Platform work in long-term care
Report on the ‘Uber-isation’ of care services
RB – 03/2020
New forms of work have already established themselves
in various service sectors (see article Oct
In a recent report, the European Economic and Social Committee’s
(EESC) Workers’ Group looked at the growing trend of platform work in the field
of long-term home care. The report looks at the working conditions of platform
work and its applicability to the field of long-term care with regard to its unique
Challenges faces long-term care in the EU
The upward trend of an ageing population in
the EU means there is an increasing need for care services. Member States
organise and finance their national long-term care independently. This results
in a very mixed picture of formal entitlements to care services. In all Member
States there is a growing trend towards prioritising home care over institutionalised
The growth in home care is a result of excess
demand for long-term care services, the shortage of long-term care facilities
and a general lack of public funding.
In addition, a large proportion of care
activities are provided by family members or by other persons of trust. The
reasons for this can be systemic, financial or cultural.
Platform work and long-term care
In the EU, the number of platforms mediating
long-term care services is increasing. Examples of these platforms include ‘Pflegix’
and ‘Pflegetier’ in Germany, ‘Curafides’ in Austria and ‘Home Care Direct’ in
Ireland. These and other providers want to take advantage of the challenges currently
facing the long-term care sector and the trend towards home care. The EESC’s
report examines the framework conditions of the platform business model in long-term
care from the perspective of clients (those requiring care or their relatives),
workers (carers facilitated by the platform) and the platforms.
Unlike most other platform services, when
it comes to long-term care platforms, family members, friends and relatives are
often involved in the process in addition to the person in need of care (care
seeker). This means that the care seeker is not necessarily the client.
Furthermore, the individual care needs of clients vary significantly. Duration
of care, individual requirements and the carer’s qualifications are some of the
special features which must be taken into account when placing the carer. These
are some of the unique characteristics associated with long-term care services,
which are of little or no importance for standard platform-based delivery services.
Platform providers usually act as
intermediaries between careers and care seekers (or their relatives). Platform-based
carers are generally categorised as self-employed workers. This results in
flexible working arrangements which are matched to the special features of
individual care mentioned above. In some cases, this allows the carer a higher
degree of flexibility in the organisation of their work. However, unlike
conventional platform services, the aim here is to provide personalised care
based on strong mutual trust between the care seeker (or their relatives) and
the carer, as well as a continous long-term care relationship. In addition,
higher demands are placed on the qualifications of carers, which in turn means
higher barriers to market entry.
This results in a more detailed contractual
process including a discovery phase, exchange phase and a relationship phase. During
the discovery phase, carers already compete with one another and have to set
themselves apart from the competition, for example, through their
qualifications. The ability to evaluate a career based on ratings from services
previously provided means that relatives tend to carry out the evaluation
rather than the care seeker. This places new requirements on evaluation systems
to assess actual care as opposed to domestic services.
The platform acts as an intermediary
between carers and care seekers (or their relatives). This can be viewed as an
open marketplace for mediating contractors and clients. Private companies
charge a service fee for the intermediated service. Services can be provided on
demand for specific work or periods of time (e.g. sick leave or holiday
replacements). As long as the platform provider charges a service fee for each
placement, this may be in the interest of the care seeker, in the sense of ensuring
continuous and personal support.
Dynamic working conditions in line with
A detailed investigation of the
applicability and challenges of platform work in the field of long-term care
requires special attention due to the personal character of the service and the
desire for a long-term relationship.
Platform work, compared to traditional employment
relationships in the long-term care sector, offers carers the opportunity to
monetise their available working time in a flexible manner. The large number of
individual or partial service contracts generated is in the financial interest
of the platform provider, but it does not necessarily result in needs-oriented care
services which meet quality standards.
Therefore, the challenge is to reconcile
dynamic working relationships with the individual needs of care seekers and
their families. In addition, whether long-term care or any other sector, the
risks to the social security and occupational safety and health of platform
workers remains (see also article Oct 2019).
In order to protect care seekers and their
relatives, platform operators should be obliged to offer platform workers
further training and conduct pre-assessments in order to avoid increased risks at
the client’s home and counteract the de-professionalisation of a demanding and
The complete EWSA report can be read here.