking to re-enter the workforce either on a part-time basis
combined with caring or on a full-time basis on the cessation of caring.
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PSI Social Services Conference June 1995
Two sets of measures need to be considered to facilitate further integration of work and family
caring roles: caregiver leave, which is not yet available in Australia, and increased provision for
part time employment. Concerns expressed about the cost of such measures and their impact on
workforce participation have generally been exaggerated and it is useful to distinguish between
making such provisions available and the extent of likely uptake at any one time.
The workforce impact is limited by much of the care of older people being provided by others
who are beyond workforce age, especially spouses. Focusing on the workforce age groups, it is
estimated that if, in 1995, one in four of the Australian population aged 80 years and over
required help to be provided by a person aged 40 to 60 years, only one in some 40 would be
affected. Most of the caregivers are likely to be women, and the workforce impact is further
reduced when the level of workforce participation of women in the upper cohorts of this age
range is taken into account.
That care giving responsibilities can have an adverse impact on workforce participation for
women in evidenced in the findings of a major study of family care giving underway in Victoria
(5). One third of the carers interviewed were working, most of them part time. Another third did
not consider themselves in the workforce, mostly because they were beyond retirement age.
Among the remaining third, carers had either had to give up their job or felt they could not take a
job because of their care giving commitments. Those who were excluded from working reported
lower life satisfaction and greater role conflict that those who worked part time and so were able
to combine work and care giving roles.
These "excluded worker" carers would benefit in many ways from more flexible working
arrangements that enabled them to integrate their family responsibilities and work activities.
Public sector unions in Australia have frequently taken the lead in gaining improved working
conditions, such as parental leave, and could take up this area.
ROLES FOR THE UNION MOVEMENT
Australian experience suggests at least four roles for union involvement in supporting the role of
older people in society and developing appropriate aged care services.
Aged care as part the retirement experience
As needing aged care is a very likely and normal experience in the later part of retirement, union
roles in ensuring adequate retirement incomes could usefully be extended to ensuring adequate
provision of aged care services. The development of a system of paying for aged care services
that is integrated with retirement income provision is an area that has yet to be taken up by the
Australian union movement, but interest in this area can be expected as part of unions' broader
concern with non-wage benefits for workers and the extension of benefits beyond working life.
The proposals put forward for a system of universal long term care social insurance linked to the
retirement income system in the Mid Term Review in 1993 have not yet attracted widespread
debate. However, with the rapid increase in resources accruing to super-annuation funds,
questions are being raised about the uses to which they are to be applied. Emerging discussions
of directed investment of super-annuation funds provide a forum in which the funding of aged
care services is likely to be raised and in which unions will become involved through their role in
managing super-annuation funds.
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PSI Social Services Conference June 1995
The changing aged care workforce
The major part of expenditure on aged care services goes to payments for labour and the labour
market implications of increasing demand for aged care need to be recognised as part of the
service sector. Three issues can be noted. First, as in the service sector generally, the conditions
of workers in aged care and the quality of services delivered are very closely related. Attention to
training and career structures is an important means of enhancing workers' conditions of
employment and achieving high standards of care. These links are seen in the implementation of
Outcome Standards in Australian aged care services, which has been accompanied by a number
of training strategies.
Second, the rapidly changing boundaries between the traditional health and welfare sectors is
bringing about restructuring of workforce roles. New categories of service staff are emerging,
and roles of established categories are changing. These changes are readily seen in the nurse
workforce as nurses are the largest single employee group in aged care. At the same time as
gerontological nursing is growing as a special field, there is a growing workforce of semi-skilled
personal care workers.
Third, the debate about payment of informal caregivers raises issues at the boundaries between
paid workers and informal carers. Rather than payments enhancing the position of informal
carers, concerns have been expressed about the emergence of a "grey economy" in which
conditions of paid workers are eroded at the same time as carers are caught in poverty traps by
low benefits made available under conditions that restrict their participation in the paid
workforce.
Changes are occurring in Australia in relationships between staff and the employing agencies,
and between workers and clients. These changes range from moves to contracting of services,
which can threaten continuity of employment and of care delivery, to individual worker-client
arrangements, such as Attendant Care Schemes. As in other fields where home-based work is
common, involvement in unions is often low and organisation of workers faces particular
difficulties. Destabilisation of the workforce not only undermines the skill base and standards of
practice, but threatens continuity of service delivery and quality of care that is based on on-going
relationships between clients and care workers.
Many initiatives in service delivery that affect workers are aimed at increasing flexibility and
choice for consumers. The main requirement to achieve these positive outcomes is additional
resources, and without further resources, many of the measures that involve workforce changes
risk potentially negative outcomes. There has been considerable expansion of resources allocated
to community care in Australia in recent years and the care workforce has expanded
considerably. Community care is overwhelmingly in the public sector and voluntary sector, and
while some recent moves have opened opportunities for private sector participation, the response
has not been strong.
Privatisation has rather come in the form of restructuring public sector services. Attempts are
being made in some States to privatise public sector services, particularly at Local Government
level, as part of more general privatisation agendas. As public funds continue to provide the
financing basis for these "privatised" services, the definition of the private sector as distinct from
the public sector is problematic. Two basic questions that need to be asked in this debate are
"what is the exact problem that privatisation is meant to solve?", and "what evidence is there that
the proposed privatisation measures are likely to be more effective than the existing
arrangements, or than other options for reform where reform is needed?"
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PSI Social Services Conference June 1995
One means of addressing these issues is through forming a closer alliance between workers and
carer and client groups, with a view to identifying their common interests. Staff of residential
care facilities have been very effective advocates for resident's rights, with nursing unions
providing a vehicle for this action, and there is considerable scope for this role to be advanced in
the community care sector.
Social integration and well-being of older people
Retired workers organisations are an important representational base for fostering the
participation of older people in policy making, in providing mutual support and in volunteering.
Developments in four areas warrant note.
First, the present Australian government has taken a central role in giving older people a voice in
policies that affect them, in accord with the participation principles of the Social Justice Strategy.
The rights of older people have received considerable attention in recent years in Australia and a
number of measures have been taken to protect the rights of users of community care and
residents of hostels and nursing homes. The contention generated by the formulation and
implementation of residents' right is a salutary reminder of the divergence of interests of older
people and many of the agencies which purport to serve them. These measures are similar to
developments in the wider disability field, and the origins of many of these moves can be traced
to the International Year of the Disabled Person held in 1981 and subsequent UN initiatives in
which Australia has participated.
Second, consultation with older people, together with consultation with unions and provider
groups, is now a feature of policy development and program monitoring in Australia. Older
Australians' Advisory Councils have been established as a formal mechanism to provide advice
to the Minister. Retired union groups are included in the membership of the Councils.
Third, a diversity of older people's groups has emerged in recent years, spanning the political
spectrum. The largest, the Australian Pensioners' and Super-annuants' Federation, is linked to the
union movement, and there are many retired union members groups. The Australian Council on
the Ageing has actively pursued a greater consumer orientation in recent years. Carers' groups
have also been established. Many of these groups receive public funding as peak bodies or for
projects operated under the HACC Program.
Fourth, action by older people's groups in the general political arena in Australia have been
sporadic and focused on specific issues and no single or unified political group has emerged as
pre-eminent. In most cases, action has been concerned with protecting the position of middle
class older people rather than improving the conditions of the most disadvantaged. The diversity
of Australia's older population suggests there is not enough common interest to provide the basis
for a single, cohesive elderly electoral constituency.
While some commentators have advocated the development of a "grey lobby", there is a danger
that such action could fuel the kind of inter-generational conflict that has emerged in the USA
and the UK. A recent survey in the European Commission countries (6) indicates that older
people prefer to be widely involved in all aspects of community life, including political life,
rather than seeking aged-based roles. The study reported the highest satisfaction among older
people, and the highest levels of support on the part of the rest of the community for social
programs supporting the elderly, in Denmark. In the Southern European countries, all age groups
recognised the loss of traditional roles of the elderly, but new roles had yet to emerge and public
support to develop these roles was seen to be inadequate by both the elderly and younger age
groups. A similar survey in Australia (7) has reported high satisfaction with their involvement in
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PSI Social Services Conference June 1995
the community on the part of most older Australians, and high acceptance of government support
for aged care and related programs.
Ensuring that workers are fit to retire
Finally, preventing disabling illness during working life can make the most fundamental
contribution to the future well-being of older people. Occupational health and safety programs
need to be extended to ensure that workers are fit to retire, and to carry health promotion
activities through the transition to retirement.
Responsibility for ensuring that workers are fit to retire needs to be more clearly defined so that
sickness and injury are not used as an excuse for early retirement of older workers, leading to
loss of income and poorer health.
