The demands for and costs of long-term care provision in the EU will rise significantly by 2050, according to a report presented by the European Commission on 28 April 2008.

Meanwhile, the vast majority of Europeans (almost nine out of ten) favour home- or community-based care over care in an institutional setting. The projected growth in demand for long-term care services presents a major challenge for national governments. But the report also shows that Member States are striving to guarantee access for all to quality care by providing adequate resources to meet this demand. The report will be discussed at a conference on intergenerational solidarity organised by the Slovenian EU Presidency on 28-29 April in Brdo, Slovenia.

"This report reveals the challenges of long term care in the future. It also shows that Member States are already preparing a wide variety of solutions. And there is also strong commitment at European level to provide access to quality care for all. I am convinced that working together at European level gives Member States a unique added value and helps them to improve care for our vulnerable citizens by co-ordinating strategies and setting common objectives", said Social Affairs Commissioner Vladimír Špidla. He added: "We should not close our eyes to reality but act now to ensure high-quality long-term care now and for the future."

The Commission's report – 'Long-term Care in the European Union' – analyses the main challenges Member States face in the field of long-term care, their strategies for tackling them and presents possible solutions. It draws on the national reports submitted as part of the EU's system of common objectives, assessment and reporting for social protection and inclusion – the 'Open Method of Coordination'. It identifies the main challenges for national governments as:

• Ensuring access for all to long-term care services;
• Securing financing for long-term care through an adequate mix of public and private sources of finance and potential changes in the financing mechanisms;
• Improving coordination between social and medical services, often involved in the provision of long-term care services;
• Promoting home or community-based care rather than institutional care to help dependent people remain in their own homes for as long as possible;
• Improving the recruitment and working conditions of formal carers and supporting informal carers.

Background
Europe's 80+ population is projected to rise from 18 million in 2004 to nearly 50 million in 2050. If the additional life years are spent in ill health or in need of assistance, the number of dependent persons would more than double by 2050. Under the more optimistic scenario which assumes that the increase of a disability-free life expectancy will be in line with the gains in life expectancy as such, there would still be a 31% increase in the number of dependent persons.

This will lead to an increase in formal and informal care, so jobs will be created, but expenditure is also likely to increase. According to projections in the report, average public spending on long-term expenditure across the EU-25 countries is expected to almost double from 0.9% of GDP in 2004 to 1.6% in 2050. The most pessimistic scenario could see an even bigger rise to 2.3% of GDP.

According to a Eurobarometer report carried out in 2007, most Europeans expect to need long-term care at some point in their lives (with an EU average of 13% seeing this as inevitable, 32% likely and 29% unlikely but possible). However, 86% of Europeans would prefer to be cared for in their own homes or that of a relative should they become dependent, as opposed to only 8% preferring an institution.

This week's conference aims to identify solutions whereby different generations can co-exist in solidarity. Long-term care is one of the topics to be discussed. The report prepared by the European Commission also features a series of good practice examples from different Member States.

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