CM(2006)194 13 November 20061
983 Meeting, 13 December 2006
6 Social cohesion
6.2 European Committee for Social Cohesion (CDCS) –
a. Abridged report of the 17th meeting (Strasbourg, 7-8 November 2006)
b. Draft recommendation Rec(2006)… of the Committee of Ministers to member states on policy to support positive parenting
Item to be prepared by the Rapporteur Group for Social and Health Questions (GR-SOC) at its meeting on 30 November 2006
1. The European Committee for Social Cohesion held its 17th meeting on 7 and 8 November 2006, with Mr Jerzy Ciechanski (Poland) in the Chair. The agenda is appended to this document.
2. As the Committee had decided to hold its meeting during the same week as the Forum on social cohesion, many of its members would be attending the Forum, which would take place immediately after the CDCS meeting (on 9 and 10 November). The theme of the Forum – “Achieving social cohesion in a multicultural Europe” – would be of considerable interest to the CDCS in its future work, so the Committee would examine the conclusions at its next meeting.
Results of activities
3. The Committee approved the draft Recommendation of the Committee of Ministers to the member states on positive parenting and agreed to transmit to the Committee of Ministers for adoption. The text is reproduced in Appendix 2. The Committee stressed the importance of its implementation and expressed its satisfaction that special attention is paid to the follow-up of this instrument in the draft programme of activities 2007.
4. The Committee took note with satisfaction of the other results of the work done by the Committee of Experts on Children and Families (CS-EF), in particular in the field of positive parenting – the report “Parenting in Contemporary Europe: A positive approach”, “the “keys for parents” and “guidelines for professionals”, as well as the “Principles and guidelines for providing support in parenting for families at risk of social exclusion”. It congratulated the members of the CS-EF and the Secretariat for the intensive work of high standard and hoped that the Council of Europe would enhance the visibility of its work in the member states.
5. The Committee approved with reservation the guidelines on supply of housing to vulnerable groups and took note of the report drawn up by the Council of Europe’s Group of Specialists on Housing Policies for Social Cohesion (CS-HO). It asked the Austrian and Swedish delegates, who wished to make modifications, to transmit their proposals to the Secretariat immediately so that these changes could be incorporated into the text. It decided that if there were substantial changes the Bureau would be instructed to finalise the text in January. If there were only minor changes then it would instruct the Secretariat to transmit the guidelines to the Committee of Ministers as soon as possible.
6. The Committee adopted the guidelines for the design and implementation of integrated models of social services and took note of the report drawn up by the Group of Specialists on User Involvement in Social Services and Integrated Social Services (CS-US). It instructed the Secretariat to transmit them to the Committee of Ministers. The text is reproduced in Appendix 3.
7. The Committee took note with interest of the results of the Conference of European Ministers responsible for family affairs, and in particular its Final Communiqué and the Political Declaration.
8. The Committee took note of the adoption by the Committee of Ministers on 4 September 2006 of the resolutions on the application of the European Code of Social Security (CS-SS) by the contracting parties. It also noted that the Committee of Ministers had extended the terms of reference of the CS-SS until the end of 2009. It took note of the results of the first meeting of the CS-SS, held in Strasbourg from 18 to 20 April 2006.
9. The Committee welcomed the training course on social security coordination held in Prague from 2 to 5 November 2006.
10. The Committee considered a document evaluating the follow-up by member states of Recommendation (2003) 19 on improving access to social rights and instructed the Bureau to examine it and to think of the best possible follow-up.
11. The Committee took note of the opinions the CDCS had transmitted to the Committee of Ministers on various Parliamentary Assembly Recommendations (see Appendix 4).
Planning of future activities
12. The Secretariat reported on the progress of the work of the high-level Task Force on Social Cohesion set up by the 3rd Summit in Warsaw. It noted that the Task Force had adopted a draft outline of the report at its last meeting, which the Chair of the Task Force would present at the Bureau meeting on 1 February 2007. The Task Force would hold its next meeting on 8 and 9 February 2007, at which it would discuss the full report. Auditions would then be organised with a large number of partners, including the CDCS, in order to consult the relevant bodies about this text.
13. The Committee took note of the draft programme of activities for 2007, which the Committee of Ministers had to adopt by the end of the year.
14. The Committee considered the planned project on “Strengthening social cohesion by avoiding exclusion and growing disparities,” which would be carried out in 2007 and 2008. It supports the general approach of the project and instructed the Bureau to adopt the terms of reference of the groups of specialists who would be responsible for implementation.
15. The Committee examined the planned project on “Rethinking family patterns in the best interests of the child,” which would be carried out in 2007 and 2008. It suggested changing the title of the project to “Taking into better consideration the diversity of family situations in the best interests of the child”. It expressed satisfaction that the activities concerning children and families would continue. It instructed the Bureau to adopt the terms of reference of the committee which would be responsible for implementation.
Consideration of ongoing activities
16. The Committee took note with interest of the work done by the co-ordination unit responsible for implementing the Building a Europe for and with Children programme, in particular the results of the launch conference held in Monaco in April 2006 and the future mainstreaming and child participation projects.
17. The Committee considered the progress of the intergovernmental activities and the multilateral and bilateral assistance activities conducted in 2006, in particular in south-east Europe (Social Institutions Support Programme, CARDS Regional Programme).
18. The Secretariat reported on the progress of the work concerning the European Dialogue Platform on Ethical and Solidarity-Based Initiatives to Combat Poverty and Social Exclusion and, in particular, on the seminar to be held in Trento (Italy) on 4 and 5 December on “Renewing dialogue and co-operation to combat poverty and exclusion: public authorities, citizens’ networks, media.”
19. The Committee took note of Resolution (2005) 47 on committees and subordinate bodies, their terms of reference and working methods and adopted its draft terms of reference drawn up on that basis. The CDCS Terms of Reference will be submitted to the Committee of Ministers as soon as the internal control procedure is accomplished.
