Issue March, 2007
Carla Facchini, Milano, Annamaria Campanini, Calabria and Walter Lorenz, Bolzano (Italy)
Social work training in Italy, at the instigation of the Italian professional Association of Social Workers, was delegated entirely to the universities in 1990. This has given the profession an enormous boost in terms of its public status, and at the same time an enormous task to find ways of utilizing the new opportunities. While the incorporation into the university sector underlined the scientific standing of the profession, its development is overshadowed by the absence of a specific disciplinary category that would give social work an independent base in the Italian academic system. The Ministry of Universities and Research until now has not instituted a category for academic appointments in social work and the discipline is represented vicariously by sociology. Professors responsible for teaching relevant subject areas are chairs either in General Sociology or in Sociology of Communicative Processes, and many social work courses are managed by other disciplines like politics, medicine, law or pedagogy. Not even the title of social work (‘assistente sociale’)appears in the academic qualifying award; instead the degree is called ‘Laurea in Servizio Sociale’, i. e. Bachelor in Social Service, which begs the question of the boundaries of this field. Several professions are currently contesting the ground of social services, among them social pedagogy, educators and care workers, sociologists and latterly also community nursing. Although there is a national register of title-holders of social work and being registered is a precondition for appointment to certain public posts of responsibility in social services the field of social services is undergoing profound changes.
It is therefore a significant development that the Ministry of Universities and Research has awarded a prestigious research grant to a consortium of professors of social work from four universities (Bolzano/Bozen, Calabria, Milan Bicocca and Pisa) under the directorship of Prof. Carla Facchini of Milan for the purpose of evaluating the current state of professional social work in Italy in relation to training and practice. The research programme forms part of the ‘co-financed’ projects meaning that the Ministry provides 70% of funding with the participating universities being obliged to contribute the remaining 30%. The scheme applies to research proposals of national importance and significance.
The research grant was awarded on the strength of the proposal which was evaluated by an international panel of peer reviewers. The national and international research profile of the consortium partners counted significantly in the selection process. Prof. Facchini has conducted previous research profiling the background and orientation of students of social work, Prof. Campanini of Calabria is Coordinator of the current EU funded Thematic Network of social work and chief organizer of the conference of the European Association of Schools of Social Work at Parma to be held 15-17 March 2007 and Prof. Lorenz was previously coordinator of the First Thematic Network of the Social Professions (ECSPRESS) and is involved in several regional and European research programmes.
The application was grounded in the following observations concerning the current state of social services and of social work in Italy and defines its objectives as follows:
‘Social work is undergoing a significant set of transformations pertaining to the sphere of education and training, professionalisation, social services’ organisation and modes of insertion in the labour market.
The research programme aims at building a sound basis for knowing and analysing ongoing changes in social work, with regard to three distinct but connected aspects:
1) The insertion of social workers’ training programmes into the university system has produced changes both on training programmes and methods and on career opportunities for social workers.
2) Social services’ territorialisation and pluralisation, the move towards users’ choice, the increasing complexity of needs and responses are likely to impact on the organisational and professional dimensions and on the role, position, expertise and profile required from social workers.
3) the recent transformations of labour market regulation – the recourse to “atypical” job contracts and to self employment – are likely to have an impact also onto social workers’ employment conditions. This phenomenon should be looked at also in relation to the accessibility of managerial positions.
These three distinct but interrelated analytical perspectives deserve specific attention, given the poor level of information available at present. In Italy, in fact, there is no tradition in the study of social workers as a professional group, nor a structured information system on social professions. Existing knowledge is scarce, discontinuous and fragmented.
The research is articulated in one national survey and four parallel thematic researches implemented by each one of the units.
The national research, based on a survey conducted over a representative sample of social workers and a relevant number of in depth interviews, will explore the socio-demographic characteristics, educational pathways, employment conditions, organisational position, and tasks carried out by social workers in different sectors.
The local researches will focus on:
A) The relationship between education and profession, through the consolidation and extension of the National Observatory of MA and BA social work students;
B) The comparison of European educational models of social work, with specific attention to field placement.
C) The re-definition of social workers’ professional profiles along with the changes taking place in the social service system both on the demand and supply side, namely:
C1) the actors involved in this re-definition and the underlying logics
C2) the practices of this re-definition and the changing boundaries between different social professions
Qualitative and quantitative research methods will be usefully combined in the project.
Specific attention will be devoted to the regional differentiations of the social workers’ position in relation to changes in social policy and its implementation.
Finally, the comparative dimension is of specific interest and will represent an important added value, able to place ongoing changes in Italy in the frame of broader transformations taking place in Europe.’
The research project is financed for two years and should make a considerable contribution to the clarification of social work’s professional profile in Italy. The last national survey was conducted by the national research institute CENSIS in 1998 on the 35000 registered social workers but since then important changes have taken place. In particular, it can be hypothesised that public social services are involved in a process of diversification and decentralisation which shifts the emphasis more towards giving non-governmental agencies a role in social service provision, with a concomitant reorganisation of professional groupings involved.
Likewise at the university level there is great uncertainty about the practice relevance of the basic degree programme the composition of which is defined by ministerial decrees in considerable detail leaving little room for adjustments to the changing requirements of the field. At the same time the relevant Ministry is dragging its feet over the re-definition of postgraduate curricula in the light of the Bologna Process. The current array of ‘specialisations’ at the postgraduate level under the old system of regulations does not conform to an overall plan of development of competence areas..
It is hoped, therefore, that the data from this research will provide important reference point for the future development of social work, and beyond that of the social professions in general in Italy. Apart from the overall national picture it will be interesting to analyse on the one hand different regional variations, as for instance in the Autonomous Province of Bolzano where the newly founded Free University educates both social workers and social pedagogues and, while being governed by Italian rules and regulations, nevertheless is strongly influenced by models of social work from other European countries as many lecturers on contracts come from abroad. On the other hand different components of the professional profile of social workers will be evaluated in greater detail, as for instance the placement component of the training in an international context, as well as the orientation of the academic programme towards the achievement of specific professional competences. Both aspects have great significance internationally as curricula and course regulations in social work everywhere in Europe are in a state of transition in the light of the Bologna Process and the Italian experience will hopefully have something to contribute to those developments.