Health promotion programs around the time of retirement are only now receiving attention in
Australia. Population based programs have proved effective in reducing cardiovascular disease in
Australia over the last decade, and a more concerted effort to address health promotion around
retirement age appears warranted. Anti-smoking programs, for example, have mostly
concentrated on preventing young people taking up smoking and are only now giving attention
to older smokers. Directing information on the benefits that can be derived from quitting even
after long term smoking to older smokers appears particularly important in countering beliefs
that little improvement in health could come from quitting.
Another means of promoting well-being of older people and their integration in the community
which raises particular issues for the union movement is volunteering. Information on the areas
in which of volunteers are active suggests that there is little substance to concerns that volunteers
will displace paid workers. For example, the contributions that volunteers make to the HACC
program and the Community Visitors Scheme in nursing homes and hostels are quite different to
the roles of paid workers. Maximizing the effective contribution of volunteers requires careful
consideration of the ways in which volunteers can supplement and extend the functions of the
paid workforce rather than substituting for paid workers.
Providing opportunities for volunteers is an important means of gaining community support for
aged care programs which can thereby have a wider integration function in addition to providing
care. Older Australians have reported that volunteering offers many opportunities for
participation in the community, and volunteers have reported higher life satisfaction and wellbeing. Volunteers demonstrate strong commitment to the services in which they are involved;
these are almost exclusively public and voluntary sector services.
FUTURE PROSPECTS AND OPPORTUNITIES
In pursuing its interests in aged care and wider issues of ageing, there are a number of
opportunities for PSI to link up with other international developments over the next few years.
First, the UN International Plan of Action on Ageing provides a basic framework for canvassing
areas for action. Review of the Plan of Action, and national responses to it, would be a useful
means of identifying opportunities for union involvement.
Second, the declaration of 1999 as the UN International Year of the Elderly provides a timetable
within which goals might be set and achievements monitored. Several opportunities for
involvement in the International Year warrant consideration if the union movement is to be
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represented among the many groups that will be promoting their roles. Such action is required to
provide an important balance to the exploitation of commercial opportunities likely to be pursued
by the private sector. For example, unions involved in aged care services might be encouraged to
demonstrate the direct contributions that their members make to the well-being of frail older
people as well as promoting the wider role of the public sector. Retired union groups especially
need to take up opportunities for participation in community based activities. Given the lead
times for International Year activities, planning needs to commence in the near future.
Third, the World Health Organisation has recently reactivated its Ageing and Health Programme.
The new programme is oriented to health promotion and aims to promote health and well-being
throughout the life span. The six key components of the programme are information services,
policy development, advocacy, community based programmes, training and research.
Implementation of the programme will involve a wide range of working groups and information
exchanges, including the establishment of "Partnerships for Ageing and Health" with
community, industry and research organisations. A partnership involving the union movement
could make a unique contribution to promoting the health of older people.
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PSI Social Services Conference June 1995
References
(1)
Commonwealth Department of Health, Housing and Community Services (1991) Mid
Term Review of the Aged Care Reform Strategy. Report. Australian Government
Publishing Service: Canberra.
(2)
Commonwealth Department of Health, Housing, Local Government and Community
Services (1993) Mid Term Review of the Aged Care Reform Strategy Stage 2. Report.
Australian Government Publishing Service: Canberra.
(3)
Organisation for Economic Cooperation and Development (1994) Caring for Frail
Elderly People: New Directions in Care. Social Policy Studies No. 14. OECD: Paris.
(4)
Australian Bureau of Statistics (1995) Focus on Families: Caring in Families - Support
for persons who are older or have disabilities. ABS Catalogue No. 4423.0. ABS:
Canberra
(5)
Victorian Carers' Project. University of Melbourne. Work in Progress.
(6)
Commission of the European Communities, Directorate-General V, Employment,
Industrial Relations and Social Affairs (1993) Age and Attitudes: Main Results from a
Eurobarometer Survey. EC Commission: Brussels.
(7)
Department of Human Services and Health (1994) An Optimistic Future: Attitudes to
Ageing and Well-being into the Next Century. Aged and Community Care Service
Development and Evaluation Reports. No. 13.
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PSI Social Services Conference June 1995
CARE FOR CHILDREN, FAMILIES AND THE ELDERLY IN SWEDEN
Åsa Nelander, Svenska Kommunalarbetareförbund (SKAF)
Department of Social Welfare, Sweden
The Nordic welfare model is unique in many respects and this is true not just with regard to
services for children, families and the elderly. Our aim here, however, is to describe the
Nordic welfare model in this particular sector by outlining the situation prevailing in Sweden
and also by putting Sweden and conditions in Sweden in the social welfare field into an
international context. Unfortunately, relevant statistics are often lacking, particularly from
developing countries, but also from other countries. For practical reasons, therefore,
comparisons have been largely limited to Western Europe.
Women go out to work in Sweden, but still give birth to lots of children
One important precondition, if women are to be able to go out to work, is that there must be
an efficient system to provide care facilities for children, families and old people. In Sweden,
as in other countries in the Nordic region, such a system does exist and women have therefore
had the opportunity of taking jobs outside the home to a greater extent than women in many
other countries.
These days in Sweden almost as many women go out to work as men. In 1993, the workforce
included 88 per cent of the female population of child-bearing age and 90 per cent of the
male. The incidence of the number of women in gainful employment has increased
substantially over the last 30 years. In 1960, the figure was only 43 per cent.
The incidence of working women has increased markedly in other countries too, both in
Europe and outside it. Diagram 1 shows the incidence of working women in a range of
different countries.
Diagram 1: Numbers of women in the workforce between the ages of 25 and 64,
expressed in per cent.
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PSI Social Services Conference June 1995
88
85
Sweden
Finland
79
76
75
76
74
Norway
Canada
USA
France
Great Britain
Increase 1980-93
Increase 1970-80
1970
72
Portugal
66
65
62
Germany
Japan
Netherlands
60
Italy
52
Spain
0
20
40
60
80
100
Even though more women go out to work in Sweden than elsewhere, they nevertheless give
birth to more children than women in most other countries. In many countries, women are
forced to choose between having a job of their own and having a family; if a women wants to
have a job, she has to refrain from having children.
In Sweden, there is no need for women to be faced with such a choice. Out of all the women
in Europe, it is only the women of Ireland and Iceland who give birth to more children per
capita than Swedish women. Sweden's high birth rates should be viewed as a testimony to the
quality of the Swedish welfare model.
Diagram 2: Average number of children per woman, 1991
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PSI Social Services Conference June 1995
2.5
2.2
2.1
2
1.9
1.8
1.8
1.8
Number of children
1.7
1.6
1.6
1.5
1.4
1.6
1.4
1.4
1.3
1.3
1
0.5
Finland
Norge
Sverige
Storbritannien
Portugal
Nederländerna
Luxemburg
Italien
Irland
Frankrike
Spanien
Grekland
Tyskland
Danmark
Belgien
0
X
(Belgium Denmark Germany Greece Spain France Ireland Italy Luxemburg Netherlands Portugal Great Britain Sweden Norway Finland)
Thus, Swedish women occupy a strong position on the labour market. However, a relatively
large proportion of Sweden's women, 45 per cent in all, work part-time. Wage differentials
between men and women in Sweden are less than in other countries. One explanation may be
that women in Sweden show a higher level of union membership than in other countries; this,
incidentally applies to men too. More than 90 per cent of the women working in the public
sector belong to a union.
There is a clear correlation between social services and the strong trade union organisations in
Sweden. Extension of social services such as day care facilities for children and services for
families and the elderly gave women in Sweden the opportunity of going out to work and thus
of joining a union. But, throughout the trade unions have never ceased to press for broadening
the range of social services such as child care.
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PSI Social Services Conference June 1995
Diagram 3: Level of union membership among employees in different countries,
expressed in per cent.
84
Sweden
75
73
Finland
Denmark
56
53
Norway
Belgium
47
44
Australia
Austria
39
37
34
32
Great Britain
Canada
Italy
W Germany
28
Switzerland
24
24
Netherlands
Japan
16
USA
10
France
0
20
40
60
80
100
Per cent
Care for children and children of school age
An important precondition, if women are to be able to go out to work, is the existence of an
efficient day care service for children. Sweden has a new law which entitles all children
between the ages of 1 and 12 to access to day care facilities. This law came into force in 1995,
but at the very moment that it did so there was a shortfall of some 60,000 places in day care
and after-school recreational centres for children. Many local governments are thus at present
unable to comply with the law in terms of meeting the demand for child care.
