Care Crisis in Central and Eastern Europe

Greater Risk of Problems Deepening Further, Trade Unions Warn

The new report by the European Federation of Public Service Unions (EPSU), “Building collective bargaining in Central and Eastern Europe’s care sectors.” Photo credit: EPSU

The care sector in Central and Eastern Europe is facing a serious crisis, with increasing demands on care services but next to no improvement in care workers’ rights, according to a new report by the European Federation of Public Service Unions (EPSU). The report warns that this situation is leading to high stress, burnout, and problems in workforce retention across the region.

Although the need for services such as long-term care (LTC) for the elderly, early childhood care, and support for those needing daily assistance continues to grow, a lack of investment in public care services at the national level persists. The report shows that this gap has hit care workers the hardest, with wages lagging behind those in other sectors. This is especially visible in areas with low unionization rates or where the private sector dominates—as is the case in many European countries.

For example, low union membership in Poland and Hungary makes it difficult for trade unions to advocate for better working conditions in collective agreements. Most agreements are limited to individual companies or facilities, which weakens workers’ collective bargaining power, although their overall numbers are high.

In the European Union, there are approximately 6.3 million formal LTC workers, accounting for 3.2% of the total workforce. However, the report points to a worrying contrast between formal and informal care provision, as 44 million people across the region still act as informal care providers. “Informal care provided by relatives or friends plays a large role in meeting LTC needs, but results in loss of workforce, health issues for the carers and, as most informal carers are female, issues around gender inequality,” the report states.

This observation points to a long-standing contradiction in EU social policies. While governments are keen to talk about the importance of integrative, people-centered, and community-based care, they fail to back this with sufficient funding. The gross domestic product (GDP) expenditure on long-term care in the EU is expected to reach only 2.5% by 2050. In comparison, many EU countries are already pledging 2% of their GDP to NATO defense goals, with military spending set to increase even further.

This lack of investment has a direct effect on working conditions and workers’ wellbeing. The report notes that inadequate pay, increased workloads, and administrative tasks linked to digitization are adding to the emotional and physical burden placed on workers. Without building stronger support systems—including by improving salaries and working conditions—the care sector in Europe is heading toward an even more acute crisis.

As part of the solution, the EPSU report highlights the importance of strengthening unionization and collective bargaining in the sector, in part by the implementation of a recent EU directive on minimum wages. However, this will need to be coupled with greater recognition of the essential role care workers play and a commitment from governments to invest in the sector. Without such developments, the care crisis in Europe will continue to worsen, putting both workers and care recipients at risk.