Ceci est une version HTML d'une pièce jointe de la demande d'accès à l'information 'Expert Group on De-Instititionalisation (DI)'.


 
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. 


     
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.  


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.