20. The Committee was informed by Mrs Assia Tcholashka (Bulgaria) about the work done by the Council of Europe in connection with 2005 European Year of Citizenship through Education. It instructed Mr Riccardo Venturini (San Marino) to represent it in the relevant activities.
21. The Committee took note of the work done by the Committee of Experts on the protection of children against sexual exploitation and abuse and of the proposed convention on the matter. It thanked Mr Stephen Vella (Malta) for having represented it in the discussions.
22 The Committee was informed by Mrs Biserka Davidovič Primožič, representative of the Committee on the Rehabilitation and Integration of People with Disabilities (CD-R-RR) of work carried out by this committee. She invited the CDCS to send a representative to the following committees: Ad Hoc Group of Experts on Community Living (Deinstitutionalisation) of Children with Disabilities and the Committee of Experts on the ageing of people with disabilities and older people with disabilities (P-RR-VPH).
23. The delegate of Georgia drew the Committee’s attention to the violation of the rights of Georgian legal migrant workers and their families in the Russian Federation and submitted documents on this issue. The delegate of the Russian Federation answered to this declaration and gave information on the situation of Georgian legal and illegal migrants in her country.
24. The Committee elected its Chair, Vice-Chair and two Bureau members. The results of the elections were as follows:
- Chair: Mr Jerzy Ciechanski (Poland)
- Vice-Chair: Ms Lis Witsoe-Lund (Denmark)
- Bureau members:
The Committee instructed its Bureau to examine the question of the election procedure and of the duration of the terms of reference which could be based on the civil year if it is confirmed that the CDCS will meet only once a year.
25. The Committee was informed that only one plenary meeting can be held in 2007 for budgetary reasons.
The following dates were decided:
- CDCS (18th meeting): 29-30 March 2007
- CDCS (19th meeting): 27-28 November 2007 if the COE budget permits.
- CDCS Bureau (19th meeting): 31 January and 1 February 2007.
I. Opening of the meeting and adoption of the draft agenda
II. Statement by the Secretariat
(a) Decisions of the Committee of Ministers and other recent developments relevant to the CDCS
(b) Report of the sixteenth meeting of the CDCS and the eighteenth meeting of the Bureau
(c) Practical information concerning the 2006 Social Cohesion Forum:
Achieving social cohesion in a multicultural Europe
III. Task Force on Social Cohesion
Report on work being undertaken within the Task Force
IV. Activities concerning children and families:
V. Examination of guidelines on supply of housing to vulnerable groups drawn up by the Group of Specialists on Housing Policies for Social Cohesion (CS-HO)
VI. Examination of policy guidelines for the design and implementation of integrated models of social services drawn up by the Group of Specialists on User Involvement in Social Services and Integrated Social Services Delivery (CS-US)
VII. Examination of the project of activities for 2007-2009 on strengthening social cohesion by avoiding exclusion and growing disparities
VIII. Activities concerning social security
Training Course (Prague, 1-5 November 2006)
IX. Follow-up given by member states to Recommendation Rec(2003)19 on improving access to social rights
X. Progress report on social cohesion activities
(a) Intergovernmental cooperation activities
(b) Bilateral and multilateral assistance activities in South East Europe (Social Institutions Support Programme, CARDS Regional Programme
(c) Other bilateral and multilateral assistance activities
XI. Recommendations of the Parliamentary Assembly in the field of social cohesion
XII. Cooperation with other Council of Europe bodies
XIII. Activities of other international bodies relevant to social cohesion
XIV. Other business
XV. Dates of future meetings
Recommendation of the Committee of Ministers to member states on policy to support positive parenting
(adopted by the Committee of Ministers on …
at the … meeting of the Ministers’ Deputies)
The Committee of Ministers, under Article 15b of the Statute of the Council of Europe;
Considering that the aim of the Council of Europe is to achieve a greater unity between its member states, inter alia, by promoting the adoption of common rules;
Referring to the work of the Council of Europe in the field of children and families and reaffirming in general the following legal instruments:
– the Convention on Human Rights and Fundamental Freedoms (ETS No. 5), which protects the rights of everyone, including children;
– the European Social Charter (ETS No. 35) and revised European Social Charter (ETS No. 163), stating that “the family as a fundamental unit of society has the right to appropriate social, legal and economic protection to ensure its full development” (Article 16);
– the European Convention on the Exercise of Children’s Rights (ETS No. 160);
– the Convention on Contacts concerning children (ETS No. 192);
– the Recommendations of the Committee of Ministers to member States: No. R (84) 4 on parental responsibilities; No. R (85) 4 on violence in the family; No. R (87) 6 on foster families; No. R (94) 14 on coherent and integrated family policies; No. R (96) 5 on reconciling work and family life; No. R (97) 4 on securing and promoting the health of single parent families; No. R (98) 8 on children’s participation in family and social life; Rec(2005)5 on the rights of children living in residential institutions and Rec(2006)5 on the Council of Europe Action Plan to promote the rights and full participation of people with disabilities in society: improving the quality of life of people with disabilities in Europe 2006-2015;
Bearing in mind the Revised Social Strategy for Social Cohesion for which families are the place where social cohesion is first experienced and learnt and that a social cohesion strategy, while fully respecting the autonomy of the private sphere and of civil society, must seek to be supportive of families;
Recalling the Parliamentary Assembly’s Recommendations 751 (1975) on the position and responsibility of parents in the modern family and their support by society; 1074 (1988) on family policy; 1121 (1990) on the rights of children; 1443 (2000) on international adoption: respecting children’s rights; 1501 (2001) on parents’ and teachers’ responsibilities in children’s education; 1551 (2002) on building a 21st-century society with and for children: follow-up to the European strategy for children (Recommendation 1286 (1996)); 1639 (2003) on family mediation and equality of sexes; 1666 (2004) on a Europe-wide ban on corporal punishment of children; 1698 (2005) on the rights of children in institutions: follow-up to Recommendation 1601 (2003) of the Parliamentary Assembly;
Stressing the importance of the United Nations Convention on the Rights of the Child, to which all the member states of the Council of Europe are parties, and the basic principles of which should always underlie the rearing of children;