The authors work as professors at the following universities teaching social work students. For further details and indeed for observations and suggestions please contact:
Prof. Carla Facchini, University Milano Bicocca firstname.lastname@example.org
Prof. Annamaria Campanini, University Calabria email@example.com
Prof. Walter Lorenz, Free University of Bolzano, firstname.lastname@example.org
March 14th, 2007
Lesley Cooper and Richard Freeland, Kitchener/Ontario (Canada)
The personal is political. This statement is an activist imperative, used by 1970s feminists to explain the influence of race, class and gender on the exclusion of women from decision making. Prior to this, from a completely different perspective, Mills (1959) made the observation that private pains are the manifestations of public issues. Many of the choices we make are not about our personal feelings, experiences or preferences but are strongly defined by the broader social and political context. Exclusion from decision making and services is a public matter.
If the personal is political, let’s begin by talking about the personal. Last year I migrated to Ontario, Canada from Australia. The very first question I was asked by colleagues and friends was “Have you found a doctor?” I answered in the negative and was bewildered as to why this was an issue. As I understood that Canada has a national health system, I had understood that as in Australia, I could call any doctor and obtain an appointment within hours.
I quickly came up against the difficulties facing people seeking to obtain health care in the province of Ontario. In order to receive health care, I needed to register for a health care card, an administrative process requiring my being photographed and the provision of other personal details. I also had to demonstrate that I was legitimately residing in Canada and not a freeloader from Canada’s near neighbour, the USA, which does not provide its citizens ready or easily affordable access to quality health care. Certainly Ontario appeared to go to extreme lengths to prevent “refugees” from the US privatized health care system using their services.
When I first attempted to make a medical appointment for a minor ailment, I discovered that doctors’ patient lists are closed, i.e., that new patients are not accepted. The only recourse to obtain minor treatment was to join a queue of over 20 people waiting outside an “Urgent Care Clinic” before the clinic had opened. Whilst no appointment was necessary at this clinic there was no provision for anyone to actually make an appointment. The queue that I joined comprised people without the benefits of having their own doctor as well as many who did have their “own doctor” but were not able to make an appointment within fewer than several days. The health care services I eventually received were free but quite detached from any treatment as an individual person. The system appeared equally capable of excluding both the wealthy, middle class and the poor.
I began the process of enlisting help in finding a doctor from local colleagues. My provost gave me a web address listing doctors in the region who were accepting patients. When I checked, the list comprised only two names, both psychiatrists. This was not what was immediately needed. Others advised me to make contact with the local general hospital which had similar lists. I could leave my name and when a vacancy occurred in a practice, I could make contact with the relevant doctor. The vet who assisted my cat, offered to write to his doctor asking for him to include our family. Finally, after much helpful advice, I meet a social worker whose husband was a doctor and through her good will, we were provided with the name of local GP. There is no real choice of doctor in such a system.
From this personal experience I will extrapolate a broad picture of the Canadian health care system and then attempt to provide a picture of how this situation has developed.
One unintended consequence of a public health system with an excess of demand and insufficient physicians is the rationing of services through long waiting lists and a process of excluding broad groups of people. It is emotional rather than evidence based. Migrants and refugees coming to Canada are excluded. Internal migrants are not assisted. The Indigenous population has poor access, this being a particular problem in their settlements. There are particular difficulties in rural and remote areas.
Canada has a national health system where all Canadians have access to doctors, specialists and hospital care. Canadians pay taxes so this service can be provided equitably to all. Canada does not have a dual health care system of private care for the wealthy and public services for the poor, as does its near neighbour, the United States. I discovered at first hand the experience of being excluded from a nationally funded health care system. What factors contribute to the breakdown of this national system and how are policy makers considering remedying this situation?
The Canadian national health care system which is funded from general taxation revenue and known as medicare has been in place for over forty years. The health care system grew out of concerns over financial barriers to accessing health care and was developed on the basis of a set of core values, including universal coverage for all citizens. The scheme is publicly administered on a not for profit basis with a system of cost sharing between the federal and provincial governments. Whilst it provides a comprehensive approach to provision of necessary hospital and physical services, dental health care and pharmaceutical services are not included. Citizens may obtain these services through private health insurance. As this is generally provided through employers, this poses difficulties for those on contract work, for the unemployed and for people who have retired. Even those with access to insurance to dental and pharmaceutical services, may find significant differences in levels of reimbursement depending on their employer’s insurance arrangements. A unique feature of this universal Canadian health care system is the absence of private hospitals.
The different provinces have constitutional responsibility for health care whilst the Federal government raises and holds the bulk of revenue achieved through the taxation system. Despite decentralisation of health care being a subject of debate health service delivery has remained a responsibility of the provinces (Burke and Silver 2006). Despite these debates over the virtues of central or provincial systems, the current mixed model involving both federal and provincial authorities creates administrative duplication, provincial variations and potential inefficiencies. Whilst there is legislative provision for portability of entitlement across provinces, services available and services provided may well vary from province to province.
Canadians are immensely proud of their national health care system and the value of this scheme for all citizens. It is clear however that the main basis of this public perception is through comparison with that of their nearest neighbour (the USA), rather than with other OCED countries. This most visible comparison is not necessarily the best. This pride is evidenced in a public and transparent review of the system in 2002 (Romanov 2002) where the aim was to renew the health care system and establish a new collective vision for the future sustainability of universal health care for all Canadians. The commission’s intent was to affirm and tinker with the existing system rather than change it.
This Romanov Commission, however recommended many changes including increased targeted funding to enhance rural and remote access to services, establishment of a diagnostic services, funds to improve wait times for such things as CT scans, MRIs and other technologically advanced procedures, greater emphasis on primary health care and provision of home care. A key recommendation was to set up a “catastrophic drug transfer” program to provide pharmaceutical treatment in cases where patients are unable to afford necessary drugs. Of particular relevance to social work were recommendations for the integration of home care services in mental health, case management, palliative care and post-acute hospital care in the home environment. As a result of this home care provision, academic policy analysts are concerned over any possible transfer of care and responsibility from the public to the private and/or family sphere.
As a way of fostering inter-government collaboration and monitoring and reporting on the progress of the health care renewal, the government established the Health Council of Canada. In recent days, the Interim Chair of this Council has announced that ‘Canada fails to measure up’. The Chair has stated that the various Federal and provincial government agencies have not provided any data essential to knowing whether care is getting better, safer and more timely (Toronto Star February 1 2007, page A21). Whilst Governments continue to move ahead with some changes, development of impact and outcome measurement is being neglected.
