Ref. Ares(2013)3217522 - 10/10/2013
EUROPEAN COMMISSION
Employment, Social Affairs and Equal Opportunities DG
Directorate-General
The Director-General
Brussels,
D(2009)
NOTE TO THE ATTENTION OF MS KRISTIN SCHREIBER,
HEAD OF CABINET OF COMMISSIONER SPIDLA
Subject:
Your Note CAB D/183, 20.02.2009. Creation of an Ad Hoc Expert Group
for Institutional Care Reform
During recent years, the issue of institutional care reform has been dealt with in the
framework of several of our policy initiatives, as outlined in the annex.
The Ad Hoc Expert Group for Institutional Care Reform now set up by Commissioner Špidla
can play an important role to assess the different instruments that the Commission and DG
EMPL in particular, have been using and could use in the future to support a favourable
development in institutional care reform.
While focusing its work on moving from institutional care to more individualised community
based care in the Member States, as stated in your note, the ad hoc group can make a
significant contribution to strengthening policy developments in this field over the next years.
It may bring in additional know how and ideas, in a structured way, that will be beneficial for
the Commission's continued work in this area.
In particular, we welcome the commitment from the Expert Group to link the four distinct
"de-institutionalisation narratives", and we expect that all the Commission services involved
with a different role within this framework will cooperate with the group. As regards future
DG EMPL policy developments, the outcomes of the work of the group will be useful in
several regards.
The findings and the recommendations of the Ad Hoc Expert Group will be directly relevant
for developing the new EU Disability Strategy 2010-2020, as promoting the right for people
with disabilities to live independently and to have equal access to affordable and quality long-
term services will be among its priorities. Similarly the work of the group may feed into the
EU Social Protection and Social Inclusion Process, in particular inn relation to the issues
concerning children deprived of parental care. Such synergies will be encouraged by the
assistance to be given by the concerned DG EMPL units given to the work of the Ad Hoc
Expert Group, in particular the Disability and the Social Inclusion units.
Commission européenne, B-1049 Bruxelles / Europese Commissie, B-1049 Brussel - Belgium. Telephone: (32-2) 299 11 11.
http://ec.europa.eu/
On the other hand, it is important that the work remit of this ad hoc group remains clearly
focussed and avoids becoming too general, as might be the case by covering long-term care in
general as indicated in the report from the groups' first meeting on 10 March. This would
entail the risk that instead of delivering a focused report on a specific field of expertise, the
groups' stock-taking report would more reflect the positions of the participating NGOs, than
gathering facts and experts' ideas for stronger reform work on institutional care as stated in
your note. For all this reasons I would strongly advise to keep the mandate as pointed out in
your note from 20.02.2009 (D/183) and to avoid duplicating work and discussions that are
already being carried out in relevant EU work processes.
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Annex
Over the past recent years, the issue of institutional care reform has been developed within the
framework of several policy initiatives led by DG EMPL.
Studies and research
• In 2003, within the framework of the European Year of People with Disabilities, the
project “
Included in Society” was supported, aiming at analyzing the conditions in and
prevalence of large residential institutions for people with disabilities in Europe.
Information on the living conditions in large residential institutions in 25 European
countries were collected, creating the basis for policy recommendations addressing the
need for more community based services for disabled people.
• In 2007, within the framework of the Community action programme to combat
discrimination 2001/2006, the study "
Deinstitutionalisation and community living –
outcomes and costs" was supported. The study aimed to bring together the available
information on the number of people with disabilities living in residential institutions in
28 European countries, and to identify successful strategies for replacing institutions with
community-based services, paying particular attention to economic issues in the
transition.
• A report on
Child Poverty and Well-Being in the EU - Current status and way
forward adopted by the Social Protection Committee in 2008 identifies the predominant
factors affecting child poverty in each country. It also reviews the national monitoring and
evaluation systems of child well-being across the EU. Highlighted in the report is the need
to further investigation instruments at EU level for monitoring income and living
conditions of the most excluded children (children in institutions, in foster care, children
with chronic health problems or disabilities, abused children, street children, etc). Their
specific situation requires also regularly data collection and specific monitoring
instruments (whether at national and/or sub-national levels). There is also a specific
recommendation on reinforcing statistical capacity on the most vulnerable children in the
report, recommendation 10.1
The EU Disability Action Plan 2003/2010 and the Disability High Level Group
• The
Disability Action Plan 2003-2010, by means of mainstreaming the principles of non-
discrimination and accessibility in all the EU policies, has contributed to raise the issue at
European level of access to quality care and community-based services for people with
disabilities.
• Both the European Community and the Member States have signed the
United Nations
Convention on the Rights of Persons with Disabilities, committing themselves to take
all the necessary measures in order to fully respect the human rights of disabled people,
such as the
right to living independently and being included in the community. As a
follow-up to the Presidency Conclusions of the second EU ministerial disability meeting
and of the Conference on the Integration of Persons with Disabilities held in May 2008
1 Child Poverty and Well-being in the EU, current status and way forward, Social Protection
Committee, January 2008.
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under the Slovenian Presidency, Member States decided to exchange good practices in the
implementation of the UN Convention. Independent living was set as one of the priority
areas, and contributions sent by Member States will be part of the second
Disability High
Level Group report.
The EU Social Protection and Social Inclusion Process • Set up at the Lisbon European Council of March 2000
The Open Method of
Coordination on Social Protection and Social Inclusion (OMC) provides a
framework of political coordination where Member States has agreed to identify and
promote their most effective policies with the aim of learning from each other.
Moreover in July 2008, the Commission proposed to reinforce the social OMC to
allow the EU to achieve better results for the 2008-2010 period and pave the way for
the introduction of a sound framework post-2010.
• A key feature of the OMC is the joint analysis and assessment by the European
Commission and the Council of the National Reports on Strategies for Social
Protection and Inclusion submitted by the Member States. The Joint Reports assess
progress made in the implementation of the OMC, set key priorities and identify good
practice and innovative approaches of common interest to the Member States. The
2008 National Strategy Reports show the strong interlinks between improving access,
enhancing quality and ensuring sustainability in a number of policies.
• The most recent
Joint Report on Social Protection and Social Inclusion presented
in 2009 highlights the need to reaffirm commitment to ensure universal access to high
quality and affordable long-term care. Dependent people prefer long-term care in a
residential or community setting rather than institutional care, but in many countries
institutional care still accounts for more than half of public expenditure. Accordingly
countries are firmly focused on enhancing tailored home and community care services
and moving away from institutional care, whilst allowing and/or securing institutional
care access if alternatives are unsuitable or unavailable.
Looking at people with disability, there is a trend from centralisation to de-
institutionalisation and service provision closer to the citizen. Many Member States
are making efforts towards deinstitutionalisation of care for people with disabilities
and to develop more community-based services. However, progress tends to be slow,
and it seems important to strengthen the financial resources allocated to support this
process. Structural Funds are sometimes used to help revamp the crumbling system of
residential institutions, and it should be looked at how this can be prioritised and
strengthened in coming years.
Moreover, despite the increased emphasis on prevention, a number of children in all EU
countries are still deprived of parental care; being orphaned, victims of violence and
abuse, or for economic reasons (e.g. families in financial distress who lose their homes).
Most Member States are striving to avoid the institutionalisation of these children and to
promote foster care arrangements. Some countries have set up measures to improve the
status of foster families, and to provide them with financial support or specific training
and to improve monitoring systems. In most countries, measures are also being taken to
raise the standards and quality of institutional care.
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