Day care for children in Sweden
The number of places in municipally run children's day care centres was almost doubled
between 1980 and 1994, increasing from 211,000 places to 401,000. Children of pre-school
age are catered for by municipal day nurseries or "family day nurseries", i.e. registered child
minders who look after children in their own homes. There are also private day nurseries
financed by government or local government funds. In 1994 Sweden had 798,000 children
between the ages of 3 months and 6 years and of them 431,000, or 54 per cent, were attending
some form of day nursery. The breakdown was as follows:
Municipal day nursery
302,000 children
Family group
99,000 children
Private day nursery (financed by public funds)
30,000 children
__________________________________________________________________
Number of children in publicly financed day care centres
431,000 children
The situation varies a great deal from one municipality to the next. In fifteen municipalities,
so many children attend municipal day care centres that one can say that needs are close to
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PSI Social Services Conference June 1995
being fully covered. In five municipalities, however, only 35% of the children were attending
municipal day nurseries.
Children under the age of two are most often looked after by a parent in their own home.
Sweden has a parental insurance system which enables a parent to stay at home until their
child is at least 15 months old (see next chapter). It is therefore more interesting to study day
care facilities for children who are two years old or more. Most of these children attend some
form of day care centre.
Nevertheless, there are major differences between the children of blue-collar workers
(members of our blue-collar national centre, LO), white-collar workers (members of our
white-collar national centre, TCO) and academics (members of the academics' national centre,
SACO). The children of white-collar workers and academics are far more likely to attend a
day care centre than the children of blue-collar workers. Three out of every four children
between the ages of 2 and 6 with parents in the white-collar or academics category go to a day
nursery, while the figure for the children of blue-collar workers in this same age-group is only
59%. The children of blue-collar workers are more often looked after during the day in the
home of a registered child minder, while it is more frequent for the children of academics to
attend a private day nursery.
There are a number of reasons why the children of blue-collar workers do not have access to
day care centres to the same extent as other children. one explanation is that many LOmembers (blue-collar workers) work awkward or irregular hours when no child care facilities
are available. Another explanation is that many local governments have raised the cost of
places in day care centres over the past few years, which is why some parents are try to find
other solutions for financial reasons.
Day care facilities for children have two main purposes; one is to enable parents to go out to
work or to continue their education. This is why day care facilities are open from early
morning through until the evening; 7 a.m. to 6 p.m. or later are common opening hours. Many
local governments also provide evening or night-time child care facilities for parents working
during these hours. Children attending day care centres have their lunch and a snack there
every day.
The other main purpose of day care centres is to stimulate children's development, while at
the same time providing them with the company of other children and good, safe supervised
surroundings. The law on child care puts it as follows:
The role of pre-school facilities is to offer children a sound upbringing and care in an
educational environment. Such facilities shall be staffed by persons having the training
and experience necessary to meet the children's needs in respect of care and a good
educational environment. The groups of children shall be of appropriate composition
and size. Premises shall be suitable for the purpose.
Facilities shall take account of the needs of each child. Children who for physical,
mental or other reasons need special help in developing shall be offered the care
necessary for their particular needs.
The quality of child care services is very much conditioned by the training of the staff. Those
who work with the children in day care centres have a training as pre-school teachers or
children's nurses. The family group option is based on registered child minders. Facilities for
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PSI Social Services Conference June 1995
children of school age include recreation instructors and recreation leaders. It takes three
years at a teachers' training college to qualify as a pre-school teacher or recreation instructor,
while to qualify as a children's nurse or child minder requires a three-year course of training at
the higher secondary school level.
Out of the approximately 100,000 people employed in day nurseries and after-school centres
for school children some 46,000 have a training as pre-school teachers, 38,000 as children's
nurses and 10,000 as recreation instructors or recreation leaders. 800 have some other form of
training pertaining to child care, while only 2 700 have no training at all. A fairly large
proportion of the registered child minders lack training.
Up to now, the quality of child care facilities in Sweden has been very good. However, over
the last few years even child care has been the target of cuts in costs. Most local governments
have made savings by increasing the number of places for children, while making cuts in the
numbers of people employed to run the centres.
Approximately 7 per cent of the children attending day care centres funded by local
government go to a private day nursery. Many white-collar workers and academics have
elected to move their children to private day care facilities when the municipal facilities have
deteriorated due to the need to cut costs. Resources in these private centres are more
commensurate with needs, since they do not have such long opening hours as the municipal
facilities, nor do they cater for children with special needs. The proportion of children from
academics' families in private day care centres is at present eight times that of the proportion
of children from blue-collar homes. Naturally, the segregation generated by this situation also
has a negative effect on municipal day care centres, their resources and the quality of their
facilities.
After-school facilities in Sweden
Children in Sweden have the right to after-school care up until the age of 12. Facilities
provided take the form of recreation centres, places in the homes of registered child minders
or some other type of extra-mural (open) activity. Children are enroled at the recreation
centres and there have access to educational activities outside school hours. Some children go
to the home of a child minder. In the context of open recreational activities, 10-12 year-olds
can engage in activities which interest them.
The role of these after-school facilities is to act as a complement to school and to offer school
children meaningful recreational activities and stimulus for their development. The idea is for
children to be given the opportunity of engaging in and themselves planning activities
together with schoolmates and adults so as to give their leisure time a meaning. The facilities
are intended to enhance the children's skills.
In 1993, some 160,000 school children were attending after-school facilities of some
description - more than double the number in 1980! Half of all the 7-9 year-olds go to afterschool facilities, while only 5 per cent of the 10 to 12 year-olds do. Most school children are
looked after outside school hours in after-school recreation centres. Only 30,000 go to the
home of a child minder.
Day care facilities for pre-school and school children - trade union issues and claims
Access to day care has always been an important issue for the trade unions in Sweden. LO,
our national centre, no less has been pushing hard for extending child care facilities. If women
are to be able to go out to work, there have to be reliable and good quality care facilities for
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PSI Social Services Conference June 1995
their children. The right to have a job of ones own is without a doubt the most significant
issue in respect of equal opportunities.
Throughout the eighties the shortage of day care places for children, and particularly for the
children of blue-collar workers, forced many women to stay at home. Now claims are being
put forward for the right to child care facilities even for those working awkward hours, while
keeping the cost at a level that all can afford.
In recent years, cost cuts have been made in the public service sector and not least in child
care facilities. Over the past five years, the number of children attending day care facilities
has increased by 20 per cent, while the costs have fallen by 17 per cent. One of the results of
this has been that the groups of children have grown in size, while ratio of members of staff to
the number of children has deteriorated. But, at the same time, the quality has increased
thanks to closer cooperation with the schools. The unions' view is now that child care
facilities cannot stand any further cost-cutting without causing the quality to decline seriously.
Cost cuts have also led to increased segregation in that the children of well-educated and
comfortably off parents have been moved to private day care centres. One important item on
the trade unions' shopping list of claims is elimination of segregation in the child care sector.
In the case of conditions for those working in the child day care sector, the situation is
relatively good compared to that in other sectors. However, the cutbacks are putting increased
pressure on the job situation. The decentralisation measures introduced over the last few years
have meant that responsibility for important issues has been delegated to the day nurseries and
after-school recreation centres themselves. The unions are pressing for better conditions of
employment and for continuation of the trend towards giving employees a greater say, which
they consider issues of great importance. The trade unions are also giving the question of
regular further training courses for all employees high priority.
Care facilities for pre-school and school children - international comparisons
Only a very few countries have a relatively good network of day care facilities for children
under the age of three; Denmark and Sweden are among them. Most countries do not offer
any after-school facilities at all for school children up to the age of ten; Denmark and Sweden
are exceptions. The age group best provided for in terms of need for day care facilities
through services financed by public funds is that of children between the age of 3 and the
compulsory age for starting school (which varies between the ages of five and seven).
It is difficult to compare day care facilities for pre-school and school children in different
countries. Authorities responsible, financing, standard, opening hours, staff to children ratios
and educational approaches etc. vary greatly. Nor are the statistics available entirely up to
date. The following table taken from the EU publication "Childcare Network" gives data on
publicly financed childcare facilities going back to about 1990 (data referring to Sweden are
from 1991)
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PSI Social Services Conference June 1995
Table 1: Percentage of children with places in public or private, registered day
nurseries, in the homes of child minders or after-school recreation centres in 1989-1990.
Country
Belgium
Denmark
West Germany
Greece
Spain
France
Ireland
Italy
Luxemburg
Netherlands
Portugal
Great Britain
Sweden
Percentage
Percentage
Percentage
0-2 years
3 years - school age
School children
20-25
48
3
4-5
6
20
2
5
2
2
6
2
35
95
85
70
65-70
65-70
95
55
87
55-60
50-55
35
47
72
..
29
4
0
0
..
0
..