Recalling the 3rd Summit of Heads of State and Government (Warsaw, Poland, May 2005) and the commitment made their to fully comply with the obligations of the United Nations Convention on the Rights of the Child, to effectively promote the rights of the child and to take specific action to eradicate all forms of violence against children, and the ensuing programme “Building a Europe for and with children”, officially launched in Monaco, on 4 and 5 April 2006;
Referring to the Final Communiqué and Political Declaration of the European Ministers responsible for Family Affairs at the 28th Session of their Conference (Lisbon, Portugal, 16-17 May 2006), particularly:
– recognising that parenting, though linked to family intimacy, should be designated as a domain of public policy and all the necessary measures should be adopted for supporting parenting and creating the conditions necessary for positive parenting;
– recalling their commitment to promote and pursue a common European policy in the field of family affairs and the rights of the child within the framework of the Council of Europe;
Recognising the child as a person with rights, including the right to be protected and to participate, to express her/his views, to be heard and be heeded;
Recalling that public authorities have a vital role to play in supporting families in general and parents in particular, which is expressed through three core elements of family policy: public transfers and taxation, measures to balance work and family life, childcare provision and other services;
Considering that the family is a primary unit of society and that parenting plays a fundamental role in society and for its future;
Conscious of the many changes and challenges facing families today which require parenthood to be given greater prominence and better support, considering that such support is essential for children, parents and society as a whole;
Recognising that all levels of society have a role to play in supporting children, parents and families;
Considering that public authorities in conjunction with the economic and social sectors and civil society can, in taking action in support of parenting, help strive for a healthier and more prosperous future for society, as well as an improvement in the quality of family life;
Noting the need for a cross-sectoral and co-ordinated approach;
Keen to promote positive parenting as an essential part of the support provided for parenting, and as a means of ensuring respect for and implementation of children’s rights;
Recommends that the governments of member states:
– acknowledge the essential nature of families and of the parental role and create the necessary conditions for positive parenting in the best interests of the child;
– take all appropriate legislative, administrative, financial and other measures adhering to the principles set out in the appendix to this recommendation.
Appendix to the Recommendation Rec(2006)…
For the purpose of this Recommendation, the term:
“Parents”: refers to persons with parental authority or responsibility;
“Parenting”: refers to all the roles falling to parents in order to care for and bring up children. Parenting is centred on parent-children interaction and entails rights and duties for the child’s development and self-fulfilment;
“Positive parenting”: refers to parental behaviour based on the best interests of the child that is nurturing, empowering, non-violent and provides recognition and guidance which involves setting of boundaries to enable the full development of the child.
2. Fundamental principles of policies and measures
Policies and measures in the field of support for parenting should:
i. adopt a rights-based approach: this means treating children and parents as holders of rights and obligations;
ii. be based on a voluntary choice by the individuals concerned, except when public authorities have to intervene to protect the child;
iii. acknowledge that parents have the prime responsibility for their child, subject to the child’s best interests;
iv. consider parents and children as partners sharing, as appropriate, the setting up and implementation of the measures relating to them;
v. be based on the equal involvement of parents and respect for their complementarity;
vi. guarantee equal opportunities for children irrespective of their gender, status, abilities or family situation;
vii. take into account the importance of a sufficient standard of living to engage in positive parenting;
viii. be based on a clearly expressed concept of positive parenting;
ix. address parents and key players having childcare, health and educational and social responsibilities towards the child and who should also respect the principles of positive parenting;
x. recognise the diverse types of parenting and parental situations through adopting a pluralistic approach;
xi. adopt a positive approach to parents’ potential, particularly through placing priority on incentives;
xii. be long-term in order to guarantee stability and continuity of policy;
xiii. ensure that the number of common rules of principle at national or federal level are kept to a minimum to promote equal standards at local level and that there is a local network of services providing parenting support measures;
xiv. ensure inter-ministerial co-operation, encouraging and co-ordinating the action(s) in this field of the different ministries, departments and agencies concerned in order to implement policy that is coherent and comprehensive;
xv. be co-ordinated at international level, through facilitating exchanges of knowledge, experience and good practice in the application of the guidelines on positive parenting.
Governments should organise their policies and programmes on positive parenting with a view to achieving the following three types of objectives:
i. the creation of the conditions for positive parenting, by ensuring that all those rearing children have access to an appropriate level and diversity of resources (material, psychological, social and cultural) and that broad social attitudes and patterns of prevailing life are receptive to the needs of families with children and also those of parents;
ii. the removal of barriers to positive parenting, whatever their origin. Employment policy, in particular, should allow a better reconciliation of family and working life;
iii. the promotion of positive parenting by developing awareness of it and taking all the necessary measures to make it a reality. In order to have efficient policies to support parenting, public authorities should promote initiatives aiming to make people aware of the value and importance of positive parenting. Governments should take a pro-active approach to promoting awareness of parenting issues and to normalising participation in parenting programmes. Information should present different images of parenting in order to avoid stigmatising differences.
The goal of policy and measures should be the harmonious development (in all its dimensions) and proper treatment of children, with due regard for their fundamental rights and dignity. As a priority, measures should be taken to eliminate all child neglect and abuse and physical or psychological violence (including humiliation, degrading treatment and corporal punishment).
It is also essential to implement and further develop a suitable policy to bring about a change in social attitudes and patterns of life in order to accommodate more effectively the needs of children, parents and families and in particular to promote family-friendly working environments and services.
