How Poland runs social care and can the UK learn from it?

The Polish prime minister caused a sensation at a recent EU summit by claiming his country’s voting rights were affected by the number of people it had lost in the second world war.

The summit was being held in Germany and Jaroslaw Kaczynski was bringing his country into direct confrontation with its erstwhile foe. By saying that Poland’s population would have been much higher now had it not lost five million people in the war and the Holocaust – and therefore that its voting power based on population size would be stronger – he was intentionally taking Poland into choppy waters.

Kaczynski’s words also signified how Poland is asserting itself on the international stage.

In the UK, where they have the right to work, the Poles are the largest group of immigrants since the accession of eight east European states to the EU in 2004.

Their arrival has meant services have had to be developed to support those who arrive only to find themselves without work and homeless (see Meeting the needs of people in a strange land).

The influx of Poles has also aroused ­curiosity about the similarities and differences between Poland and the UK. The Department of Social Work at the University of Central Lancashire (UCLan) decided to investigate further. With the help of the European Commission’s Erasmus programme, which enables students to take part of their course in another country, social work lecturers and students visited Poland to see how its social care system worked.

What they found was surprising: they saw a method of care rich in person-centred care and human touch, and devoid of performance indicators. They were impressed.

There is little statutory provision in Poland. The Catholic Church funds most care services. In many places, the care is delivered by nuns who have received no formal training, but are highly experienced.

Social work training is gathering strength, based on the social pedagogue model which produces generalist practitioners.

However, the training is at polytechnic level and the status of social workers low. Even the director of a children’s home with a PhD earns only €400 a month. But all these facts belie the excellent care provided to many service users.

Dawn Judd, a senior lecturer in social work who organised the recent trip of UCLan staff and students to Poland, is impressed by the country’s social care pedagogue approach: “The staff deal with all aspects of care. It shows when they come to work in the UK because they have a great understanding of people’s needs. They know you have to look at people holistically.” Judd adds that, as in many parts of Europe, the care staff have the “huge responsibility” of also handing out benefits.

Her colleague Mark Foord, a principal lecturer, emphasises the importance of personalised provision in Poland: “There is a lot of time for people there is less emphasis on performance indicators and inspections,” he says. “It was refreshing for our students, who are prepared for a lot of forms and bureaucracy.”

He admits there is a danger that the 15 MA and BA social work students who visited Poland could become disillusioned once faced with all the bureaucracy their profession will demand in the UK. “It is going back to something that we have increasingly lost,” he says of Poland.

Foord adds that the gap between the boundaries of social work and social work practice in Poland is small, with social care practitioners very “hands-on”.

Standards of care

Tracy Paul, an MA student who was on the trip to Poland in May, complains that social workers in the UK suffer burn-out, and the quality of service delivery can be affected by staff being overworked: “They haven’t got time to think often about whether the service is right for a particular person. The hands-on work is done in this country by people who aren’t valued. In Poland, if you look at the services, it seems the staff have their heart in it.”

Paul says the standards of care in Poland are “very, very high”. She says a facility for older people with mental disorders the students visited provides better, more thorough care than its equivalent in the UK, for example.

Both Foord and Paul highlight the different attitudes in Poland towards personal space, while emphasising that people are valued as individuals. Foord says: “The collective rights were much more important. Most people there were sharing rooms, but nobody seemed worried about privacy. People are seen as individuals within larger groups.”

Paul adds: “The children we saw came from large families where they were used to sharing a room.”

A hospital in Lodz that cares for cancer patients also impressed its UK visitors. As well as a sensory room that creates the feel of a beach for up to 15 people, there were alternative therapies, physiotherapy and hydrotherapy available to patients.

Innovation was also evident in ways that might not be allowed in the UK. For example, older people at a day care centre next to a children’s home are encouraged to act as “foster” or substitute grandparents for some of the children. “This wouldn’t be acceptable in Britain,” Judd says.

But not everything the group saw was of a high standard. A unit for homeless people, including some older citizens, was “extremely basic”, according to Foord. “It was clear that services for homeless people were in a state of development – it is a facility of last resort,” he says.

Poles working in care

UCLan has begun to develop its links with Poland from a different perspective too, by exploring the role of Polish people working in the care sector in the UK.

“The care sector here has a large number of people from eastern Europe, and we are looking at whether they want to become social workers,” Foord says.

Many work in the UK for a year or two before returning home, sending money back to Poland. But the university would like to look at whether it can use some of the skills and experience gathered in Poland to become effective social workers here.