Some evidence is currently available about the overall performance of the health care system. Using OECD figures, the Fraser Institute, an organization committed to market solutions to health care, has stated that Canada does spent a large percentage of its GDP on health and that on adjusted figures this proportional expenditure is second only to Iceland (Esmail 2006). Money, they argue is not at issue. Given their commitment to a market driven system, the Institute argues for a market driven system or a model that combines government and private services. This is a diametrically opposed view to that of the Romanov review which strongly opposed private provisions and argued for maintenance of universal provision.
Access to timely diagnostic services, waiting times for access to surgery and specialists, shortages of physicians and an increasing expectation that family and friends will provide home care as an alternative to hospital care are regarded by Burke and Silver (2006) as major issues. There is ample evidence of problems in all these areas. Schoen et al (2005) report that when investigating the experiences of sicker adults across six nations (Australia, New Zealand, United Kingdom, Canada, the United States and Germany), Canadians waited longer in emergency rooms, had difficulties in getting a same day appointment with a doctor, have the longest wait for specialist appointments and wait the longest for elective surgery. This evidence supports the belief of many Canadians that their system requires fundamental changes. It also indicates that the general public perception of the Canadian health care system compared to that of the USA may be misplaced.
The question remains, what does access to health care actually mean in Canada? In the early development of the universal health care system in Canada, access meant that financial barriers imposed by poverty should not preclude obtaining medical and hospital care. More recently access in the Romanov Commission Report (2002) refers to the need for Canadians to have care when and where it is needed. The defacto measures of access have changed from financial barriers to ones that include waiting times for diagnostic procedures, specialists and surgical procedures. Despite the difficulties inherent in determining waiting times and lack of consensus about when these waits begin, Canadians who find themselves on waiting lists have at least got access to a general practitioner and specialist health care but little clarity of when they may receive the specialist services they have been referred to. Nor can they be confident of the level of assistance they may receive towards cost of pharmaceuticals. Clearly there are other hidden barriers to access. These barriers are also associated with the social inequities surrounding particular underserved populations including Aboriginal communities, rural and remote areas, visible minorities and immigrants and refugees.
It appears that the Canadian health care system does not make a clear distinction between utilization of services and access to services.
Rather than addressing access difficulties a 2000 Health Canada report referred to concepts of underservice and underserved populations. Underservice means people will experience difficulty in obtaining care when and where they need it. They may receive no care, less care, a lower standard of care or access to services that do not met their health needs. The underserved populations are not necessarily the poor or those on a low income. Some consumers may have low status because of their mental illness or addictions. They may have persistent language and cultural barriers that prevent care at many levels. Some people are subject to overt discrimination because of their religious beliefs or sexual preferences. Many groups of Canadians through lack of information or education may lack awareness of availability of many basic services. Or they just may not live in an area where the required services are available. Underservice may also happen to people like me, or you.
Besner, J. (2007) ‘Canada Fails to Measure Up’, Toronto Star, Thursday February 1, 2007, A21.
Burke, M. and Silver, S. (2006) ‘Universal Health Care: Normative Legacies Adrift’ in Westhues, A. Canadian Social Policy: Issues and Perspectives, Wilfrid Laurier Press, Waterloo, Canada.
Esmail, N. (2006) How Good in Canadian Health Care? An International Comparison of Health
Health Canada (2000) “Certain Circumstances: Issues in Equity and Responsiveness in Access to Health Care in Canada”
Mills, C. Wright (1959). The Sociological Imagination, Oxford University Press, New York.
Romanov, R. J. (2002) Final Report: Building on Values, the Future of Health Care in Canada, Commission on the Future of Health Care in Canada, Saskatoon.
Schoen, C. Osborn, R. Huynh, P.T. Doty, M. Zapert, K. Peugh, J. and Davis, K. (2005) ‘Taking the Pulse of Health Care System: Experiences of Patients with Health Problems in Six Countries,’ Health Affairs. http://content.healthaffairs.org
Lesley Cooper is dean at the Lyle S. Hallman Faculty of Social Work at Wilfrid Laurier University, Ontario.
March 14th, 2007
Ulrike Wisser, Brussels (Belgium)
Having decided to put a more human face to the European Union’s core objective – the single market – the European Commission recently updated its agenda. The European Commission dedicated its term’s work programme to prosperity, solidarity and security, with the continued focus on jobs and growth. It includes a long term work on the social reality in Europe following the aim to look deeper into the direct impact of the main European initiatives on citizens’ life. Firstly mentioned in the citizens’ agenda communication paper of May 10th last year, the Commission did propose a so called “twin track” strategy, including a review of the internal market strategy and the “social reality check”. The drive for a deeper and wider economic integration should go hand in hand with further support for one of Europe’s most unifying and fundamental values: solidarity. The Commission announced to take comprehensive stock of the reality of European society, and launch an agenda for access and solidarity, a social dimension in parallel and close coordination with the single market review, next year. Being supported by the highest decision making EU-body, the European Council, actions have been moving on.” We need a modern social vision to accompany our drive for open markets. Open markets and social solidarity are not, and should not be, contradictory. There is no greater instrument of social cohesion than full employment. And welfare states need to be put on a firm financial footing to be sustainable for future generations. Europe must reform and modernise its policies to preserve its values”.
Stock taking should focus on problems
Commission President Barroso did argue in his speech at the “Global Europe-Social Europe debate”, organised by Policy Network end of last year. It should be a debate about access and opportunity. At the same time results should allow a better insight into some key issues and provide appropriate answers to:
- Why one fifth of school children don’t reach the basic standards of literacy and numeracy;
- Why one in six young people are still leaving school without any qualifications, when we know that fewer and fewer unskilled jobs will be available;
- Why there is still a strong correlation between students achieving a place at university and the educational background of their parents. In the knowledge economy we have to ensure higher educational standards for a broad majority;
- Why some Member States are so much better than others at integrating second generation migrants, enabling them to achieve more in the education system;
- Why access to childcare is so patchy when the evidence is so strong that better childcare leads to higher fertility, more job opportunities for women and greater gender equality;
- Why child poverty continues to blight the prospects of a fair start in life for a fifth of Europe’s children;
- Why work is a strain and stress for too many, and decent family life and traditional support structures are put under too much pressure;
- Why so many older people drop out of the labour force too early when in an ageing society we can ill-afford to throw their talents and contributions on the scrap heap.