4. Incorporating children’s rights in public policies
Public policies on support for parenting should incorporate childhood-related issues, acknowledging the needs and interests of all children and paying attention to their varying needs depending on their age, capacity, and level of maturity. For this purpose, the principles enshrined in the United Nations Convention on the Rights of the Child should be respected by all, regardless of context, and particularly guide the activities of all bodies working in the field, both public and private, especially for the following rights and general principles:
i. the right to non-discrimination;
ii. the best interests of the child should be of primary consideration;
iii. the child’s right to life and development;
ix. the child’s right to participation, to express her/his views, to be heard and be heeded, to receive information and to join associations and other organisations;
x. the right to protection and care.
For this purpose, it is important for the child to grow up in a favourable family environment and in a positive atmosphere.
5. Considering parents’ responsibilities, rights and obligations
In the best interests of the child, the rights of parents, such as entitlement to appropriate support from public authorities in fulfilling their parental functions, must also be given prominence. The exercise by parents of equal and shared responsibility for their children makes a major contribution to the harmonious development of the child’s personality.
Particular attention should be paid to the important role of fathers in the care and rearing of their children, taking into account in particular the principle of gender equality, the impact on families of the reconciliation of work and family life and family breakdown, which can often result in fathers living apart from their children.
6. Core components of policies and measures
Policies to promote and encourage positive parenting will work best if they are based on consultation and dialogue with parents and on their voluntary involvement and participation, in order to reach a real partnership. In addition to the essential elements at point 4 and 5 of this Recommendation, core components include the following.
6.1. Supporting parents
i. alongside the measures proposed by public authorities to afford and improve support for parents, support from other agencies (such as municipalities, social security and associations) should also be acknowledged and encouraged;
ii. policies should be geared to engendering support for parenting at the following three levels:
– informal: creating and strengthening existing social bonds and encouraging new links between parents and their family, neighbours and friends;
– semi-formal: empowering parents’ and children’s associations and NGOs and activating a range of self-help and other community-based groups and services;
– formal: facilitating access to public services.
6.2. Promoting education in children’s rights and positive parenting
i. parents should be encouraged to become more aware of the nature of their role (and how it is changing), children’s rights, the responsibilities and obligations that derive from these and their own rights;
ii. governments should also arrange for comprehensive guidelines and specific programmes to assist them in challenging life situations, conflict resolution, anger management through non-violent approaches and mediation techniques;
iii. prevention programmes regarding the different forms of ill-treatment of children should be promoted and parents made aware of this serious problem and of its consequences on the child’s development;
iv. children should also be taught about their rights and duties in order to make them aware of the concept of positive parenting and what this means for them.
6.3. Reconciling family and working life
i. public authorities should create the necessary conditions – and employers should be encouraged – to implement a better reconciliation of family and working life through legal and other provisions (such as flexible working arrangements, adjustment of working and school hours, leave policies, various types of good quality childcare services, provisions for looking after children with disabilities as well as sick children, etc.);
ii. the social partners should be encouraged to negotiate and develop tailor-made policies adapted to the specific needs of each company and of their employees;
iii. good practices make it clear to employers that a comprehensive work/life balance policy creates a win-win situation within companies.
6.4. Policies at local level
The action taken at local level is particularly important in providing a response tailored more closely to the needs and characteristics of the populations concerned. Co-operation and co-ordination at national or federal and local levels and between these levels are necessary in order to offer families better service and optimise available resources and the use made of them. Administrative procedures should allow for an appropriate level of flexibility in service provision, consistent with ensuring equitable treatment of all families.
7. Targeting of policies and measures
Particular attention should be paid to difficult social and economic circumstances and to crises within families, which require more specific support.
It is also essential to supplement general policies with a more targeted approach. Parenting in certain situations and at certain periods in the life cycle is by its nature more challenging. Despite the variations from country to country, the needs of the following groups should be especially attended to:
i. first-time parents ;
ii. teenage parents ;
iii. families with particular needs;
iv. families in difficult socio-economic circumstances.
In the case of separated parents, support policies should be aimed in particular at maintaining links between children and both their parents, unless this is contrary to the child’s best interests. Access to professional counselling should be provided and attention should be paid to cases where the parents have different cultural backgrounds or are of different nationalities.
Public authorities should stimulate and facilitate the creation of networks of mutual assistance associations between families and make available places where parents could meet to discuss – with professionals, if necessary – on issues relating to parenting, and provide parents with adequate support services like free help lines and counselling services.
8. Parenting in situations of social exclusion
Parenting in situations of social exclusion or at risk of social exclusion can be particularly difficult and special attention should be paid to the needs of children and families in this situation, with reference in particular to the following:
i. providing long-term support, as appropriate, to help them achieve the same results as other children and families; this support should include reaching out to them in their homes or in the places they frequent, and take into consideration the possible fear of parents in a situation of social exclusion towards social services, particularly of having their children taken away;
ii. giving sufficient means to support parents and to allow them to acquire the necessary competence to fulfil their responsibilities towards their children;
iii. guaranteeing access to social rights (including the right to adequate income, health, education, housing and employment) and the same quality targeted services as those enjoyed by other families;
iv. ensuring that families and children suffering exclusion are considered in their social context (including the extended family, the community and their relational networks) and enjoy the same quality services, including local ones, as those enjoyed by other families, in accordance with their needs;
v. building a trustworthy relationship with the families and enabling parents to regain control of their own lives;
vi. organising training for professionals and parents together in order to achieve better mutual knowledge and understanding, to built a common project in the best interests of the child and enabling professionals to learn about what these families are experiencing and to better know their family project, with a view to focusing their practice on it;
vii. ensuring personal and collective support for professionals in order to raise their level of competence in working with people in very difficult situations and take the necessary steps to create new approaches;
viii. taking ad hoc measures to avoid the risk of marginalisation of migrant families;
ix. avoiding measures and administrative practice that stigmatise children and parents by treating them differently because their families are less well-off than others;
x. introducing measures to prevent dropout from school as an efficient means to counteract family distress.
