RETAIN report puts forward solutions to the worker shortage crisis in long-term care

In 2019, before the novel coronavirus changed our world, UNI Europa and its affiliated care unions recognized a crisis looming on the horizon in the long-term care (LTC) sector and initiated the RETAIN project, an in-depth research initiative funded by the European Commission to study the causes of worker shortages and propose solutions.

Click here to see the full report and other key documents.

Unfortunately, the Covid-19 pandemic made this potential disaster a real one, and it showed policy makers, the public and care providers the urgency of overhauling a sector that has fallen into a perilous cycle of inadequate investment, overwork, and burnout among carers, leading to high turnover and labour shortages.

These shortages are particularly acute given that the EU population over 65 projected to grow by more than 40 percent over the next 30 years.

To reverse the trend of too few care workers to meet an aging population’s needs, RETAIN identified four areas that must be addressed:

• low wages and poor working conditions,
• lack of collective bargaining and union representation,
• inadequate training and career progression,
• and poor health and safety standards.

RETAIN’s research also points to broader trends that negatively impact long-term care and that can also be alleviated through increased union organizing, improved social dialogue, and enlightened national and EU policies. Those trends include the exploitation of migrant workers, gender inequality and lack of adequate funding in the LTC sector as a whole.

“Being a long-term care worker is mentally demanding, physically difficult and vitally important,” said Oliver Roethig, Regional Secretary of UNI Europa. “The pandemic exposed how broken our long-term care system is, and a worker shortage is a symptom of that dysfunction. But the RETAIN research shows we can change this failed model of care—and avoid another crisis—by elevating workers’ rights and enacting protections for resident well-being.”

RETAIN’s recommendations include:

• Improving wages and working conditions to create family-sustaining jobs with fair minimum wages, good work-life balance, fewer administrative tasks, shorter travel times and more worker autonomy overall.
• Increasing staffing to improve quality of care in part by investing more financial resources in recruitment and introducing minimum staff-to-resident ratios with financial sanctions for providers that do not comply.
• Supporting union organizing, collective bargaining and improved social dialogue among providers, unions and other stakeholders in the sector.
• Improving health and safety in what has become one of the most dangerous jobs in the world. Those improvements must address physical and mental health concerns and must begin with member nations ratifying ILO Convention 190 on eliminating violence and harassment at work.
• Improving training and creating paths to professionalization for workers in LTC jobs.
• Improving migration policies and ratifying ILO Convention 189 to give domestic workers the same rights as other workers.
• Ensuring that national governments and the EU increase funding in the LTC sector and that the conditions of public funding include respect for workers’ rights, minimum staff-to-resident ratios and mandatory collective bargaining agreements.

In early implementations of these recommendations, several UNI Europa affiliates succeeded in expanding membership and winning collective bargaining agreements with improved working conditions.

This progress is a clear indication that if policy makers, private and public service providers and trade unions work together to meet workers’ and patients’ needs, they can change the current trajectory of the LTC sector. Instead of cutting costs by cutting workers out of the equation in an ongoing race to the bottom, stakeholders must take the high road by investing in workers and care systems that improve quality and accessibility of care.

Click here to see the full report and other key documents.