The newly launched consultation is about to seek for views on current social trends and on what contributes to today’s ‘well being’. Views are welcome on the partly dramatic changes, which are underway in European societies: “in the nature of work; modern family life; demographic trends; the position of women in society; social mobility and the incidence of poverty and inequality. Values are changing and societies are becoming increasingly multicultural. This social dynamic presents new challenges.”
The Commission is aware of the existence of national and international studies and data on these changes. That is why it especially addresses its call to research on politics and society as well as think tanks. In order to guide the open debate a background paper on “Europe’s Social Reality” has been prepared by the Bureau of European Policy advisers. That is an advisory body to the European Commission, whose mission is to provide timely, informed, policy and political advice to the President and Commission Services on issues relevant to the President’s agenda and the future of policies in the Union.
European Commission looks into trends on social changes
The paper, written by Roger Liddle and Fréderic Lerais seeks to cover a wide range of social issues and in the same time summarizes data, analysis and thesis. The authors try to show trends about how changes on social factors and in the social system actually develop. It is especially about the trends the Commission would like to exchange views on. The paper takes a stance on the main transitions making European societies change, the transition to a post- industrial knowledge and service economy, the impact of the Welfare State as well as the mass affluence, citizen as consumer, gender equality and demographic change and the trend to individualisation.
The second part of the paper is dedicated to analyse the foundations of social quality and the situation of today with regard to access, opportunities and exclusion. It is an attempt to summarize the complex and diverse reality and its valuation and keep it workable and readable to the audience. The scope is wide and covers the main fields of daily lives, such as employment opportunity, access to educational opportunity, to good health, family life and well-being, poverty and its impact, crime, migration. Whether the increase of inequality in Europe matters is a discussion point to one of the chapters. As long as relative poverty is reduced in relation to median income, does it matter if incomes at the top race ahead? Statistics show that the most equal societies in Europe have the least number of poor: the most unequal societies have higher concentrations of poverty risk, is pointed out by Liddle and Lerais. “If one measures inequality by the ratio between the earnings of the top quintile and bottom quintile, the Member State with the highest levels of inequality in the EU15 is Portugal (with a ratio of 7.2 against an EU average of 4.4), followed by Greece, Spain, Ireland, Italy and the UK: these also happen to be the Member States with highest ‘at-risk of poverty rate after social transfers’. Among the new Member States, the countries with the highest levels of poverty are also those - Estonia, Latvia and Slovakia – with above average measures of inequality.”, trends of need for discussion.
Migration has long been part of European experience. The pressures that led to the great emigration to the New World also led to population movements within Europe. Think of the Irish in Britain or the highly diverse character of big cities such as Prague before the Second World War. Migration in Europe remains a complex and diverse phenomenon.
The paper should stimulate experts from all different stake holders to take part in the debate. Two main areas are put up for discussion: well-being and opportunity and access. In view of “well-being” the authors introduce the following questions:
- In what order – by importance - would you list the key factors contributing to well-being, for example: being in work, satisfaction in the job, opportunity for a good family life, adequate housing, good health, access to educational opportunity, chances of social mobility, good neighbours and friends, strong local community ties, feeling secure on the streets and in one’s home?
- And what do you think are the main obstacles in Europe today: not enough money, lack of decent jobs, too much pressure on the family and leisure time, poverty and inequality, inadequate public services such as health and education, prevalence of crime, lack of respect, problems of migration and multiculturalism?
When it comes to “opportunity and access” the authors on behalf of the European Commission would like to analyse and argue on most important factors in maintaining or increasing one’s opportunities in today’s society, such as education, social status, wealth, health, public services etc.
The social reality stock taking is about to highlight ‘problems’, says the paper. “European societies face major social challenges. The knowledge economy can appear to be threatening to those with low skills and low educational aspirations. Unemployment and inactivity still blights too many people’s lives, as do unresolved problems of widespread poverty. Generational disadvantage may be becoming more embedded and social mobility more problematic. The social consequences of self perceptions of failure in our unequal societies may be causing new stresses and problems in terms of family dysfunctionality, crime and anti social behaviour, mental illness and the new diseases of affluence.” The European advisers clearly favour an open and wide spread exchange in order to get the most complete picture on circumstances and framework conditions of good or bad living conditions. Additional information is available on the corresponding homepage.
This exercise for sure is a crucial one in the debate about the modernisation of the European Social Model.
The author works as policy adviser in the field of EU youth, education and social politics at BBJ Servis gGmbH, Brussels office.
March 14th, 2007
Spyros Pantazis, Ioannina (Greece)
This article introduces an insight in the historical evolution, the social role, the ideology and the orientation of social work in Greece.
Society is a space that guarantees democracy, social justice, equal opportunities and welfare to all its members. However, a large number of scientific studies show that equal opportunities are not a feature of western societies. Social work in Greece as well as other European countries begins with the establishment of charitable associations, which means that the evolution of social work aimed at the social integration of individuals when it was realized by the state that social problems could not be overcome through repressive measures, which were later complemented by public policies.
1.Historical evolution of social work in Greece
The history of social work in Greece begins in antiquity. The city of Athens had very early recognized the importance of health for its citizens (i.e. personal and general welfare) and promoted a line of measures that guaranteed free medical care (what is commonly known as public doctor) and social welfare. This welfare was later expanded to include the relief of handicapped as well as adolescent children, who enjoyed the welfare of the state until adulthood. This provision was later expanded to include the elderly, the sick, the helpless, the blind and so on. These social measures were also continued during the Byzantine period, under the influence of Christian teachings.
During the Ottoman Empire period (1453-1831) there was no form of social welfare for the enslaved Greeks. However, during this period, the Greek communities were activated, and this activity was very significant both during the classical antiquity and the Byzantine era. In parallel to the Communities were the guilds and the unions, for all three of which, the obligation to support the poor and the handicapped, as well as the people who were in need of social welfare, was included in their activities. Along with the bodies mentioned above, the Church also offered social welfare to the enslaved nation.
The newly founded Greek State (1831) was seriously interested in the social welfare of children, especially the orphans of war, and towards this direction, special measures were promoted for their welfare as well as their education. In the context of this attempt, there was a significant amount of contribution from the benefactors of the nation (i.e. Greek citizens who lived and worked abroad), who funded the establishment of schools and charitable institutions, in order to help the orphans and relieve the misery of the poor.
