»Die Tragödie in den europäischen Pflegeeinrichtungen ist nicht allein das Ergebnis einer unzureichenden Reaktion auf die Coronakrise«

In most countries, long-term care has long been neglected. Organisation, funding, and provision of care within the sector tends to be fragmented, with a diffusion of responsibility and lack of accountability. This section of the report examines these deficiencies. The impact of the pandemic has not been experienced evenly; Finland and Norway in particular managed to largely contain the pandemic in the general community and limit the spread within nursing homes. On the other hand, Portugal and Germany saw high[1]er cases in the general community yet managed to limit the spread within nursing homes. These examples are in the minority. Most EU countries experienced high infection rates both in the general community and in nursing homes, with the consequence of overwhelmed hospital systems and high COVID-19 death rates especially among long-term care residents. There is an urgent need to ensure resilience of long-term care through adequately resourcing the sector, reforming funding models, and integrating the sector with strengthened public healthcare systems.

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Conditions of work within the care sector fundamentally shape the quality of care that care recipients receive. This section of the report examines the deterioration of working conditions during the pandemic and the im[1]pact on both workers and care recipients. Throughout the pandemic, care workers experienced understaffing, work intensification and dangerous working conditions. A lack of adequate protection led to a much higher rate of COVID-19 infection among the long-term care workforce compared with the general workforce. The resilience of long-term care has been severely affected by exhaustion and moral injury. Existing gaps in social protection for care workers who were infected need to be addressed through recognition of COVID-19 as an occupational disease

Workforce shortages are worsening. The sector remains highly gendered, with 80% of the care workforce in the EU being women. Since the onset of the pandemic, Europe has faced a situation of workforce exodus on an unprecedented scale, especially among the residential care workforce. This section of the report assesses these trends and their implications for the sustainability of the sector in the future. Resilience of the long-term care sector is undermined by low levels of pay; it is below the workforce average in all countries in Europe. Many care workers are approaching retirement, which will make recruitment of younger workers especially necessary. There is a need for substantial pay increases and improvement in working condi[1]tions to retain existing care workers and attract new workers into the sector.

An alarming aspect of the crisis is the surge of private investment into Eu[1]rope’s long-term care market that has taken place during the pandemic. Es[1]pecially for investors in real estate, the sector is extremely lucrative, and has attracted record levels of investment in 2020. Many providers meanwhile face financial difficulties, thus creating conditions for takeovers. This final section of the report considers the implications of this dynamic. There is a critical need to undertake reforms that remove perverse incentives which encourage profit-extraction from care at the expense of workers, care recipients and their families.

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