1
1
6
0
50
The above does not, however, take the contents of the day care facilities offered into
consideration. Content varies greatly from country to country depending on the system in
place. A factor of major significance, not least in respect of women's opportunities for going
out to work, is how long day nurseries stay open each day.
In Denmark and Sweden, day nurseries and day care facilities with child minders are as a
rule open for at least eight hours a day. In Italy and France there are also full-day nursery
schools, which take almost all children from the age of three upwards.
In Germany, most children in this age group have access to kindergarten, but kindergarten
opening hours are mainly restricted to four hours in the morning. In certain cases, this is
prolonged by two hours in the afternoon after a two-hour lunch break during which all
kindergartens close.
In Belgium almost all children in the 3-5 years age group have a place in a nursery school, but
these close at 3.30 p.m. and also close for one hour at lunchtime. Even in the Netherlands
nursery schools close for lunch and approximately 50 per cent of all the children start nursery
school at the age of three.
In Great Britain a quarter of the children in this age group attend nursery school. This
normally comprises 2½ hours either in the morning or the afternoon. A further 20 per cent of
the children are provided for by voluntarily starting school a year early (at the age of four).
The figure in the table refers to the percentage of children in the age group who are attending
school or to nursery school.
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PSI Social Services Conference June 1995
Diagram 5 takes a sample of the countries under study and shows that only a small proportion
of day care facilities are full time, i.e. stay open long enough to permit both parents to go out
to work.
Diagram 4: Percentage of children between the age of 3 and starting school with access
to day care facilities financed with public funds
France
95
87
Italy
85
Denmark
72
Sweden
Full-time care
Only part-time
70
W Germany
Netherlands
55
Ireland
55
47
Great Britain
0
20
40
60
80
100
Family policy
Family policy in Sweden consists mainly of financial assistance for families with children,
partly in conjunction with the birth of children and partly as a supplement to the family
finances. The most important form of financial assistance is the child allowance, which at
present amounts to SEK 750 per month for each child. If there are three or more children, the
family qualifies for the "large-family allowance". This for a family with three children means
an extra SEK 200 per month.
Families with children may also qualify for a housing allowance. This allowance is subject to
a means test and, in order to qualify for the full amount, the family's income must be less than
SEK 9,600 a month. A family with two children and an income of over SEK 25,000 receives
no allowance at all. The maximum amount for which a family with two children can qualify is
SEK 3,200.
If one parent has sole custody of a child, the other parent is required to pay child maintenance.
If that parent does not pay, the child receives what is termed an advance on maintenance.
This advance on maintenance amounts to SEK 1,173 per month.
In addition to these various forms of allowances for families with children, financial
assistance is also paid on the birth of a child and compensation is available to enable a parent
to stay at home when a child is ill. The idea behind the Swedish system is that parents should
not need to give up work, being instead offered the opportunity of taking paid leave. All these
different types of financial assistance for families with children are granted regardless of
whether the parents are in work or not, but some of the allowances are linked to income.
When a child is born, parents qualify a parental grant, i.e. 450 days of paid leave. This leave
is granted to both parents jointly, if they can agree themselves on how to share it. However,
one month is earmarked for each parent and cannot be transferred to the other. There are three
levels of compensatory payment:
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PSI Social Services Conference June 1995
80 per cent of income for 300 days
90 per cent of income for 60 days (father's month and mother's month included)
SEK 60 per day for 90 days.
The parental leave must be taken before the child's eighth birthday. it may be taken as full,
half or quarter days. This makes it possible, for instance, to opt to work half-time and take
half-time parental leave. In addition, under the parental grant system fathers have the right to
take ten days off in conjunction with the birth of the child.
If an expectant mother has a job which involves physical effort, she qualifies for pregnancy
leave for a period of 50 days prior to the birth.
If a parent wishes to remain on leave longer, that is permitted, although without pay. In
Sweden both parents have by law the right to take leave for 18 months following the birth of a
child.
If a child is ill, there is a system of temporary parental leave with pay to enable a parent to
stay at home with the child for a maximum of 60 days per child and year . The level of
compensation is then 80 per cent of pay for the first 14 days and 90 per cent thereafter.
In the case of children between the ages of four and twelve years, there is an entitlement of
two days of leave per year in order to visit the child's school, day nursery, after-school
recreation centre etc. These "contact days" are included in the temporary parental leave
described above.
Over the past few years, economic difficulties have led to a series of deteriorations in the
Swedish welfare system, not least in the area of family policy. Further detrimental cuts have
been proposed and decisions on them are expected this year. These proposals in involve, for
example, cuts in child allowances and cuts in the levels of compensatory payment in relation
to parental leave and advances on maintenance .
Family policy - union issues and union claims
The fundamental trade union view is that family policy should be such as to permit both men
and women to combine having a job with having a family. The unions have therefore
defended the parental insurance system and the "safety net measures" applying if, for
example, a child falls ill.
With the aim of improving Sweden's economy and reducing the budget deficit major cuts
have been made and are still to be made in the field of family policy, among others. The trade
unions have protested against the cuts aimed at families with children; there is, for instance, a
proposal on the table which involves reducing child allowances and lowering the level of
compensation on all social insurances to 75 per cent.
Family policy - international comparisons
Swedish family policy is second-to-none in Europe and in the world as a whole, with the
exception of the other Nordic countries. Many ingredients of Sweden's family policy are
totally lacking in most other countries, e.g. advances on unpaid child maintenance, paternity
leave and contact days.
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PSI Social Services Conference June 1995
Most countries offer some form of economic assistance to families with children. The two
main channels are cash handouts and tax relief. Cash payments vary greatly from country to
country. They may be payable to all or only to members of the workforce or to those
belonging to a given trade union. The same amount may be payable to all or may vary in
proportion to income or be means-tested. The trend in a number of countries is towards
reducing general allowances to families with children and instead focusing on those who are
worst off.
A number of countries offer different forms of tax relief, but there is no a tendency for the
scope of this form of assistance to be reduced. Out of all allowances granted to a typical bluecollar family in 1985, cash payments accounted for 75-100 per cent in all countries. Tax relief
is often related to the number of children in a family.
The right to paid leave in conjunction with the birth of a child exists in all Western European
countries, even though nowhere are the terms as generous as those in Sweden. In the countries
of the European Union the average amount of paid leave was 16 weeks in 1990. Most
countries lie within the range of 14-18 weeks. The rules governing leave are markedly better
than average in Denmark, Finland, Norway and Italy.
On comparison, Sweden's parental insurance is shown to be substantially better than the
systems in the various countries. It allows fathers to stay at home with the children on the
same terms as mothers.
The period during which compensation for loss of earnings is paid amounts to 52 weeks in
Sweden; compare this with 32-38 weeks in Norway, 28 weeks in Denmark, a little more than
20 weeks in Italy, 14-18 weeks in Germany, France and the Netherlands and only 6 weeks in
Great Britain. In addition, the Swedish system provides the right to further leave with a low
level of compensation for an additional period. Table 2 gives an approximate estimate of the
extent of leave in a number of countries. The data are from 1990 and may therefore have
changed somewhat since then.
Table 2: Leave in conjunction with the birth of a child as stipulated in the law in 1990
Number of weeks:
Before
After
Sweden
Denmark
Finland
Norway
France
Great Britain
Germany
Luxemburg
Netherlands
Belgium
Total
52 weeks +90 days
28 weeks
15 weeks+170 working days
32 weeks or 38 weeks (reduced
pay)
4 weeks
24 weeks
2 weeks
30 weeks or 38 weeks
6 weeks
10 weeks
6 weeks
8 weeks
minimum
4 weeks
6 weeks
8 weeks
8+4 weeks
8 weeks maximum
16 weeks
6 weeks+12 weeks
14 weeks
16 weeks+4 weeks
16 weeks
8 weeks
14 weeks
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PSI Social Services Conference June 1995
Ireland
Portugal
Italy
Greece
Spain
2 months
7,5 weeks
6 weeks
14 weeks
13 weeks
Approx. 21 weeks+26 weeks
15 weeks
16 weeks
3+6 months
7,5 weeks
10 weeks
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PSI Social Services Conference June 1995
Care for the elderly
Care for the elderly in Sweden
Eighteen per cent of Sweden's population, 1.5 million people, are 65 or over. Of these, almost
400,000 are over the age of 80 and belong to the age group in which the need for care is
particularly great. The number of elderly people in the population has grown substantially
since the sixties. In 1960, fewer than 900,000 out of the total population were over the age of
65 and of these only some 140,000 were over 80.
The big rise in the number of older people occurred at the time when more women started to
go out to work. Care facilities for the elderly have therefore been very much increased over
the last few decades. At the same time, the health of older people has been improving greatly.
Most elderly people can manage on their own and remain in their own homes without help
from the community.