In 1915, one of the most important social institutions of Greece was founded, the “Patriotic Institution of Social Protection and Custody” (PIKPA in Greek), which among its obligations had the protection of mothers, children and the youth under its auspices. The disaster of Asia Minor (1922) brought about the migration of one million Greek people from Asia Minor to Greece. This emigration caused tremendous social problems. The Ministry of Hygiene, Welfare and Custody (1922) was greatly activated in order to deal with the problems of adults but mainly of children. The establishment of four institutions was then promoted, the National Orphanage, the Nursery School, the National Rural Kindergarten and the Rural Housekeeping Schools. Especially in the Health Sector, a line of measures was then promoted for the medical care of the citizens. For instance, doctors were appointed in great cities having the obligation to examine and treat patients in order to eliminate various transmitted diseases (malaria, tuberculosis). At the same time, special regulations were promoted for the improvement of the national health system as well as the training of suitable medical staff, particularly nurses (1930). For this reason, the first Medical School and the first School of Nurses were then founded.
In parallel with the state’s measures, initiatives from private bodies were undertaken for the provision of children. Among these initiatives are the professional training schools, further education schools as well as institutions for homeless children. Similar initiatives of international character, worth mentioning, are the YWCA (HEN in Greek, 1923)(offering help, support and education to young females) and the YMCA (HAN in Greek, 1922, offering young males education and material support).
In 1937 the Free School of Social Welfare was established, providing education to young girls desiring to engage in social work. This school was shut down due to World War II. Concluding, the main characteristics of social work in Greece before WWII can be summarized in the following: Social work, despite the lack of state programs, exhibits some progress and relative development in the treatment of social problems, which is complemented and expanded by private initiatives as well as the Church of Greece. The WWII and later the Civil War (1944-49) caused a great disaster in Greece, both in human lives (10% of the population –men, women and children- were killed, 10% suffered from tuberculosis, 10% suffered from malaria, 25% of the children were orphaned) and in material damage (20% of the population became homeless). In order to deal with such tremendous problems and damage, Greece received help from International Organizations, like the UN, as well as from countries like the USA. At the same time, the government tried to help the population through various programs in order to overcome this emergency situation. In this context, the Royal National Institution was founded in order to help dealing with the social and educational needs.
However, the greatest amount of help in social welfare was provided by two institutions: the National Welfare Organization (initially Royal Welfare) and the Northern Provinces’ Welfare. The National Welfare Organization put initial emphasis on children who were unprotected after the war. Around 40,000 children received provision in child centers of the organization. In collaboration with helping groups, the organization took over the repair and construction of schools, churches, public buildings, water supplies and so on. In the 1950’s the organization maintained 263 institutions in northern Greece, the so-called “Children’s Homes”, which were later renamed as “Social Centres”. Today, there are the so-called Family Care Centres working under the supervision of the Social Welfare.
2. The role and direction of Social work in Greece
If we take into consideration that social work in order to fulfill its emancipating demand, should present theories and approaches that maintain a critical attitude towards the social reality and consequently the practice of social work itself, then the present summary constitutes a minor contribution that we hope to prove useful.
Through this historical review, it appears that, like in other countries, also in Greece, social work began with the establishment of charitable associations that were founded by wealthy people and were supported by the church. Charity, that is, was a form of bringing balance aiming at material equalization. Also, the ideology behind charity intended to create the attitude that charity would contribute to the elimination of poverty. In this context, a number of institutions were founded (orphanages, kindergartens, nursery schools, as above mentioned) and the institution of the public doctor was promoted.
These attempts continued in the later years, during which, social work exhibits an interesting progress towards the preservation of the present system. Particularly after WWII, the officially recognized practice of social work is expressed through measures concerning medical social work, psychiatric social work and child provision. In recent years, the sector of child provision has been under development, with the sector of school social work following immediately after.
Based on the following, in relation to social work in Greece, one can notice three distinct approaches that developed in different eras, but remain active until today and influence the entire field of social work. These are namely the approach of private provision (focusing on the weak and provision deriving from the wealthy), the approach of state intervention (the state undertakes a controlling role of the citizens’ condition) and the approach of social action (offered collectively by all citizens).
The general view of the context, role and aims of social work in Greece nowadays, focuses on a triple scheme, which includes, in mutual interaction, the maintenance of social class and the provision of services in groups with increasing needs, the personal “reinforcement” of individuals and the facilitation of social transformations. In the same spirit, the social organizations try to adjust and help those affected.
What also needs to be emphasized is the fact that irrespective of the level of social work in Greece in comparison to other countries of the EU, social work in Greece is lacking, to a great extend, the critical approach towards the theory as well as the practice of it, which is necessary for the qualitative enhancement of the profession of social work. Moreover, the rate of progress for the profession of social work, which has been significantly promoted in the past few years, will depend on whether social work schools prepare professionals who can realize a prospect aiming at social transformation.
3. Social Work in Greece today
Today, the most important actions of social work are undertaken by the Social Welfare (previously National Welfare). Its actions focus on the provision and education of the family and the child, the provision of adults, people with special needs and the financially weak, the social housing and so on, aiming, like in the past, at the “partition of sporadic cases” and the individualization of problematic situations in contrast to a collective treatment. The administration of the Social Welfare (on a national level) consists of the Departments of Social Relief, the Departments of Social Services Provision, the Departments of Control and Supervision and the Departments of Social Research and Social Insurance. At the same time, the services mentioned above, are adjusted in groups of individuals with similar problems and interests (for example unemployed young people, adults, foreigners etc.). These services materialize programs for all ages. The rapid evolution of society and constantly arising social problems, require the readjustment of the Social Welfare programs and social work, in order to deal with the social problems that constantly increase and become complicated.
In 1982 the General Secretariat of Young Generation was formed, having as its main purpose, the formation, the surveillance and the coordination of the state policy for the young generation. The General Secretariat of Young Generation undertakes a number of actions and programs in the core of the policies for the youth, particularly in the following sectors: Participation, Information, Spare time, Venturing.
It pays great attention to the cooperation with the social bodies, particularly the organizations of the youth and the local forces dealing with the youth and childhood, basically aiming at the alleviation of problems and their resolution.
