Developing Community Care
It is impossible, even for the richest countries, to maintain parallel structures in social care: large institutions established in the previous century and small networks of community care built recently. Recognising this obvious difficulty, the Czech Republic has decided to invest in the development of capacity at the local level to complete the transition from institutional to community-based care.
Signatory to the UN Convention on the Rights of People with Disabilities, the Czech government amended its legislation in 2007 and 2010 to make it compatible with the Convention. Inspired equally by the work of the European Deinstitutionalisation Expert Group, set up by the (former) Czech Prime Minister and European Commissioner Vladimir Špidla, the Czech authorities founded a National Centre for Transformation of Social Care (TRASS) whose mission is to raise awareness and provide methodological support, advice and training to staff involved in the transition to community care.
The Ministry of Labour and Social Affairs has also launched its first major deinstitutionalisation project thanks to the support of the European Structural Funds (ESF and ERDF). Some 17 institutions from 13 counties have been selected in the pilot phase and their transition will be closely monitored. All participating counties agreed that once their institutions are finally closed and buildings vacated, they will not use these facilities for social care purposes to prevent potential re-institutionalisation. Instead, regional authorities are invited to sell or refurbish them to serve business or leisure purposes.
The conference ‘Life in Community’, co-organised in Prague by the Ministry and TRASS, was an opportunity to take stock in the first stage of the transformation. An interesting picture has emerged from practitioners who spoke of the surprisingly positive reaction of the local population who – by and large – accepted their new neighbours without complaints. They praised cooperation between public authorities and local NGOs and emphasised that without EU funds the process would have stalled.
The challenges were also discussed. Several speakers brought up the question of staff in institutions, stressing that these professionals may be among the strongest opponents of community care and may exit the care profession altogether, contributing further to staff shortages – unless they get sufficient training and feel supported. Other challenges included the lack of awareness of community care alternatives, insufficient capacity of community care, difficulties in accessing services and high prices of the housing stock.