There are two separate elements in the system of care for the elderly. One of them consists of
a series of different types of accommodation specially designed for the "senior citizen". About
60 per cent of this accommodation consists of just a room with no kitchen attached in old
people's homes and nursing homes. But now, many elderly people live in service apartments
or communal flats with a kitchen or kitchenette. All in all, 129,000 people live in housing
specially designed for the elderly and 92,000 of them are at least 80 years old.
The other element consists of home help from the social services and nursing in the home;
that is, care and assistance provided in the home. This means help with everyday chores,
shopping etc. and a degree of medical care in the home, such as medication, dressing of sores
and administering of injections. In December 1993, 176,000 elderly people were receiving
this kind of assistance in their own homes and 89,000 of them were 80 years old or older.
The Swedish system of care for the elderly in 1993 can be summed up as follows:
Number of people
65-79 years
Over 80
Special housing for the elderly
129,000
37,000
92,000
Home help/home nursing
176,000
87,000
89,000
No old people's services
1,230,000
(80%)
1,013,000
(89%)
217,000
(55%)
TOTAL
1,535,000
1,137,000
398,000
In addition to these forms of services for the elderly, there is the transport service, day-time
occupational activities for the elderly, chiropody, security alarms and telephone service. As an
example, some 370,000 elderly people benefit from the transport service, while 54,000 have
the security alarm.
Care for the elderly has to date been of good quality in terms of the actual care, premises and
staff. However, in recent years a number of deteriorations have occurred. Most of the elderly
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PSI Social Services Conference June 1995
people in accommodation designed for their group have their own room or own apartment.
Only 14 per cent share a room with a person to whom they are not married, 77 per cent have
their own private toilet and 59 per cent their own shower or bath. More than half have a living
area in excess of 30 square metres.
As regards home help from the social services, 38 per cent received such help for a maximum
of 9 hours per week, while 19 per cent received help for more than 50 hours per week.
Just under 200,000 persons are employed in the field of care for the elderly and the disabled.
Most of them are nursing auxiliaries and assistant nurses, 178,000 in all, while 17,000 are
supervisors. Training for nursing auxiliaries/ assistant nurses takes 3 years and is provided at
the level of the higher secondary school. Supervisors have a 2 ½ year period of college
training.
Most elderly people thus manage without help from the community. This is particularly true
in the case of the younger retirees. An ordinary pensioner will be active, in good health and
enjoying a good social life. Despite the fact that it is the community that provides most of the
care, older people in Sweden retain good ties with their families. 32 per cent of pensioners
over 60 years of age are in daily contact with their family; this can be compared with the
situation in Great Britain, where 22 per cent have this kind of contact, despite the fact that
elderly people in Great Britain mainly receive assistance from relatives, friends and
neighbours.
The general retirement age is 65 and as of that age everyone has the right to a state old age
pension. The pension for a single person amounts to SEK 4,400 per month. If in addition that
person has been in gainful employment, a supplementary pension is payable. This
supplementary pension is based on previous income. The state old age pension and the
supplementary benefit may together amount to a maximum of SEK 14,200. Most have in
addition a service pension from their employer.
Pensioners also receive a housing allowance. This amounts to 85 per cent of the rent between
SEK 100 and 4,000, i.e. a maximum of SEK 3,315 per month. The housing allowance
diminishes, if the pension is greater than the state old age pension. The housing allowance is
also decreased, if there is income on capital and other assets.
Care for the elderly - trade union issues and trade union claims
The trade unions also believe that the right to a good and secure old age is of fundamental
importance, as is women's right to a job of their own and to be able to provide for themselves.
Good care for the elderly run by the community is therefore an important claim on the trade
union side.
Over the last few years many local governments have made cuts in care for the elderly and
some local governments have simply privatised parts of their services for the elderly. The
trade unions have stressed the importance of maintaining good quality in care for the elderly
and that privatisation may not be permitted in a way which sidelines continuity in the care
provided.
Many people who have jobs caring for the elderly have to carry heavy loads both physically
and mentally. The cutbacks of the last few years have caused the weight of the work and the
stress involved to increase further. Only 20 per cent of those employed by the social services
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PSI Social Services Conference June 1995
home help division work full time. The trade unions have therefore focused their attention on
creating a good work environment for employees and more full-time posts.
Care for the elderly - international comparisons
The proportion of older people over the age of 65 in Sweden has remained high compared to
other countries. But now the proportion of older people is increasing in other countries, while
in Sweden the percentage remains more or less at the same level. There are more older people
in society, while at the same time more and more women are venturing out on to the labour
market, thus substantially increasing the need for care for the elderly in many countries.
Diagram 5: Proportion of the population over the age of 65 expressed in per cent
W Germany
Japan
Sweden
Italy
Denmark
Finland
1990-2010
France
1990
Great Britain
Spain
Norway
Netherlands
Canada
USA
-5
0
5
10
15
20
25
A large ingredient of care for the elderly consists of depending on help from relatives, i.e. in
reality on the unpaid labour of wives, daughters and daughters-in-law. This is the traditional
pattern and it still dominates the scene, although to varying degrees depending on the
countries.
As a back-up to the help provided by family, various forms of day centres and organised
home help for older people and the disabled have evolved in most countries of Western
Europe. These services may be provided by local governments, church groups, voluntary
organisations or private suppliers of services. Even the forms of financing vary ranging from
funding via taxation pure and simple via gifts/charity to user charges in various hybrid forms.
Most countries, in addition to having services offering help with household chores, personal
hygiene etc., have organised home nursing for the elderly provided in their own homes. In this
instance too, the way in which the services are organised varies.
All countries have special forms of institutionalised accommodation with integrated care and
nursing facilities for older people needing a lot of care. Authorities responsible and modes of
financing vary from country to country and within countries.
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PSI Social Services Conference June 1995
The realisation that there is a need for care for the elderly is a relatively "new discovery" in
many countries and numerous countries still do not acknowledge this is a public matter. The
ways in which care for old people is organised and financed are also very varies, something
which to contributes to the very unreliable picture of services for older people in Europe. The
following description of the system of services for the elderly in selected countries
nevertheless gives a rough idea of the situation prevailing in a few countries around 1990.
80 per cent of the elderly people in Germany who need assistance or medical attention live
alone or with relatives in ordinary, private homes. A majority get the assistance they need
from their relatives. Organised help with household chores and other everyday tasks is
underdimensioned in relation to needs. Up to now, the recipients of help have had to bear
most of the cost or the social welfare services have had to foot the bill. The care insurance
scheme voted on in 1994 means change. As of April 1995, old people living in their own
homes can have such costs covered by the sickness insurance scheme up to an amount related
to the degree of need for assistance/invalidity and to a maximum of DM 2 100 per month.
Stationary facilities providing assistance/care for the elderly - retirement homes, nursing
homes etc. can cater for a total of approximately 700,000. This corresponds to 4.3 per cent of
the number of people over the age of 60. Standards vary and charges are very high. 70 per
cent of those living in such institutions depend on social welfare. As of July 1996
institutionalised assistance for old people will also be covered by the care insurance scheme,
something which will reduce the need for financing via social welfare.
Care for the elderly in Great Britain is also based on the assumption that old people will
continue to live in their own homes or with relatives. Free and means-tested municipal home
help services are available for old and disabled people in need. Voluntary organisation also
play an important role.
About five per cent of all people over 65 live in retirement homes or other institutions for the
elderly. Such institutions are to be found under both public and private management. Places
are expensive, but those who cannot afford them can obtain financial assistance via the social
insurance system.
In the Netherlands, too, care in the home is the predominant approach. This is supported by a
large number of voluntary organisations and an extensive system of district nurses
specialising in geriatrics.
Institutionalised facilities are extensive and provide for 12 per cent of the population over the
age of 65. Old people's homes, nursing homes etc. are usually run by private groups, above all
organisations and foundations linked to the churches. A place in an old people's home is
expensive, but the State pays the difference for retired people receiving only a basic pension.
The financial situation of older people varies widely. Swedish pensions are relatively high. In
most EU member states only employed persons are covered by the old age pensions system.
Sweden also makes a good showing in terms of the level of compensation:
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PSI Social Services Conference June 1995
Table 3: Old-age pension in different countries. Source: J. Palme, 1988
Population entitled to basic pension
(or having started to gain entitlement
to a pension by installments).
Percentage
100
100
100
Retirement pension for the
"avergage worker" after tax, as %
of an average worker’s salary after
tax. Percentage
76
57
69
France
Netherlands
Italy
Great Britain
West Germany
Belgium
60
100
53
59
68
54
58
50
73
52
55
84
Canada
USA
Japan
100
67
76
46
53
59
Sweden
Denmark
Finland
To sum up, it is clear that childcare, family care and care for the elderly is well developed in
Sweden and the Nordic countries in general and have given both children and old people a
sense of security and a better quality of life. At the same time, the social services have been a
pre-condition for women being able to go out to work and an important cornerstone for equal
opportunities for men and women.