9. Qualitative guidelines for professionals
In order for the above rights and principles to be applied, benchmarks and standards must be set. Guidelines on the focus of their services – as the Council of Europe guidelines on positive parenting for professionals should be given to professionals and practitioners (including those not directly involved with children but whose work could have an impact on their rights), with particular emphasis on:
i. the principle of equity and accessibility, which should underlie all action taken;
ii. the principle of becoming partners with and empowering parents. Partnership presupposes recognition of parents’ own experience and their knowledge of their own children;
iii. application of the concept of partnership to co-operation and interdisciplinary co-ordination between agencies, specifying the particular areas of activity of each department, providing for a sharing of facilities and working in a cross-curricular network;
iv. ensuring that the application of comprehensive services is conceived in terms of support and assistance, encouraging family initiative without creating excessive dependency. Accordingly, strengths and resources of families should be supported. This also means that professionals should act as support for parents, in ways that are non-judgmental and non-stigmatising;
v. building up parents’ self-confidence, enhancing their competencies and potential and motivating parents to be informed and trained;
vi. enabling children to communicate their feelings and needs, in particular very young children and children with communication impairments;
vii. the importance of service provision and professional practices by ensuring that the emphasis is placed on:
– thorough training of the professionals concerned;
– ongoing evaluation, both external and internal (self-evaluation);
– continuity of action;
– responses based on the understanding of the child and families in their context;
viii. devising methods to identify risk factors regarding failure to provide parental care to be disseminated among social services, health-care professionals, those dealing with young people, teachers and childcare staff to train them in identifying families with problems in this respect and offer support. A better co-ordination among the services working to support a family should constantly be sought;
ix. co-ordinating the implementation of measures to separate children from their parents, when this is necessary, with work with the family of origin (particularly in partnership with the parents) in order to enable them to prepare or better prepare for and accept this step as a means of ensuring the best interests of the child. The aim of any such measure should be the return, if possible, of the child in the family environment.
10. School and child care environment
An integrated approach to the provision of assistance with schooling and support for parenting should be encouraged (especially where children lack stable roots or a permanent home – for example children with a Roma or Gypsy background, children of migrants); childcare and school integration as well as dialogue between these service providers and parents should be encouraged, with special attention to families in difficult situations and to those with particular needs.
11. Key messages for parents and all those having responsibilities for children and their rearing
Key messages on positive parenting should be issued to all parents and persons providing care and involved in the rearing of a child on a daily basis (such as childminders or school staff). These messages should make clear how the child is to be respected as a person and how his/her participation should be promoted, and that parents have rights as well as responsibilities. Key messages should be drawn up on the basis of consultation with all the stakeholders involved, especially parents, service providers and children, and be monitored to ensure that they are effective and are being adhered to.
12. International co-operation
Measures should be put in place to improve international co-operation and exchange of best practice in relation to parenting.
Draft policy guidelines for the design and implementation of integrated models of social services
drawn up by the Group of Specialists on User Involvement in Social Services and Integrated Social Services Delivery (CS-US)
We have twin girls aged five, both have a moderate learning disability. Jenny also has autism. We’re totally confused with all of the different professionals and agencies we have to deal with. The following are some of the people we deal with on a regular basis: GP, counselling nurse, speech and language therapist, occupational therapist, psychiatrist, psychologist, teacher, classroom assistant, ophthalmologist, audiologist and administrators – to name but a few.
We’re so confused sometimes. We don’t understand the different roles and have so many appointments that clash.
Can nobody or no system sort it out? 2
1.1 These guidelines aim to assist stakeholders (i.e. principally policy makers on the national and local levels, service organisations and those who use their services) in designing and implementing effective integration policies. An important purpose of service integration is to improve access to social rights, reduce the social exclusion of vulnerable groups, and contribute to the overall objective of strengthening social cohesion. In developing integrated services, an essential consideration is the mainstreaming of issues such as gender, ethnicity, age, disability and poverty.
1.2 There is growing evidence that the integration of major services is becoming a prominent policy issue in many European countries, as seen in new legislation, research projects, European conferences and information on integration initiatives. The focus is substantially upon social and health services and to a lesser extent includes other public services, such as education and employment.
1.3 These guidelines are based on the findings from commissioned research work and the discussions and proposals of the Group of Specialists on User Involvement in Social Services and Integrated Social Services Delivery (CS-US), set up by the European Committee for Social Cohesion. The research work is presented in a separate report (see document …. ‘Integrated social services in Europe’), which includes material from a wide range of European integration programmes and projects.
1.4 For the purposes of these guidelines, the term integration is defined as a range of approaches or methods for achieving greater coordination and cooperation between different services in order to improve their delivery to users. These approaches include: merger of two or more separate services into a new single service structure; service coordination; cooperation; partnerships; collaboration; inter-professional or joint working. The degree of integration may vary and therefore it should be seen on a continuum.
1.5 There is a strong consensus that there is “no one size fits all” in integration work. The particular approach to integration has to be chosen to suit specific needs, circumstances and possibilities.3
2. Advantages of integrating social services
In designing integration policies, decision-makers should clearly justify the need for integration. They should take into account the main arguments in support of integrating social services with one or more other services, namely that it would :
2.1 deal more effectively with the diverse and complex problems related to social exclusion;
2.2 facilitate access by service users to a range of services;
2.3 allow the adoption of a more holistic approach in meeting the needs of service users;
2.4 foster the development of more personalised relationships between users and providers and increase user involvement;
2.5 contribute to ensuring continuity and sustainability of service delivery;
2.6 simplify and accelerate the decision-making process in service delivery;
2.7 improve efficiency and effectiveness of service provision;
2.8 reduce overlapping of the different services.