Summarizing, we could say, that in relation to social work in Greece we notice three distinct approaches that developed in different times but remain active till toady and influence the whole spectrum of social work. Namely, that of private provision (focusing on the weak and provision derives from the wealthy), that of state intervention (the state undertakes a controlling role of the citizens’ condition) and that of social action (offered collectively by all citizens).
In recent years there is an ongoing discussion expressing the view that the new social policy should rely on the basis of the cycle of life, as the earlier distinction of the citizens’ periods of age does not correspond to the new demographic, family, social and technological data. What is suggested, is mass investments in childhood, education, the youth and women, that guarantee the well-being and prevention of social exclusion in later stages of life. It remains to see the future of these initiatives.
The author works as professor for educational science and social pedagogy at the University of Ioannina.
March 14th, 2007
|June 8, 2007||to||June 9, 2007|
Social work and Social Policy in a Changing Europe
ECCE Conference in co-operation with the Social Services Department of the Autonomous Province of Bolzano
Find more information at http://www.ecce-net.eu
March 14th, 2007
|March 24, 2007||to||March 25, 2007|
A conference for Social Workers, Academics, Service Users, Carers and Students in social work.
Saturday & Sunday 24th & 25th March 2007
In April 2006, 270 social workers, students, service users and academics from all over Britain met in Liverpool University to debate the current crisis of social work. Over two inspiring days, practitioners, academics, service users and activists discussed ways in which we can develop a different kind of social work practice. A practice that challenges the scapegoating of young people and asylum seekers; a practice based not on business principles, but on notions of social justice and combatting poverty, inequality and discrimination. This conference will continue these discussions and develop the networks – local, national and international – which can forge a new, engaged practice.
More information at: www.gcal.ac.uk/shsc/events/conferences.html
March 13th, 2007
Willem M.J. Blok, Leeuwarden (Netherlands)
This article presents results of a national survey on the situation of Polish Social workers.
Modern professional Social Work is important for a society that wants to be fair and democratic toward all its citizens. Social workers support citizens to participate in society. They do not only support vulnerable citizens (unemployed, disabled, homeless, orphans, elderly etc.), but they also offer services to citizens in housing districts and villages who want to improve the quality of everyday life, as well as citizens depending of vital services who wants to organize and participate as patients, clients or consumers. Because of these functions, Social Work is for authorities and institutions an important instrument to develop and carry out social policy.
As in other Eastern European countries, Social Work in Poland has little priority and insufficient means to cope with the many social problems, and to support the upcoming civil society. Operating as Social Worker in these circumstances is much more difficult than in Western countries where Social Work is an established, integrated part of a relatively well provided social infrastructure.
To find out details and to come up with hard facts on the position of professional Social workers in Poland, the Dutch-Polish Matra SIC! Project initiated and financed a nation wide survey. As Project manager I designed a research programme and a questionnaire, formed a research group, and directed the implementation by Fundacja SIC! Social Innovation Centre, operating from Poznan.
The questionnaire was titled “50 Questions to Polish Social workers” and was conducted via Internet, from June 8 until July 17, 2006. The questionnaire was aimed to collect facts and opinions about working conditions, workload, career satisfaction and expectations.
A total of 1162 Polish social workers responded by filling in and returning the records. This number of respondents is relatively high. It means that 4% of the approx. 30.000 professional Social workers in Poland took part in the survey!
Polish Social Workers
The characteristics of the 1162 respondents correspond with what is known of the population of Polish Social workers:
- gender: 89% of the respondents is female, 11% is male.
- age: 26% is 20-29 years, 36% is 30-39, 29% is 40-49 and 9% is 50-59 years
- education: 54% of the respondents has a diploma of Social Worker, 15% has a bachelor’s degree, 46% as a master degree and 10% has various education
This outcome is more than 100% because 45 % of the respondents did two studies
- experience: 56% has 10 years or more experience in the job, 23% of the workers has 4-9 years experience, and 21% less than 3 years
- position: 72% of the respondents is frontline Social Worker, 8% is supervisor, 11% is middle manager, 2% is consultant, and 15% is in other positions
This outcome is more than 100%, because some workers have more than one position.
- work fields: all work fields are represented.
- Most of the respondents work in two or more fields
The respondents are working all over Poland, in small and big places, in small and big institutions, in the governmental, non governmental and private sector.
- provinces: respondents come from all 16 provinces in the country. Statistic analysis shows that our sample is representative for the distribution of the population over the provinces, with a maximum deviation of 3%.
- cities and towns: 17% of the respondents is from big cities (500.000 or more), 14% is from medium sized cities (100.000-500.000), 44% is from towns with less than 100.000 inhabitants and 25% of the respondents is from rural areas
- institutions: 28% of the respondents work in institutions with 1-9 workers, 36% in institutions of 10-49 workers, 13% in institutions with 50-99 workers, and 24% of the respondents work in institutions with over 100 workers. This outcome is more than 100% because 4% of the respondents works in two or more institutions. 96% of the institutions are governmental institutions.
The characteristics of the sample group do not show relevant significant differences of what is known of the population of Polish professional social workers.
This similarity is caused by four factors, namely:
- the large number of respondents;
- the nation wide research approach;
- the use of national media and Internet to reach social workers and to stimulate their participation;
- in between mailings to social workers in provinces with low response.
One aspect seems to be questionable: the participation of workers without computers with Internet connection. I deliberately write: “seems to be”, because, despite their participation via Internet, 19% of our respondents report (via Internet, sic!) that they have no access to internet at work, and another 8% has only limited access!! (question 31.4)
“Insiders” will not be surprised by this fact, because networking and mobilizing resources are key qualifications of social workers!
80% of social workers works fulltime or more (37-48 hours per week), while 15% works 8 hours or less per week. Half of the workers (52%) say that they normally make overtime, without being paid for it. If workers receive compensatory time for it, 40% is not able to take this time off.
Besides the 15% with a handful of hours and a small rest group of 5%, it is obviously not attractive to work part time in Social Work. At the other hand, working more than the agreed number of hours is not attractive either, because in many cases it is not paid or it is hard to compensate it in free time.
More than half of the social workers (58%) works outside regular office hours and/or in shifts. Most of them are workers with 1-3 years experience.
10% of the social workers works in weekends, while 1 on 3 workers incidentally works on Saturdays or Sundays.