Translated from Swedish by C Davies
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PSI Social Services Conference June 1995
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PSI Social Services Conference June 1995
THE ROLE OF PUBLIC EMPLOYMENT SERVICES
IN PROMOTING SOCIAL COHESION AND DEVELOPMENT:
The Canadian Experience
presented by Susan Giampietri, Executive Vice-President
Public Service Alliance of Canada
INTRODUCTION
The nation-state has an important role to play in establishing and maintaining cohesion and
stability within its borders. This cohesion and stability has traditionally been maintained
through the provision of a wide variety of services, including internal security and emergency
services, national defence, the legal system, the taxation system, health and social services,
education, local transportation systems, and employment development services. Canada and
Canadians have long understood the importance of a strong public sector.
However, it is becoming increasingly clear that Canada, like many governments around the
world, undervalues the public goods that the public sector produces. A continuing obsession
with the size of the public debt has led, over the past ten years, to a concerted ideological
attack against public services in addition to slow and steady cuts to public financing: Canada
has reduced firefighting protection at airports when deregulation of the airways has resulted in
more air traffic; resources directed towards anti-pollution projects have been cut at a time
when the Great Lakes environmental problems are identified as worse than previously
believed; and Canada has reduced funding for the unemployed and those not in the labour
force but wanting to work at a time when the unemployment rate remains persistently high.
OVERVIEW OF THE CANADIAN LABOUR MARKET
The Canadian labour market is changing. After a long period of rapid economic expansion
from the end of World War II to the mid-1970s, the rate of growth of the labour force and
employment has declined. Unemployment rates have been high (over 8% since the early
1980s) and are expected to remain above 10% for the rest of this decade.
The demographics of the labour market are also changing: members of the four designated
employment equity groups (women, aboriginals, persons with disabilities and members of
visible minorities) now constitute a majority of the labour force. Employment opportunities in
the service sector are growing, particularly at the high end, while those in the manufacturing
sector are decreasing.
Long-term unemployment in Canada remains a problem. The average duration of
unemployment rose from 17.9 weeks in 1989 to 25.1 weeks in 1993. One feature of the
recession of 1990-92, in contrast to the recession of the early 1980s, was the predominance of
permanent as opposed to temporary layoffs. There is an obvious need for policy to address
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PSI Social Services Conference June 1995
labour adjustment issues for the growing number of workers who are seeing their way of life
irrevocably changed through the loss of their job.
An important contributor to labour adjustment policy in Canada is the Canadian Labour Force
Development Board (CLFDB), a national, not-for-profit organization established in 1991 to
work toward the creation of a coherent and co-ordinated system of labour force development
that is equitable, effective and efficient. The CLFDB is made up of partners from business and
labour (eight representatives each), education and training (two representatives), and the four
equity groups (one representative each). These 22 voting members, who are nominated by
their individual constituencies rather than the government, represent over 90 national
organizations. In addition, federal and provincial/territorial government departments
responsible for labour force issues are represented by non-voting members. Decisions are
reached through consensus.
CURRENT ISSUES
Canada's system of social security programs is at present under review and the subject of
much debate. The government insists that these programs are too expensive, despite the fact
that they account for only 2% of the country's deficit. On the other hand, 50% of the deficit is
attributed to tax avoidance by wealthy people and corporations. All federal programs in the
areas of working, learning and security have been under intense scrutiny since September
1994, when the Prime Minister outlined the components of Canada's Jobs and Growth
Agenda. Programs such as unemployment insurance, employment development services,
child care and federal support for post-secondary education and social assistance are now
being "re-designed".
To date, the focus of Canada's system of programs and services for those out of work has been
on funding the unemployed through federal unemployment insurance and provincial social
assistance.
This focus is not entirely negative. On the contrary, workers contribute to unemployment
insurance primarily to ensure a reasonable level of income replacement in the event that they
are unemployed. Similarly, general tax revenues are used to fund social assistance payments
that are, in essence, the last line of defence against absolute poverty for those who do not
qualify for unemployment insurance.
While income maintenance during periods of unemployment is absolutely essential, many
unemployed workers require additional services and real assistance to enable the transition
back into meaningful employment. Too often in Canada today, training programs have little
to do with client aptitudes and labour market opportunities. Course offerings are driven by
what is available rather than by what is needed. Programs are offered by different levels of
government and are often not coordinated.
That said, it must be underscored that not everyone who is unemployed lacks skills. The
reality in Canada today, as in much of the industrial world, is that there are simply not enough
jobs available.
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PSI Social Services Conference June 1995
PROBLEM AREAS
The number of Canadians officially out of work, added to the number of social assistance
recipients and others who have given up looking for work, is close to 2.5 million people. Yet
we are in a period of growth. Many people are out of a job for the first time in their lives;
many are receiving no assistance at all. Others may be receiving social assistance or
unemployment insurance benefits, but no help in preparing to re-enter the workforce.
The current training and labour market adjustment system is fragmented by the division of
federal-provincial/territorial responsibilities and lack of systematic participation by all the
labour market partners.
This fragmentation stems in part from the Constitutional division of powers in Canada
between the federal and provincial governments. In essence, education is a provincial
responsibility, while unemployment insurance has been, as a result of a 1948 Constitutional
amendment, determined to be an area of legitimate federal responsibility. Labour market
training falls somewhere between these two Constitutionally determined responsibilities, and
can easily be argued to be an adjunct to unemployment insurance or a normal part of the
education system.
In Canada today, a number of provincial governments believe that they should assume control
over labour market training. It needs to be remembered, however, that the Constitutional
responsibility for unemployment insurance was vested in the federal government in 1948,
because the then existing patchwork had demonstratively failed to meet the needs of the
unemployed for income maintenance. It could easily be argued that the current patchwork and
balkanization with regard to employment training is no less of a Constitutional crisis.
It also needs to be underscored that the federal government makes the most significant
financial contribution to labour market training in Canada at the present time. In 1993-94, the
federal government spent over $3.3 billion out of general revenues and the Unemployment
Insurance Account on training and development programs for the unemployed. In addition to
this direct expenditure, the federal government also contributed to provincial training
programs through its cost-sharing of provincial social assistance.
Unfortunately this level of funding has not necessarily helped the number of people get jobs
that one would expect. This is due, in large measure, to the fact that while the system purports
to be client-centred, it often attempts to fit people into predetermined boxes.
In 1993-94, more than a half a million Canadians participated in various labour market
training and development programs. Programs are delivered not only through the 437 Canada
Employment Centres, but also through third parties such as community colleges, private
trainers and community-based organizations. In any given year, Human Resources
Development Canada has some 37,000 agreements in effect nationally for the delivery of
programs.
Career and employment counselling, as a key part of a strategy designed to assist with labour
force transitions, has been largely ignored, despite repeated emphasis on this area by labour
market partners through the CLFDB. Funding cutbacks at Canada Employment Centres
(CECs) have meant fewer resources available for counselling, at the very time when the
number of clients is increasing. Many clients obtain career and employment counselling from
more than one agency at a time. Central funding agencies provide insufficient support in the
form of policies, staff training, counselling materials, or evaluation procedures. Small cities
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PSI Social Services Conference June 1995
and towns often only have a high school and a local CEC through which counselling can be
obtained, and this counselling is clearly not accessible to everyone who needs it.
Career and employment counselling was once available to all people who were in the labour
force or planning to enter it. Now, requests for such assistance are denied unless the
individual is receiving unemployment insurance or social assistance. Yet there is an increased
need for employment counselling due to the continuing high levels of unemployment. Federal
and provincial governments increasingly enter into contracts for project-based counselling
intended to provide clients with specific employability skills. Yet there are no professional
standards that these service providers must follow, nor are there quality assurance standards
for the services provided.
This is in contrast to the situation in Europe, identified in a CLFDB survey (Conger et al,
1993):
In the United Kingdom, schools are responsible for personal and educational counselling and
have careers teachers who give courses in career development. The Careers Service of the
Department of Employment provides career counsellors in the schools for individual and
group career counselling and for the job placement of students.
In Germany, the Federal Employment Institute provides career counsellors to counsel students
and their parents on students' careers. These counsellors have the authority to place students
in the extensive German apprenticeship program. The Federal Employment Institute operates
151 well-equipped Career Information Centres (and 20 mobile centres).
In France, the Department of Education has established career information and counselling
centres that form part of an autonomous organization. Students cannot graduate from
secondary school without having satisfactorily used the services of a centre.