The following example illustrates the value of integrated services for one major marginalised group in many countries – unemployed women.
Box 1 : Integrated interventions for women in Greece
The initiative to provide integrated services for women who are unemployed or at risk of social exclusion has grown from work started 10 years ago. The General Secretariat for Equality and the Research Centre for Gender Equality set up a pilot project staffed by an interdisciplinary team providing counselling and information services. The Unit’s methodology has three major pillars:
§ provision of a complete set of services (e.g. psychological and legal counselling, career advice) to enable the unit to function as a ‘one-stop shop’ for women to receive different but integrated services relevant to their employment search;
§ a gender-sensitive approach allowing women to understand, negotiate and – if needed – redefine their social role;
§ networking among related agencies.
The unit started in Athens but eventually spread to other cities. Key findings were that government agencies found it difficult to inform women about policies and services to help them into employment; and what was needed were a) effective networks to distribute information, b) decentralised services tailored to local needs, and c) a commitment from the top.
Based on this initial experience, the original sponsoring actors designed in 2003 the ‘Integrated Interventions for Women’ programme. Central features of this programme include:
§ an integrated unit (as above) in all thirteen Prefectures in Greece;
§ units to form public-private partnerships between agencies experienced in this field;
§ units to draw up ‘Action Plans’ to implement integrated interventions with specified services – not just counselling as previously;
§ action Plans to be monitored centrally.
Evaluation of this programme is underway indicating that so far an average of 47% of the women who benefited from integrated services entered successfully into the labour market.
Commitment from the top is essential to success. The main barrier to progress has been the unwillingness of local authorities to support the programme;
§ Not all partnerships are working effectively e.g. disputes among partners;
§ An underlying cost reduction from the integration of services.
This integrated services model may have application to other target populations in need, e.g. rehabilitation of mentally ill people.
3. Critical success factors of integration programmes
In order to design integration policies which meet the expectations of the main stakeholders and go on to achieve valuable and realistic outcomes, the policy-makers should consider a number of important requirements.
3.1 A fully inclusive, open and transparent process of consultation with stakeholders, and particularly with service users/beneficiaries, should be undertaken. Reliable information should be provided regularly.
3.2 The problems which have led to a proposal for service integration as a solution should be clarified and assessed.
3.3 A feasibility study of possible positive and negative effects of the proposed integration should be undertaken. This might include:
3.4 The methods for monitoring and evaluating the outcomes of integration should be determined.
3.5 The necessary resources to carry out the integration initiative should be calculated, for example finance, human resources and ‘know-how’.
3.6 Arguments against the proposed integration should be assessed and seriously considered.
Moreover, the following preconditions should be taken into account when an integration initiative is being considered:
3.7 a political environment which is favourable to integration and is supported by important decision-makers;
3.8 a willingness among leaders to put the common interest beyond the needs of their own organisation and a commitment to find solutions;
3.9 a common working culture of shared principles, objectives, planning, responsibilities, accountability, and concrete national policies with legislation, i.e. for national programmes;
3.10 a proper and equitable balance of power between parties within the new integrated service;
3.11 a shared and standardised system of assessing the problems of service users based on mutual understanding. The system should clearly identify the roles of all the professionals;
3.12 new skills and competences demanded by the complexity and specificity of the integrated services must be acquired by the staff;
3.13 a new, common quality-management system, which involves distinctive leadership, consultation and participation of providers and users, building trust between stakeholders and setting up a monitoring system.
4. Challenging elements in the integration of social services
In designing integration policies, policy-makers should evaluate the challenges involved and consider how to address them.
4.1 While recognising the positive elements brought about by integrating services, partners need to adapt to a new working culture in order to break down institutional domains.
4.2 There is a relative lack of formal evaluations of integration projects and, where they exist, not all are positive. Consequently, it is difficult to provide clear evidence of the benefits of integration with scientific certainty.
4.3 The funding and other resources required for introducing new and more efficient integrated systems of service delivery may be substantial and should not be underestimated.
4.4 The initial stages of the process may be time-consuming in terms of designing frameworks, information technology, financial and other procedures.
4.5 Entrenched interests of bureaucracy and professional groups may hinder successful integration.
Various elements related to costs should be considered :
4.6 The main justification for integrating services is to produce better outcomes for service users. Reductions in service costs can also be achieved but as yet there is insufficient evidence to guarantee this benefit in all cases.
4.7 Cost effectiveness studies of integration are challenging to construct and implement, for example accurate comparisons of costs of separate compared with integrated services. This also entails comparing the costs of providing the same improved service delivery without integration since they could be higher than those generated by an integrated approach.
4.8 Initial start-up costs in structural integration can be quite high. These costs may be considerably less for countries without a system of well established separate services requiring expensive reorganisation. In the long term, however, cost savings may be achieved in both cases.
5. Integration models and methods
Policy-makers should examine the various integration models and methods in order to determine which one suits their particular needs. A number of examples from different countries are described below.
5.1 Integration at different levels. Social services may be integrated with one or more major services at the macro (national); mezzo (regional); or micro (local) level. There are no indicators to determine at what level(s) integration should be introduced – so much depends on particular circumstances in individual countries. The most important level for integration of some kind is at the level of the individual service user (see ‘case management’ below).
5.2 Structural integration. This can be seen as the most complete or radical form of integration as it involves bringing together staff and resources from different services into a new organisation under a single unified structure. It is also a particularly difficult and costly approach to integration. It may be introduced as a radical solution to the negative consequences of service separation which are unlikely to respond to more informal approaches to integration. An advantage of successful structural integration is that it can provide a lasting, stable solution to problems of service coordination, resulting in a more effective use of staff in the interests of service users.
