The place for social and health services in the European Platform Against Poverty
During the European Platform Against Poverty (November 26-27, 2013), social and health services have been discussed in two workshops: "Ensuring adequate access to health care in times of austerity" and "Innovative financial instruments developed with the private sector". The common denominator of both workshops was about financing of these services.
In fact in the first one it was highlighted that affordability is one of the main barriers to have access to healthcare: on the one hand public authorities have less money to deliver healthcare and ask patients for increased contributions; on the other hand, people have reduced incomes and therefore reduced capacity to pay (Robert Anderson, Eurofound). The representative of the Greek government stated that the economic crisis is not the cause of the difficulties of the health sector in Greece, which are due to other problems, such as burdensome bureaucracy, corruption, excessive number of doctors providing specialised care rather than primary care. Some participants counter argued that the picture of healthcare systems in Greece is completely different: to give an example, vaccination for children is not available any more for free, even if this right is provided by law. Jean Lambert MEP said that there is need for reform in many countries. However, one should not understand reforms as cutting costs: to carry out effective reforms, you need money to invest and adequate human resources.
The second workshop focused on tools such as social impact bonds where private investors invest money to experiment innovative social services. Social investors are interested in both the financial return of a service and its social impact. It is a way for investors to engage in a more responsible capitalism and for social organisations to fill in their financial gaps, strengthen their accountability and marketing force. For governments these tools allow a boost for innovation (Rowell from Big Society Capital).
Ruth Owen from FEANTSA pointed out the positive and negative aspects of the use of social impact bonds in the homelessness sector. Among the positive ones, she quoted the scope to improve outcomes of interventions and to generate cost offsets, definable populations that make it possible to measure outcomes, the potential to mobilise funding for innovation and to implement evidence based policy and practice. However, she affirmed that social impact bonds are not a suitable instrument for funding the majority of social services (and the representative from Social Finance confirmed this) as they represent an additional instrument to finance social services and do not replace public money.
The debate with the audience largely confirmed that these tools are not the response to finance all social services. Nonetheless they are interesting tools to experiment new interventions and preventative interventions.
At Social Platform we have started debating these instruments during the last meeting of the Working Group on Services of General Interest. We will continue with a seminar on financing of social services on December 18 and go on next year.