POSITION OF TRADE UNIONS
We believe, as enunciated by the Canadian Labour Force Development Board, that a coherent
Canadian system for transition into employment should contain the following ten
characteristics:






support the development of meaningful employment opportunities and prepare
individuals for them;
serve the diversity of needs; it should integrate principles and practices of equity into
each of its aspects;
incorporate appropriate mechanisms to assess and provide the basic skills (literacy,
numeracy, communications, and problem solving) needed to work and learn in present
and future environments;
ensure that skills and competencies are portable, across provinces and territories
between providers of education and training, and transferable, from one industry to
another;
ensure that linkages are established, between education and training providers and
among labour market partners, and clearly identified to develop knowledge, skills, and
experience to facilitate career progress;
contribute to an effective labour market and, hence, to the economic viability of the
country
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PSI Social Services Conference June 1995




be a responsibility of governments, but also be responsive and accountable to the
partnership of business, labour, equity groups and education and training, as a
condition of its success;
incorporate monitoring and accountability within its various elements;
develop a built-in capacity to cope with change, to allow the transition process to
adapt to changing circumstances and to occupations of the future; and
operate on the understanding that learning is a continuous process throughout one's
lifetime.
The Budget announced by the Liberals in February 1995 has left no doubt that the
government's previously-announced "social security review" is now a "financial review".
Massive cuts to training and employment programs were announced; if the provinces do not
pick up the shortfall, thousands of training places will not be available this year.
The government has accepted the idea of a Human Resources Investment Fund, proposed by
the Chamber of Commerce during the pre-budget consultation period. It is to be funded from
cuts to unemployment insurance regular benefits and from the Consolidated Revenue Fund.
This fund will bring together unemployment insurance and employment development
services, allowing the government to tap the unemployment insurance fund (funded from
employer and employee premiums and which is currently in a surplus position) and treat the
money as general government revenue, using it for non-UI claimants.
Other changes, positive or negative, announced to employment development services include
counselling, child care support, literacy programs, labour market information and selfemployment assistance. The use of sectoral councils for training and adjustment will be
expanded. There will be assistance to persons with disabilities to increase participation in the
workplace. National labour market information will be improved through the use of an
electronic hiring hall.
However, Canada's recently-announced employment development services also includes a
program called "Strategic Initiatives" which ties income support to work. Aimed for the most
part at workers who are unlikely to benefit from education and training programs - the older
unemployed and youth unable to find employment because of the lack of jobs - these
programs include community services and volunteerism as appropriate "work" activities.
Room for exploitation is great. There is no employee/employer relationship and, therefore, no
eligibility for UI benefits. There is no mechanism to guarantee the enforcement of labour and
health and safety standards. No mechanisms exists to ensure that employers, especially public
sector employers, will not get rid of their workforce in favour of this pool of low-paid
workers for whom they do not have to pay benefits. In fact, when the Canadian Union of
Public Employees Local entered into negotiations with the City of Fredericton, New
Brunswick (the site of one of the first pilot projects under this initiative), the City asked for
two concessions that appeared to be directly related to the provincial government's income
support strategy. The initiatives have great potential to set the employed against the
unemployed in a fight for an ever-diminishing number of jobs.
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PSI Social Services Conference June 1995
CONCLUSION
Experience from several European countries has demonstrated that the best employment
development system is one in which all parties work in partnership in an integrated, cohesive
system. Labour fully supports such a system for Canada.
Labour believes there are two necessary preconditions for a successful employment
development system:

There must be a job available at the end of the training line; this means a clear political
commitment to full employment in Canada.

All levels of government - federal, provincial/territorial, regional and local - must
work together to develop a co-ordinated system of policies, programs, funding,
institutional linkages, and standards. However, beginning in April 1996, the federal
funds transferred to provinces for health, higher education and social assistance will be
merged into one block fund. Because of the massive budget cuts, the federal authority
will therefore be diminished. Provinces will have the authority to force social
assistance recipients to work, under the kinds of conditions we are already seeing in
some of the pilot projects. This will put downward pressure on existing wage
structures as more people are forced into a labour market where unemployment is
already high.
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PSI Social Services Conference June 1995
Sources
Canadian Labour Congress, Federal Budget 1995 Fact Sheets.
R. Habtu, "Labour Market Developments in Canada," CLFDB Labour Force Development
Review 1994.
CLFDB, Putting the pieces together: Towards a coherent transition system for Canada's
labour force, May 1994.
CLFDB, Social Security Reform: Implications for Training and Labour Force Adjustment,
December, 1994.
Government of Canada, Improving Social Security in Canada. Employment Development
Services: A supplementary paper, 1994.
55
PSI Social Services Conference June 1995
FIRST DRAFT
SOCIAL SERVICES AND HOUSING:
Developing an Integrated Response to Common Threats
John Findlay, National Officer, UNISON UK
Introduction
I very much welcome this opportunity to prepare a paper for the conference. Social services
workers are a very substantial component of the public service workforce and of the trade
unions which represent them. UNISON itself represents 350,000 social services workers in the
UK, including home and day care workers, care assistants, social workers in field, residential
and education settings, administrators and managers. These large concentrations of social
services workers need an international focus for the promotion of their interests the exchange
of information and the development of international coordination on transnational issues.
UNISON already has close links with the International Federation of Social Workers, who are
represented at this conference, and we look forward to developing engagement by PSI on
issues of specific interest in social services. I know that the Conference will provide an
invaluable opportunity for informal contact between PSI and its constituent organisations and
the IFSW, perhaps leading to a greater degree of mutual cooperation and initiative.
It may be useful to clarify at the start what we mean by the term "social services". In the
United Kingdom, "social services" has a clear meaning, applying to social work and social
care, including work with families, child protection, support for the elderly, the mentally ill
and people with learning difficulties. I have noticed that, in the international context, at
conferences like these, the term "social services" very often means what we would call in the
UK "social welfare". Social welfare has a wider range of application, including social work
and social services but also social security, unemployment and, in some definitions, the
provision of health care. Health care is a key issue for PSI and for its constituent organisations,
but it is important that it should not dominate the social welfare agenda to the exclusion of
social services issues. I welcome the PSI Secretariat's acknowledgment that Congress
Resolution No 43 specifies that this Conference should focus on the provision of social
services and social security rather than Health Services. I hope that at this Conference we have
a clear PSI understanding of "social services": incorporating mainstream social services but
also related areas of social welfare such as housing.
This is my theme today: to examine the common threats facing social services and housing as
fundamental parts of social welfare, facing the same attacks as other social services activities:
cutback in resources, privatisation, exploitation and profiteering. I want to explore the
argument for organisational integration of social services and housing and for an integrated
trade union response at national, European and worldwide level.
To inform the exploration of this argument it would be useful to set out the issues facing social
services and housing and those who work in these services. I must apologise for approaching
this topic from very much a UK perspective, but I hope it will be of interest and that it will
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PSI Social Services Conference June 1995
prompt contributions and debate on developments in other countries represented here. It is
clear that the political trends relating to housing and social services are broadly common
throughout the world, particularly in Europe, and I would suggest that the extent of the attack
and enforced deterioration of our services is well advanced in the UK and may be a signal to
what may happen elsewhere.
Let me describe the main developments.
The major change in UK social services in recent years has been the introduction of care in the
community: the transfer of people from institutional care into the community with a
consequent shift of responsibility and funding from central to local government. While the
principle of care in the community has been widely welcomed, it is seriously underfunded.
The local authority associations have estimated a shortfall of £200 - £400 million in 1995/6,
rising to a shortfall of £700 million by 1997. Packages of care in the community are
considerably more expensive than the provision of institutional care, where economies of scale
can be achieved. There is a widely held view that the Government has set up the structure and
funding of community care to ensure that the inevitable public outcry is directed at local
authorities rather than themselves. Already 18 English counties have run out of community
care money for the current financial year and have been obliged to halt any new assessments
of need or transfers of people from institutional care.
The impact of these financial constraints are being felt by social services workers: home care
workers for example are being obliged to take on greater work loads and undertake new
personal care duties (such as bathing and toiletting) because of the change in the client group;
social workers and care managers are being forced to make assessments not on the basis of
need (as is required by law) but on the resources available. Workloads have increased
immeasurably, and with only minimal increases in the number of workers available overwork,
stress and service failures are becoming commonplace.
For the broader community, the combination of care in the community policies and the
parallel underfunding are leading to considerable hardship. People who have been discharged
from institutional care are often not receiving a properly supportive care package: this can
range from the relatively minor hardship of insufficient home care support, through to
complete service failure where, for example, discharged psychiatric patients fall through the
net entirely and are left without any community care support and end up homeless and
sometimes violent. Elderly people who actually wish to enter residential care are being obliged
to continue in their own homes, often with inadequate support, because the funding is not
available to place them in a private residential home (local authorities are required to spend
85% of community care grant in the private sector and this has led to the closure or transfer of
a very large number of directly provided local authorities' residential homes).
