The Expert’s opinion – extract from interviews with specialists in the field of services for the elderly

Diana Chiriacescu – Director of the Federation of Non-Governmental Organisations for Social Services (FONSS)

Q: How would you rate services for the elderly in Romania in 2021?

A: FONSS looks at the sector. It looks at components related to the health of social services, sustainability, funding, staffing, etc. We consider each sub-sector from the same angle, without going into very detailed analysis, as federations and coalitions like SenioriNET do.

What we see in the area of seniors is both encouraging and worrying:

– The sector is growing – it’s not a day you don’t see more home care providers, nursing homes or support services being accredited.

– Home care services are growing fastest.

– The need is huge – 1 million people in need of these services – over 65 years old, single and dependent (home help, residential).

– Nearly 13,000 elderly people benefit from home care services, 70% of which are provided by NGOs compared to 30% provided by municipalities and communes.

– Nursing homes – the main provider is the state, with old structures and large capacity – can no longer provide large-scale residential services to the elderly. This is where things need to change.

– There is no registration/accreditation of home help services at all. This type of service (cleaning, bills etc) should be regulated by the state.

Q: Related to regulation, what could you share with us?

A: It is clear that there is room for improvement in home care standards, where care services are provided alongside a medical service. Socio-medical services are accredited by both the Insurance House and the Ministry of Labour and Social Solidarity. Not to mention funding, it is well known that the sector is completely underfunded. From the consultation I did with care organisations on simplified costs, it emerged that there are very large differences in expenditure on materials between providers (400 lei/month, 200 lei/month because they have no budget).

Q: Which organisations have initiatives to represent and bring together NGOs working with the elderly?

A: The initiative is not new, it was taken by those who started home care services. . I think the same people are still in the market. Caritas, FSC, Four Change, Mutual Aid Association – they started together with the White-Yellow Cross, but they have declined in performance, not for reasons related to the evolution of the sector.

Q: When you hear about SenioriNET, what is your first thought?

A: A long-dreamed-of federation that we encourage, support and value very much, from the days when it was a coalition. We’ve been waiting for it to be formalised and strong for a long time, because it is the voice of the care system and it absolutely must exist. That way, providers can make their voices heard. We are talking about a lobby area with extraordinarily clear thematic specificity and issues for which we need a lot of information, research and documentation. It is a grey area of information: we don’t know the profile of the workforce in this sector, staff are demotivated, it is an area of extreme migration.

We believe that a federation could cover the documentation, research, reporting on the evolution of providers and the needs of clients – the elderly. Here, of course, discussions with the Ministry of Labour and the Ministry of Health for better regulation are useful. It is imperative, therefore, that we have an informed and technically robust voice. FONSS is partnering with the Caritas Confederation to bring together the social sector – a coalition of coalitions. Each sub-sector has its own voice: FONPC, Dizabnet, SenioriNET has its place.

Q: Do you think there is a need for a network to serve NGOs working with older people, i.e. older people in Romania? What do you think are the most important needs of NGOs in the field that could be addressed through SenioriNET?

A: The sector is growing, SRLs are coming, which are many in the home care sector – 287 accredited providers, of which 20% are SRLs.

From lessons learned probably need some extra assets – a very robust consensus organization. This comes with the difficulty of ensuring sustainability and having an executive team at the helm – we believe a federation cannot exist otherwise. The team comes with costs. Federations are left with an extremely small funding area. Either with projects in Brussels, or with other solutions – in the case of FONSS for the time being technical consultancy works. We have created a small component of the Federation reported as a social enterprise for cash flow: social needs assessment, public policy consultancy, we work abroad on social public policy reforms, we work on communication issues (journalism).

In the executive team there must be people with patience, good negotiators and good communicators, and who have a very strong sense of participatory, consensual decision-making.

At FONSS, we talk to everyone systematically because we had to understand what everyone needs. Some need breadth Their need is for someone to spend time with ministries. The small ones need support for very pragmatic things – how they get accredited and reaccredited, how they do their licensing dossier, how they meet the quality standard. Another need is for them to negotiate with the local authority. They need a negotiator and a mediator – we board the train and go and negotiate, including with the social inspectorate.

SenioriNET has tremendous research opportunities – it has such a large audience, the 900k should be the subject of a national survey. It would come up 200 steps ahead. Generate public policy. We would have to produce some research where the numbers are unbeatable.

Q: Which areas should SenioriNET focus on in the period 2022-2026, from the perspective of representing NGOs working with older people?

A: Need profiling – identification of national home care needs. Members can create a space to work with local authorities so that in each county a home care needs assessment can be made. Support for providers – they need input, ongoing training, new technologies. Multiplication, expansion, development. Focus on workforce – working group, strategic goal to strengthen workforce, address/explore what are the ways to reduce out-migration. Of course negotiation of legislation, which comes with federation.

Q: How do you see the network in 5 years?

A: Strengthened – more members, with a clear message in the public space and public policy of older people; with a good, recognised executive team. I see it as part of a social service network that is well established. I believe that together we can have a clearly stronger and more articulate voice. I think we will talk about good collaboration with European platforms. A lot of organisations now have membership in European organisations – I see a link with Brussels quite important. I foresee a very healthy future provided they quickly build a responsive strategy to the needs of their members and a good executive team. By the time those things are aligned, it will be a breeze. It has very good momentum – seniors are on the political and public agenda. It’s an element of opportunity that the federation can only exploit. There is a need to channel it towards the things that are missing: quality research and getting the state to meet these needs. Otherwise, the negotiating table is open.