Care home versus home care? Which direction for care services in Europe? Eligibility for European Works Councils

Authors: 
Jane Lethbridge
Date: 
May 2013

The aim of this paper is to consider the eligibility of multinational companies working in the care sector for European Works Councils.  It does this in the context of European and national policies impacting on care, particularly home care, and the strategies of multinational companies operating in this sector.

 

Long term care is a political issue for almost all Western European countries because the population is ageing.  National governments are approaching the provision of care in different ways in some cases providing cash for care services, in others making it mandatory for individuals to be part of social insurance or private insurance schemes.  In other countries older people are given a right to a basic package of care but no extra funding is made available to fund services.   The way in which individuals can access long term care, whether through care allowances, vouchers, directly provided services, influences the way in which care services are organised, which impacts on care workers, often negatively.  In Eastern/ Central Europe care services are in an early stage of development, with limited development of local not-for-profit services delivered in the community.

The for-profit sector is still trying to identify the most profitable strategies for care homes and home care.  Several countries are experiencing a decline in care homes beds with an increase in home or domiciliary care.  Private equity investors remain active in the care home sector but are also investing in home care companies.  The for-profit care home sector has been shown to deliver poor quality services in several countries. This has led to a questioning of whether outsourcing of care services is the best way of delivering care.  The use of business models that depend on borrowing capital during a period of global financial crisis has undermined the profitability of the for-profit sector in the UK. 

The extent of multinational care company expansion has not changed significantly since 2010.  French care companies continue to acquire companies in neighbouring countries (Switzerland, Spain, Belgium and increasingly Germany) but are not owned by private equity investors although are starting to engage in joint ventures with property investors.  Nordic care companies, with private equity investors, continue to operate in the Nordic region but with little expansion.  Two companies in Sweden have been criticised for poor quality care, with one now being put up for sale.