Home Care in Slovakia and in the EU

The level of the social system and care for citizens dependent on social assistance should be, after GDP and other economic indicators, additional indicators of a country’s level of development. Currently, however, it is possible to observe a pan-European trend of reducing costs for social protection and services in all countries affected by the economic crisis (Caritas Europa 2011), even though the development of countries themselves is not declining. This is reflected in reduced social services, workers' wages, and the quality of social services, including home care.

Home care is a very widespread form of social services in all EU countries. In Slovakia, home care is defined by the Act on Social Services 448/2008 Z. z.: “Home care service is a social service provided to a natural person who is dependent on another person's help or is dependent on help with personal care activities, household care activities, and basic social activities”. (Collection of Laws No. 448/2008)

The level of home care and the individual problems connected with it differ significantly, mainly between the older and newer countries of the EU. In some countries, this remains at national level only a matter of legalizing and recognizing this profession and promoting the adoption of basic ILO conventions (Delarue 2011). Developed countries focus more on migration, improving the quality of home care, and further professional training of caregivers.

Developed countries with a stable social system have recorded an increase in the number of caregivers in recent years and therefore mainly discuss issues related to the rapid expansion of this profession, such as migration regulation and the impact of migration on the host country. ILO statistics confirm that migration is what improves the availability and quality of home care services. Migration of caregivers for work does not burden target countries economically, nor does it reduce the number of available jobs, but contributes to economic growth (Delarue 2011). Together with social services, expenditures are increasing, but economic turnover also rises. Developed countries also aim to reduce the phenomenon of illegal caregiving work, which is risky for both the caregiver and the client, unacceptable, and not beneficial for society. In practice, one can observe the whole cluster of issues mentioned in the ILO convention: payment below the value of work, since the work is undervalued and performed mainly by women, who are undervalued as migrants and exploited under financial pressure. A serious issue is also women leaving their families or children, with families being separated for long periods, often for the basic material security of their households. This problem significantly affects the family, as well as women’s and children’s rights. In practice, the specific conditions of the environments in which caregivers work are often insufficiently recognized. They are often made dependent by workload and excessive working hours, with the result that their mobility is restricted. Caregivers are also subjected to various forms of psychological abuse, sexual abuse, physical violence, and even assault (Convention, 2011), (Pichler 2011).

It is positive that Slovakia is among the countries where home care has its place among professions and is also legally defined. Slovakia also accepts the basic International Labour Organization (ILO) conventions on caregivers’ work, but in reality has not yet managed to create dignified conditions for caregivers to live in Slovakia, as evidenced by the large migration of these workers, primarily to Austria and Germany (Pichler 2011). This places Slovakia more in the second half of socio-economic development in the EU. These professionals, in productive age, are able to create substantial work value, but these benefits are brought to developed countries. Receiving countries gain cheaper labour without the need for prior investment in upbringing or education. Our society loses a large amount of labour potential and investments that were made in their upbringing and education due to caregiver emigration. The reduction of workers providing care in households runs counter to employment strategy. This leads to further social exclusion of clients, unavailability of social services, and unavailability of home care (100th ILO Annual Conference 2011).

Service quality

Another difference between Slovakia and developed countries is also the quality of home care services. So far, the Ministry of Labour, Social Affairs and Family of the Slovak Republic has not issued any decree to the law that would more specifically regulate and define the quality of social services in Slovakia and monitoring of caregiving performance. The Social Services Act in section 9 imposes an obligation to improve social services through supervision, but in no way contributes to direct financing of supplementary education (Collection of laws No. 448/2008). For this reason, further qualification growth and specialization of caregivers are debatable. Home care service and the professional work of caregivers were, until now, only formally monitored.

In other countries, quality standards have already been introduced much earlier into practice and tools for monitoring them also exist. Weak material equipment and aids are also reflected in the quality of caregiving in home care, not only in care facilities. In developed countries, many such aids are a long-established standard.

Professional education

Last but not least, one can also include training of caregivers among the differences. In Slovakia, a care provider must meet qualification requirements for performing caregiving services: full secondary education with relevant specialization or completion of an accredited course of at least 220 hours (Zamestnanci v sociálnych službách, 2012). Until recently, several employees had carried out this role without this minimum education. Requalification courses for caregivers have been offered for several years now by several organizations (Akadémia vzdelávania, Červený kríž, SKCH, and many others), whose certificate is valid throughout the EU. This course, however, is already becoming insufficient and does not cover the full spectrum of specific clients in home care. In Austria and other developed countries, further professional specializations are already under way within advanced or secondary vocational education. These are, for example, separate educational programs, whose graduates are narrowly specialized within home care, e.g., as a home care service manager, caregiver within family care, caregiver with a focus on children, caregiver with specialization in children’s education, caregiver for seniors focused on nursing, or caregiver for people with intellectual disabilities or health-care caregiver.

We should realize that in all EU countries, the number of elderly citizens is increasing and caregiving practiced by the family is no longer a given. The role of the state is therefore highly significant, and its responsibility for the social situation of citizens continues to grow. Less developed countries should seek to reach the level of developed countries not only in economic indicators, but focus on providing home caregiving services primarily in the home environment, on the quality of this care, and continuous education of providers of home care services.

Author: PhDr. Ján Danko, PhD. Used literature: Caritas Europa, 2011: Press Release, 13 December 2011, Europe 2020 Strategy Must Include both Economic and Social Dimensions. In http://www.caritas-europa.org/code/EN/soci.asp?Page=1268 (20. 1. 2012).

CONVENTION, 2011: Text of the Convention Concerning Decent Work for Domestic Workers. International Labour Conference. Provisional record 15A. In http://www.ilo.org/wcmsp5/groups/public/---ed_norm/---relconf/documents/meetingdocument/wcms_157836.pdf (10. 1. 012).

Delarue R. 2011: Presentation 'Protecting the Rights of Domestic Workers with International Tools: The ILO Convention on Domestic Workers' at the Out of the Shadow, securing quality employemant for Domestic Care Workers The role of civil society organisation. Caritas Europa Seminar. Brussels 15. – 16. December 2011.

PICHLER, I. 2011: Presentation „24-Hour Care Assistance in Austria“ at the Out of the Shadow, securing quality employemant for Domestic Care Workers The role of civil society organisation. Caritas Europa Seminar. Brussels 15. – 16. December 2011.

Zamestnanci v sociálnych službách, 2011: MPSVaR SR – Zamestnanci v sociálnych službách. In: http://www.employment.gov.sk/zamestnanci-v-socialnych-sluzbach.html (18. 1. 2012).

Zbierka zákonov č. 448/2008. In: http://www.zbierka.sk/zz/predpisy/default.aspx?PredpisID=208538&FileName=zz2008-00448-0208538&Rocnik=2008 (6. 1. 2012). 100th ILO Annual Conference, 2011: 100th annual Conference of the International Labour Organization (ILO). In: http://www.ilo.org/ilc/ILCSessions/100thSession/media-centre/press-releases/WCMS_157891/lang--en/index.htm (19. 1. 2012).