In parallel with the community care changes, the Government has encouraged the adoption of
a market ethos in the provision of social services as a first stage towards wholesale
privatisation. Local authority functions are being divided into 'purchaser' and 'provider' roles
with a view to reducing the local authority role to a core 'purchasing' function. Services would
then be bought in from the private, voluntary or public sectors as appropriate. With the
requirement to spend 85% of community care money in the private sector, this means that
most of these contracts are being awarded in the independent sector and local authorities are
closing residential homes and day centres or hiving them off as independent companies.
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PSI Social Services Conference June 1995
The UK Government has begun a process of local government re-organisation which in some
areas is leading to the abolition of county authorities and the consequent transfer of social
services to district or city councils. There is considerable concern that in some cases these
councils are insufficiently large to provide the full range of social services provision,
especially specialist services.
There is no system of registration for social services and social care workers in the UK.
Proposals were submitted to central government last year for the creation of a General Social
Services Council. Despite some trade union concerns about compulsory registration, and
consequent risk of 'double jeopardy' for employees, there is general support for the creation of
such a council, but the Government has so far resisted the proposal.
Training and qualification for social services and social care staff are undergoing radical
change. In addition to the Diploma in Social Work, which is the basic professional
qualification for all categories of social worker, national vocational qualifications are being
introduced for the full range of social work and social care posts. The award of these
qualifications will be based on demonstrating work based competence and should open the
way for progression through five levels up to and including fully qualified social worker
status. The Diploma itself is being revised to slot into this structure. In this process, attempts
were made by various agencies including the trade unions to extend the Diploma from two to
three years' duration and thus comply with the general European model. This has been firmly
resisted by the Government. It is highly desirable that UK training and qualifications are
brought into line with those in other countries, particularly the European model.
A major issue for all social services and housing workers is the risk of violence and abuse.
Over the last ten years, a number of social workers and housing workers have been murdered
while on duty and physical and verbal abuse of all social services workers is commonplace.
Recent research has established that 50% of social workers have been violently assaulted, 10%
racially abused, 20% sexually harassed. UNISON is currently undertaking joint work with the
British Association of Social Workers on this issue to develop guidelines for workers and to
encourage local authorities to adopt effective programmes of risk assessment and
minimisation of violence and abuse.
Let me turn to housing. There is a high percentage of home ownership in the UK, well above
what is normal in other European countries. As a result there is major mortgage debt, with a
very substantial proportion of the population borrowing substantially in order to buy their
properties over a period of perhaps 25 years. With the recent collapse of house prices in the
UK, large numbers of people are now faced with "negative equity", where their borrowing to
purchase a property is greater than the value of their home. They are therefore unable to move.
If they are unable to maintain the repayments on their borrowing they lose their house and are
left with a substantial debt. This high percentage of home ownership has existed for many
years, but was heavily promoted by the Thatcher government, which introduced the right for
people in municipal housing to buy their homes. This move was very popular with the people
who were suddenly able to buy their homes at a discounted price, but of course it caused
havoc with the planned provision of municipal housing and had the consequence of denying
access to public housing for people who were in need. A further measure was the transfer of
public housing stock to voluntary housing associations, but now the Government is
introducing the "right to buy" principle into these associations as well, where it will have a
devastating effect, jeopardising financial stability.
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PSI Social Services Conference June 1995
These developments have depressed the housing market, restricted housing choice, denied
public housing to those who need it and increased the level of homelessness in Britain.
Simultaneous with these changes in housing policy, "community care" has been introduced, as
described earlier, encouraging the transfer of people from institutional care into the
community. Most people in the UK, including UNISON, very much support the principle of
care in the community; but because of serious underfunding local authorities are unable to
meet the needs of all those in need of care in the community, in particular those being
discharged from institutional accommodation such as psychiatric patients and the mentally ill.
The dual effect of Government housing policy and underfunded community care has led to a
steep surge in a number of homeless people in the UK, as any visitor to London will witness
on the streets only too frequently.
So, in the UK, as a result of these policies we have:










depression of the housing market;
a consequent collapse in new house building: fewer new homes were built in 1994 than
at anytime since 1945;
local authorities are forbidden by the Government from spending capital income from
house sales on new buildings (£6 billion are now held by local authorities which they
cannot use for the house building that is so desperately needed);
there is a backlog of repairs to dilapidated municipal housing, requiring expenditure of
between £8 billion and £20 billion;
many thousands of "right-to-buy" home owners are trapped in homes they cannot sell;
thousands of people have been unable to keep up their house purchase payments and
have become homeless, still carrying the burden of residual debt;
the government limits the powers of local authorities to house the homeless: the duty to
house homeless people relates mainly to those with children;
local authorities are forced to place thousands of homeless people in expensive and
squalid hotel accommodation in the private sector;
local authorities are being forced to meet the exploitative cost of this accommodation
for families (up to £400 per week);
the safety net of income support payments for those unable to keep up mortgage or rent
payments is gradually being withdrawn.
The British Labour Party is currently preparing a new policy document on housing which
would include:







increased investment in public housing;
restoration of stability and confidence in the housing market;
a revived role for local authorities, particularly an end to the restrictions on spending
capital raised from the sale of public housing;
more development of partnership between the public and private sector;
ending the British obsession with owner occupation!;
legal changes to allow tenants in rented accommodation to buy their freehold at a fair
price;
tighter regulation of the private rented sector;
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PSI Social Services Conference June 1995


a licencing scheme for the private sector, providing more security of tenure, better
standards of health and safety and fair rents;
permission for right-to-buy owners to sale their properties back to local authorities if
they wished.
This approach represents a radical change from the traditional view of the Labour Party and
British trade unions, which has always been that municipal housing is the primary, solution to
housing problems. There is now a much more pluralist view recognising that there is a "mixed
economy" of private, public and voluntary housing. Housing policy has also always been
regarded as a single and separate issue: a separate debate about homelessness, the availability
of housing, the issue of private versus public ownership and levels of rent and mortgage
payments. In fact of course, housing is a key feature of social services and social welfare and
needs to be approached in that context. It seems to me absurd that social services functions
such as family support, dealing with violence and abuse, child protection, home care, sheltered
housing and residential care are administered in the UK separately from housing. Housing is
often a cause of social problems and often a solution to them. Social workers dealing with
social problems are deeply aware of the impact of housing and that the housing of people may
be a key element of their social care.
There is in British local government some integrated working between social services and
housing but usually problems of housing and homelessness are referred to separate housing
departments which do not have a social work function. Housing workers are obviously
socially concerned and work hard to resolve housing problems that generate social denial and
social exclusion, but it is a nonsense that social services and housing are separate functions. In
the UK generally, particularly in England and Northern Ireland, social services and housing
are the responsibility not just of different departments within a local authority, but of different
local authorities. In the UK one very important step that could be taken is the integration of
social services and housing functions. The pattern in the rest of Europe varies, but there does
seem to be a general pattern of the separation of social work/social care and housing policy.
Social services and housing are not only closely related functions of social welfare, requiring
integrated provision, but they are also facing the same political pressures: underfunding (with
the consequent effect on the fundamental human right to decent housing and social
participation); privatisation; and cutbacks in services and the numbers of workers and
consequent pressures on those workers constantly striving to meet ever increasing demands.
There is a clear role for the trade unions in conjunction with local authorities and
representatives of users of social welfare services to campaign for an integrated political
initiative on social services in housing. In the UK there is major public outcry over schools
cutbacks and hospital closures, and rightly so (and this was reflected in the recent local
elections when the Conservative Party vote collapsed); but we as trade unionists concerned
about the deterioration of housing provision, the fragmentation of social welfare and most of
all about the human misery of homelessness, substandard housing and exploitation, have a
duty to raise our voices at national and international level to ensure that effective social
welfare programmes, including housing policy, are developed and implemented.
As a key step in securing this objective, UNISON would suggest that PSI could adopt an
action programme to undertake further work on key social services issues including:


the integration of social services and housing within a broader social welfare initiative;
funding of social services and housing: international comparisons;
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PSI Social Services Conference June 1995




privatisation of social services and housing;
the impact of 'care in the community' policies on users and workers in social services
and housing;
violence and abuse to housing and social services workers: the extent of the problem
and the development of an international response;
liaison with other international agencies such as the International Federation of Social
Workers on mutual policy development in these areas.
I look forward to your comments and contributions.
John Findlay, National Officer
UNISON UK
61