5.3 Whole systems working. The whole system may be defined as “… not simply a collection of organisations that need to work together, but a mix of different people, professions, services and buildings which have patients and users as their unifying concern, and deliver a range of services in a variety of settings to provide the right care, in the right place at the right time” (Department of Health, United Kingdom, 2003).
5.4 Process-centred collaboration. This is one of several approaches designed to improve cooperation or collaboration between services and their staff – without the major organisational disturbance and costs involved in structural integration. This approach focuses on caring activities rather than their organisational context. A key feature is the introduction of incentives for closer working between professionals across professional boundaries e.g. new forms of funding such as client budgets, long term care allowances.
5.5 Inter-disciplinary working. This is a form of process-centred collaboration as it involves staff from two or more professions working as a multi-disciplinary team, for example in a community mental health centre. It can be a particularly effective form of service integration if it is carefully planned with full consultation and preparation of staff concerned.
5.6 Partnerships. This is a form of integration in which service organisations and their professionals agree to participate in specific and ad hoc collaborative relationships. Partnerships can be formal which often involves changing organisational arrangements, with associated costs, or informal where organisations act as partners without structural changes.
5.7 One-stop shops or single service centres. This approach to the integration of several separate services at the local level is becoming increasingly popular, for example in France, Armenia, and Malta. Basically, the one-stop shop enables users to access in one building various different services previously housed in geographically different centres. The convenience to users is obvious, together with the strong potential for greater collaboration, information sharing and joint working between staff of the different services.
One-stop shops may vary in the extent of service integration. Many may operate in the model of the modern city department store where various companies rent space and sell their products uncoordinated with other companies in the same building. Others may function closer to the supermarket model where the one company offers a wide range of products to the customer in a highly integrated operation. One-stop shops can move closer to the second model when they offer an initial needs assessment to users as a necessary basis for selecting a package of services from those available.
The following example illustrates the one-stop shop approach.
Box 2 : Integrated Social Services Centre in Vanadzor in Armenia
International donors concentrate in their social welfare programmes in CEE on “bringing services closer to the citizen and integrating the services available so that the citizen has to visit just one location to obtain social services”. This is particularly necessary in Armenia where services are administered by a network of over 180 separate offices. The Government of Armenia is committed to a policy of improving services to citizens which involves bringing all services together under one roof.
Vanadzor is a pilot project to test all aspects of creating ISSCs in Armenia. The main goals of the ISSC will be to:
§ improve access for the citizen to social services by co-locating all social services in one building, and improving access to information;
§ enhance and extend the range of social provided to the citizen by working more closely with NGOs in health and social care;
§ improve information sharing among organisations by creating systems for sharing databases to simplify applications;
§ improve the administration of social benefits programmes through streamlining procedures, more efficient work practices, and improved staff training:
§ make more efficient use of staff and technical resources among the co-located offices.
Citizens in Vanadzor will have one location to apply for pensions and benefits, register as unemployed and enquire about other social services. Reception staff will provide information, advice and help with completing forms. Data sharing between services will reduce the number of separate, overlapping applications for benefits and services. Where necessary, customers can be directed to the NGO referral service in the building.
If successful, the new ISSC will provide important benefits to citizens that are not present in the highly fragmented system that it will replace. The particular approach to integration of services with its one-stop location will be central to this new concept.
5.8 Case management. The importance of integration of services at the level of delivery to the individual user is strongly emphasised in international work on integration. The notion of ‘seamless care’ indicates how ideally the user should experience the delivery of, say, health and social services for their particular needs. Case or care management is a well developed model for integrating services for individual users, especially for those with complex, long term needs e.g. dependent elderly people. This model is operating extensively in some countries (for example the United Kingdom) but not others. It does not seem to be a culture-specific form of service and may well be adaptable for use in countries where it is yet to be introduced.
The following example illustrates the real potential for the use of case management to produce good results for elderly people – and with financial savings.
Box 3 : Randomised trial of the impact of a model of integrated care and case management for older people living in the community
Objective: to evaluate the impact of a programme of integrated social and medical care for frail elderly people in the community in Rovereto, northern Italy
Design: randomised study with one year follow up
Subjects: 200 older people already receiving conventional community services
Intervention: random allocation to an intervention group receiving integrated social and medical care and case management – or to a control group receiving conventional care
Main outcome measures: admission to an institution; use and costs of health services; variations in functional status
§ Admission to hospital or nursing home in the intervention group occurred later and was less common than in control group
§ Health services were used to the same extent, but control subjects received more frequent home visits by doctors
§ In the intervention group the estimated financial savings were about $1800 per person per year of follow up
§ The intervention group had improved physical function; and a reduction in decline of mental functioning
Conclusion: Integrated social and medical care with case management programmes may provide a cost effective approach to reduce admission to institutions and functional decline in older people living in the community.
6. National integration programmes
6.1 Many initiatives to integrate social services with other services have been relatively small scale, local and often experimental. In countries where there is a highly decentralised political and administrative system, social services may be integrated at a regional level in some areas but not others. An argument for integrating social services with, say, employment services is that social aspects of activation and employment become more influential.
6.2 Some member States have integrated social services at a national level, or are in the process of doing so. Reasons for/expected outcomes of nationwide integration include:
· improved access to social rights and strengthening of social cohesion;
· greater openness and accessibility for user organisations and individuals;
· improved quality of services;
6.3 Typical core ‘good practice’ features of national integration programmes include:
The following example is an illustration of the merger of separate ministries into one.
Box 4 : A new employment and welfare administration in Norway
In 2004, Norway established a new Ministry of Work and Social Affairs, merging responsibilities for social services, social security and labour market policy into one new ministry. The main purposes were: to help people to return to work more quickly, where appropriate, with cost savings through less benefits payments; added value for the welfare system through more people in employment; and a more holistic approach to users’ needs together with better quality services.
