We visited Lisbon on 11-12 April in the second of our missions to Troika countries, after a visit to Greece in February. The news that 900 social canteens have been established in schools and other settings made clear to us the scale and depth of the social emergency for ordinary people. We held meetings with the Directorate General for Social Protection and Social Security and the Institute for Social Security which manages 75% of the social budget and monitors the provision of social services. It became clear to us that austerity programmes had resulted in a drop in quality, in tightening eligibility criteria and increases in the number of users per room in residential care. There is a risk that these measures will engender a return to a traditional model of welfare assistance, rather than a strategic one focused on developing people’s skills and potential.
The provision of residential model of care is common in disability, elderly and child care. The institutionalisation of children is recognised as a challenge with 9 500 children and young people currently in institutions (five years ago there were 15 000). ESN heard that the Institute of Social Security spends €700 per child placed in a residential facility (€1500 in specialised institutions). The average at entry into the system was 12/13 years. We also heard that Portugal lacks a well-developed foster care system with insufficient training and support for (would-be) foster families.
We therefore saw a clear need for re-directing resources spent on institutional care towards effective preventative family services that could avoid institutionalisation in the first place, in line with the Commission’s Recommendation on Investing in Children. Indeed, a new report on children and young people from the Institute for Social Security stresses the need for quality community based services, working with families and cooperation with other services.
The European Commission produces regular reports on the implementation of the economic adjustment programme. These have focused much more on labour market integration and health systems than social services. The programme includes measures on active labour market policies to improve the employability of young people and the disadvantaged. The maximum monthly amount of benefits has been reduced as has the maximum duration of entitlement to unemployment benefits. The Commission has also reported that the Portuguese government “will continue action to tackle low education attainment and early school leaving” in line with the EU Council Recommendation; unfortunately, we heard on our visit that ESL programmes are not being implemented because of budget cuts.
In the health sector, the Commission approves that steps are being taken “to ensure that all the population is served by family doctors and that health services are used in a more rational manner.” The BBC reported that health service fees were raised sharply in 2012 at the same time as technological advances and an ageing population were adding pressure to spending. The recession had seen many people who once had private insurance going public, adding to the burden.
There was also at the time of our visit a huge sense of uncertainty about the future especially because of the constitutional court’s decision that some of the terms of bailout were unconstitutional. This is a terribly difficult environment in which to plan for the future and move towards a social investment model, as the Commission is advocating.
John Halloran and Alfonso Lara Montero