Social work office
Shortage of staff & time pressure
According to a majority of social workers, their institutions have a shortage of staff to complete the work to an acceptable standard. This majority of 64% is equally formed by frontline workers, supervisors and managers. 22% reports not to be sure about a shortage of staff, while only 14% answers that there is a sufficient number of workers.
The shortage of staff is one of the major problems in social Work institutions. According to 64% of the workers, this shortage causes waiting lists for clients, and puts ongoing time pressure on workers.
Asking Social workers for more details, the time pressure they feel is caused by:
- too much paper work (89%),
- too much work altogether (83%)
- new duties (71%)
- complexity of work load (71%)
- too fast work tempo (57%)
- changes in policy (54%)
- covering for other staff (38%)
The effects of technology (computers, E-mail, Internet) on the work are considered positive by 71 % of the workers. The younger the workers are, the more positive they judge, but the differences between the age groups are relatively small.
From practice and literature is known, that Social workers are dedicated to their clients. In the questionnaire this is illustrated by a worrying fact, namely: 62% of the Social workers do no stay at home when they are sick, but go on working! Another 25% reports that they “sometimes” work when they are ill. Only 9 % answers that they rarely work during sickness, while only 4% simply does not work. These figures are more or less the same for all positions in Social Work.
A well facilitated work place has a positive effect on workers and their clients. Only 29% of Polish social workers are in these circumstances. 31% find their work place acceptable, while 27% of the workers consider their work environment as a problem. 13% qualifies their work place as “a disaster”! In other words: 40% of social workers do their work in poor circumstances!
Worker with client
Privacy of clients
The privacy of clients is in general an important value, and in Social Work an ethic standard. The situation in this respect is in Poland very bad. In only 18% of all cases the work place offers sufficient possibilities for the privacy of clients! A majority of workers (58%) are not able to offer their clients sufficient privacy. They straight answer “no” on our question! In the other cases (24%) the situation is considered as more or less acceptable.
We asked workers to give their opinion about six different aspects of the organization of their institutions.
On a scale of 1 (very bad) to 7 (very good) social workers scored as follows:
- modern: 3,93
- flexible: 4.12
- effective: 4.24
- efficient: 4.29
- open: 4.33
- client friendly: 5.06
The average score for the organization of the institutions is 4.3 on a scale of 7. In school terms it means that the organization of the institutions just pass for the exam (0,55 x 7 = 3.85 = beta minus)
The figures show a need for further modernization of the Social Work institutions. The scores on the different aspects indicate the priorities and the way to proceed.
Social workers gave their opinion about the management of their institutions. Our respondents scored the various aspects of the management on a scale of 1 (very bad) to 7 (very good) as follows:
- supporting workers: 3.29
- clear and consistent policy: 3.34
- delegation of responsibilities & means to workers: 3,60
- open and flexible toward staff: 3.65
- open for suggestions and changes: 3.67
- informed about everyday work: 3.68
- vision and new ideas: 3.69
- appreciated & respected by workers: 3.88
- cooperation with other institutions: 4.11
- competence / expertise: 4.57
The average score for the management is 3.75 on a scale of 7. In school terms it means that managers are not doing well, and do not pass for the exam (0,55 x 7 = 3,85). The weakest points of management are: support of workers, policy of the institution, and delegation of responsibilities & means. Stronger, but still not good, are competence / expertise, and cooperation with other institutions.
These aspects of management can be, and should be, targeted by a national programme of further education, supervision and quality assurance.
Space and influence
Social workers are educated professionals with an own professional code, working for and with clients. The workers need a certain autonomy to do their work according to an acceptable professional standard.
We asked the workers: “Does your institution offer you sufficient space to operate and to take your own decisions?” On a scale of 7, the total score on this question is low: 3.84.
More than 60% of the workers feels hampered in their professional functioning. Almost half of them scored extremely low (1 or 2). This outcome does mesh with a low score for delegation of responsibilities and means by managers.
We also asked Social workers or they have influence on the working circumstances in their institutions.
The average score on this question was even lower than that on the former one: a score of only 3.04! Almost half of the workers answered that they have no influence at all! 30% have little influence, while only 10% feels able to influence their working circumstances. Most Polish Social workers have no or little influence on the working circumstances in their institutions. They also lack sufficient space to take full professional responsibility for their work.
These are worrying facts. They are illustrative for the weak position of the profession and for the dominance of management and bureaucracy in many of the institutions. It also means that changes have to come mainly from outside and from above to win the workers’ trust and to activate them! These problems have to be targeted by the trade unions and professional interest organizations, backed up by political support.
Wages & benefits
According to the Ministry of Economic Affairs and Labour, salaries in Social Work belong to the lowest in the country, together with those in health protection, hotels & restaurants and fishery (Poland 2005 - Report Labour Market p. 41/42). The average gross monthly salary in health protection & social assistance was in 2004 (the latest published figures) 1.888.37 Polish zlotys (480 Euro). By adding 2 years x 5%, we can estimate the average gross monthly salary in 2006 on 2078 PLN (530 Euro).
1071 of our 1162 respondents work full time. Their average gross monthly salary is even lower than the official lowest salaries, namely: 1844 PLN!. Our survey proves that 65% of Polish Social workers has a gross monthly salary, lower than the official lowest average gross monthly salary in health protection & social assistance. More than half of these workers earn far less than that, namely between 800-1600 PLN gross per month. Including the 13 month salary (90% of the workers gets it), and some (small) bonuses, (the official figures are not clear about that) makes a small difference of 10-12%, but does not change the fact that most Social workers earn so little!
Social workers team in Gdansk
The salaries of frontline Social workers are even less than those of supervisors, managers and consultants. The average gross monthly salary of frontline Social workers is 1645 PLN. Most Social workers with a gross monthly salary less than 1200 PLN, are less than one year in the job. They are young and live on their own. 64% of these starters reports that they can not, or hardly, live from their salary. 28% find it difficult, while 8% reports that they manage to survive. 51% of all Social workers report that they can not, or hardly live from their salary, while 36% finds it difficult. In 80% of all cases, more than 1 person has to live from the Social Worker’s salary.