There will be a joint, integrated front-line service with an employment and welfare office in every municipality, providing a coordinated service focused on users’ needs to replace the existing service of several different offices. The new service will be based on a close partnership between the state and local authorities, with each office providing services for the unemployed and enterprises, people on sick leave, disabled pensioners, and recipients of financial social assistance, pensions and family benefits.
A central feature of this service will be respect for and close attention to the needs and interests of individual users. There will be individual plans, coordinated services tailored to the individual, and a rights and obligations contract.
Costs and benefits: It is estimated that savings from this reform will cover the considerable reorganization costs, along with reductions in lost income by better coordination, and long- term improvements in administrative efficiency.
Preliminary evaluation: Evidence so far suggests that
§ organisational reforms are expensive in time and finance;
§ team work produces good outcomes for users but is time consuming;
§ different cultures do not seem to be a major problem;
§ users are more satisfied, but less so those needing one service;
§ it is too early to assess if more people are entering the labour market.
A major evaluation programme (over a period of 6 to 8 years) has been established to document and investigate the process of integration and the results/effects of the reform.
7. Evaluation and monitoring
7.1 A common feature of the diverse material available is the paucity of completed evaluations and hard evidence as to whether and to what extent integration actually works in terms of producing better outcomes for services users and for the services themselves (e.g. lower costs.)
7.2 Nevertheless, there have been positive findings from well-conducted evaluations. An evaluation of a care management project in the United Kingdom showed that ‘providing services in this coordinated way enabled vulnerable older people to stay at home; that the services were felt to be more reliable, effective and sufficient than other arrangements; that the older people had high morale; that the distress of carers was reduced, and that the costs were no more expensive than the alternative arrangement’.4
7.3 A control group experiment of the impact of integrated care and case management for older people in part of Italy showed similar advantages (see Box 3). Admission to hospital or residential care was delayed and less common in the control group; there were physical and mental health gains for the control group, and there were significant financial savings.
7.4 The regular and routine collection of information on integrated working is necessary for both systematic monitoring and evaluation. Objective measures of positive outcomes for integration are necessary but sometimes lacking. In integrated care services such measures may include clinical effectiveness; effectiveness of social interventions; cost effectiveness; user satisfaction and increased job satisfaction of care providers.
Observations by the European Committee on Social Cohesion (CDCS)
on Parliamentary Assembly Recommendation 1741 (2006)
on the social reintegration of prisoners
“The CDCS welcomes this recommendation as a very positive step towards furthering social cohesion since the aim is the preparation of prisoners for their release and reintegration into society. For this purpose, alternative sentences, education of prisoners including vocational training courses as preparation for their future employment, access to information from the outside world, permanent contacts with families of prisoners, would prove to be helpful. In this connection, the CDCS also stresses the importance of job possibilities during imprisonment in cases when the nature of the offence committed and the sentence served would allow it.
The CDCS hopes that the principles of the recommendation are fully implemented in the system of execution of punishments of member states. The CDCS also suggests sending this recommendation to the European Committee on Crime Problems (CDPC).”
* * *
Opinion of the European Committee for Social Cohesion (CDCS)
on Parliamentary Assembly Recommendation 1749
on demographic challenges for social cohesion
“The CDCS is aware of the danger to social cohesion which demographic challenges can present through the adverse effects they can have on solidarity between generations and in particular on working conditions and social welfare systems.
Therefore it welcomes the theme of the present Recommendation which is of great importance. The current work of the CDCS on positive parenting is in line with the proposal to support family-friendly policies and services which could be of benefit to demographic challenges and social cohesion and minimise the negative impact of ageing. The CDCS understands that financial reasons have led to the termination of the Council of Europe’s intergovernmental activities in the demographic field but underlines the fact that, in this situation, it will be difficult to deal with the tasks of this Recommendation.”
* * *
Opinion of the European Committee for Social Cohesion (CDCS) on Parliamentary Assembly Recommendation 1755 on the human rights of irregular migrants
“The European Committee for Social Cohesion (CDCS) took note of Recommendation 1755 (2006) of the Parliamentary Assembly on Human rights of irregular migrants, and especially of paragraph 3.1 which instructs the relevant intergovernmental committees to establish a list of minimum rights for irregular migrants,
The CDCS draws the attention of the Committee of Ministers to the fact that this sensitive subject has already been widely debated in the past. In this respect, the Committee refers to the studies carried out under its responsibility: “The specific situation of female migrant workers in Europe in relation to social security” and the “Exploratory report on the Access to Social Protection for Illegal Labour Migrants” which was published in 2004.
As concerns the list of minimal rights of irregular migrants requested by the recommendation, the CDCS recalls that the European Social Charter does not include irregular migrants within its sphere of competence. It is therefore up to member States to decide whether or not they intend to integrate irregular migrants into their national legislation and in which measure.
Bearing in mind that the United Nations Convention on the Protection of the Rights of All Migrant Workers and Members of their Families, which came into force on 1 July 2003, lists in Part III of the text "Human rights of all migrant workers and members of their families" while Part IV of the text indicates "Other rights of migrant workers and members of their families who are documented or in a regular situation".
The CDCS is of the opinion that it does not need to take any further action on this issue.”
Note 1 This document has been classified restricted at the date of issue. Unless the Committee of Ministers decides otherwise, it will be declassified according to the rules set up in Resolution Res(2001)6 on access to Council of Europe documents.
Note 2 Midland Health Board Executive Summary (2003). Parents “Olive and Peter’ in Developing a model for Integrated Primary, Community and Continuing Care.
Note 3 The texts in boxes serve as illustrations.
Note 4 Challis, D., Darton, R. and Traske, T. (1995) Care Management and Health Care of Older People, Arena.