It is for a fact that Polish Social workers earn one of the lowest salaries in the country. In this respect there is truth after all in what many Social workers often say: “We are not better off than many of our clients.” It is no wonder that 90% of the Social workers are not satisfied or even angry about their payment. The workers expressed their opinion as follows:
In our helping profession, salary is not important 4%
Polish society can not afford to pay us more 3%
It is okay, I can live from it 3%
Comparing to the work they do, Social workers don’t get much 48%
Social Work is an underpaid profession 35%
It is a shame what society pays us 7%
The character of Social Work, and the conditions under which it is done, are not without personal effects on workers:
- 80% of the workers reports that their social and family life is negatively affected by the stress of the job
- 43 % of the workers is more irritable with colleagues, and 38% with clients
- 27% reports to get sick more frequently
- 24% feels depressed
- 19% makes more mistakes
We asked Social workers to rate the satisfaction with their career as Social Worker on a scale from 1 to 7 (very dissatisfied until very satisfied). 37% is unsatisfied with their career, 40% is satisfied, and 23% keeps the middle. The most pleased with their career are workers between 50-59 years with a gross monthly salary of more than 2600 PLN. Very unpleased are workers from 30-39 who earn no more than 1200 PLN.
To make career satisfaction more concrete, we asked the workers: “Would you advice your child or someone else to choose a career in Social Work?” Only 10% answers “yes”, and 35% answers straight forward “no”. 40% let us know that it depends, while 15% is not sure.
Obviously many social workers are hampered to be proud of their profession, because of the difficult working conditions and a disappointing societal appreciation of their work. In order to motivate workers, and to make the profession attractive for young people, these problems have to be tackled and solved.
Role of the government
The financing of Social Work will stay, despite fashionable market talk, mainly a public matter and responsibility. The governments, and their Social Policy, are of vital importance for Social Work.
We asked the workers to score the following three statements:
The governments invests more than enough in Social Work 3%
The government does not invest enough in Social Work 34%
The government neglects Social Work 63%
This outcome is very critical toward the government. Social workers in Poland feel neglected by authorities. It is high time governments pay attention to this important professional group and make some gestures of good will.
Role of scientists
Social workers do not only feel neglected by public authorities, but also by the intellectuals, the scientists in Polish society. The workers scored on three statements about scientific support as follows:
Scientists do not offer any meaningful support to Social Work 33%
Only a handful of scientists support Social Work 62%
Scientist offer sufficient support to Social Work 5%
This outcome means that professional Social Work in Poland has hardly any scientific support.
Role of interest organizations
There is a lot to do for the “own” organizations of Social workers. These organizations however, have to improve their own functioning, because many workers are not satisfied with it. On the statement that Polish Social workers are well organized and represented, the workers responded as follows:
- true: 3%
- it could be better: 21%
- we are far from that: 54%
- not true: 22%
I hope this outcome will be taken serious by the existing organizations, and that they will treat it as a challenge to change and to improve their functioning and organization. My first advice to them is: listen to the workers. Listen carefully. Pick up the core of what they say, translate it in new policy and act according to that.
Problems and barriers
We asked workers to mention, in order of importance, the most urgent social topics where Social Work has to deal with. The outcome is as follows:
child and youth care 17%
isolation / loneliness 15%
elderly care 13%
alcohol and drugs addiction 8%
crime and vandalism 8%
democracy & participation 7%
low income housing 6%
Social workers also mentioned the most important barriers for the further development of professional Social Work in Poland. The outcome is as follows:
lack of money for Social Work 31%
shortage of Social workers 20%
lack of legal standards 19%
unattractive image of Social Work 12%
lack of training for workers 10%
low status of Social Work 10%
poor conditions of Social Work 9%
lack of governmental support 9%
lack of time / many new duties 9%
Polish Social workers operate under marginal and difficult conditions. It is clear that workers consider these conditions as barriers for the further development of the profession.
The outcome of the survey shows the weak position and difficult situation of Polish social workers. Polish social workers do their work in poor organizational circumstances with questionable management. In many institutions a shortage of staff is causing working in overtime and a permanent time pressure on workers.
Social workers have limited professional powers to do their work according to an acceptable standard. Changing their situation is not easy, because workers report to have little influence on their working circumstances. Social workers feel ignored by the government, and underestimated by the public opinion.
Polish social workers have hardly any scientific support, and do their work in difficult circumstances, mostly not able to offer privacy to their clients. Social Work can be a stressful and exhausting job, resulting in sickness. However, many social workers are so dedicated to their clients that they keep on working, even when they are ill.
As if this is not hard enough: the salaries of Polish Social workers belong to the lowest in the country! It is understandable that 90% of the social workers feel underpaid, and say they can not live from their salary or find it hard to do so.
Social workers in Poland are good willing professionals, mainly women, doing their valuable work for society under difficult circumstances as known now thanks to their willingness to take part in this survey. Social Work in Poland is a helping profession in need. It is high time that workers, interest organizations and governments become active and work together to improve the position and situation of social workers in Poland. Because of their valuable work for society - helping people, coping with social problems, stimulating participation and fighting social exclusion – a wider interest than only that of the social workers is at stake here. To improve the quality of life for all citizens, the country can not do without a modern, well equipped system of professional Social Work.
The outcome of the survey was presented during a press conference in Warsaw on Friday October 27, 2006. At this meeting the four national organizations of social workers in Poland (Polish Association of Social Workers, Orange Movement of critical social workers, National Association “Forum” of social work directors, and Fundacja SIC! Social Innovation Centre) were official represented. They announced the forming of a coalition to improve the working conditions of social workers. The Polish Ministry of Social Affairs was also represented at the meeting. The official took the outcome of the survey for granted, and was willing to cooperate with the new formed coalition.
Presentation of the survey results in Warsaw, October 27, 2006
In the frame work of European cooperation and funds, there are today more possibilities than ever to support Polish Social Workers in their efforts to build up an effective and efficient professional system of social work services, and to create proper circumstances to do so. In my opinion, especially forms of durable “twinning” between social work institutions, schools and studies of social work, and social policy departments of cities and towns can be very helpful to initiate and support new approaches, methods and organization forms.
Fotos: Klaas van Langen, NHL, Netherlands
The author is senior lecturer of NHL University of applied sciences in Leeuwarden, Netherlands. He works in Poland on part time base since 1992. The last four years as initiator, manager and research leader of the Dutch-Polish Matra SIC! Project that stimulated the modernization of social work and the development of local social policy in Poland. Contact: email@example.com
March 12th, 2007