If nothing else, the experiences of the UCLan group remind us that direct personal contact with service users is crucial, and that forms, indicators and inspections do not in themselves provide the care service users desperately need.

It is also important to remind ourselves that the most developed countries do not have all the answers. “We should take the best from what each country offers,” Paul says.

CASE STUDY
‘I was surprised by the extent of help in the UK’

Alicja is a 51-year-old nurse from southern Poland. She says: “I worked abroad as a nurse. When I came back to Poland I couldn’t find work. I found an advertisement for a recruitment agency offering positions in nursing homes across the UK and decided that I would like to try.

“I arrived in the UK by plane in September 2005. Before I came here I tried to find out as much as I could about England, life here in general, work, cost of living etc. I believed the most important thing was language, and I already spoke English before I came here.

Training days

“The recruitment agency paid for my flight. It was a respectable recruitment company and I trusted that they would deliver. There were four days of training when I got here, during which time I was provided with accommodation in a hotel and meals.

“From mid-September 2005 until the end of October 2005, I lived in a room in the nursing home. After some time I rented a small flat nearby. Then I lost my job in September 2006 and had to move out as I did not have money to pay for rent. I found a squat, where I have lived since.

“I lost my job because I became a victim of a conflict with a co-worker. When I was told by the employer that my job was in danger, I became depressed and did not turn up for a meeting with them and was sacked.

“When I lost my job, I realised I didn’t know how to look for a new job in England. It is not easy to find a good job here.

Broadway help

“I received some help from my friends. Also, I received a lot of help from Broadway Project. I come to the project every day. I can take a shower here and wash my clothes. I also received warm clothes and a duvet and pillows, which really helped during the winter because our squat does not have any heating. I was surprised by the extent of help available in the UK it is much better than I had ever expected.

“I still have my daughter and parents in Poland. All the time I had a job, I was helping my daughter. I call once or twice a week.

“I see a chance here for myself but I don’t want to stay here indefinitely. I am really worried though about Polish people here. After I lost my job, I met lots of Polish people and it was shocking. Many of them drink too much and don’t even try to find a job. It is very sad.

“Once I have a job again, I want to rent a room or flat and live normally again. I would like to stay here a few more years and than probably go back to Poland.”

Poland factfile

● Poland has a population of 38.6 million.
● Life expectancy is 79 and 70 for women and men respectively, compared with 81 and 76 in the UK.
● The infant mortality rate is 6.8 per 100,000 births, compared with a world average of fewer than six.
● The unemployment rate is 11%, down from 19% in 2004.
● There are about 17,000 social workers in Poland.
● 29% of children live in poverty.
● Benefits include unemployment, family, disability, sickness and maternity.
● 80,000 citizens of the eight accession countries came to UK in 2005, 70% of whom were Polish.

Meeting the needs of people in a strange land (back)

In the past 18 months, London-based homeless charity Broadway has seen an increase in people from A8 countries using its day centre in Shepherd’s Bush.

The charity offers a full range of support, from street outreach to tenancy support. It immediately worked with partner agencies and made sure councils and the Department for Communities and Local Government were aware of what was happening. The Polish consulate visited the centre and provided financial assistance, recognising the importance of the work the Broadway Centre was doing.

Broadway is also working with the Polish-based Barka Foundation for Mutual Help to identify people who, given the barriers to them finding work in England, might be better off returning to Poland. Those who do return are offered help from the foundation with gaining employment and training.

To understand the needs of Poles in England, Broadway conducted research across London services to find out what people’s expectations were of coming to this country, what problems they have faced, and what help they have needed.

There is no typical case study of a homeless person from Poland. Although some people do arrive here with existing issues, such as alcohol dependency, there are others like Alicja (see case study, previous page) who have skills and speak English but are open to abuse or maltreatment simply because they are not informed and empowered.

The one issue that does stand out, though, is a general lack of understanding about rights and about the processes to go through on arrival in terms of getting an address, a national insurance number, a job and a bank account.

Another issue is crime. Rough-sleeping Polish people are more likely to be victims of crime, which can often result in official documents going missing and therefore create a huge barrier to them establishing an identity and finding legal work and accommodation.

Because of the varying needs of the Polish people Broadway works with, it is impossible to say there’s one single solution. But the charity is clear that a comprehensive national response to the issue is needed to acknowledge and provide for different groups with different needs within the EU population.

Broadway believes the British government needs to work in partnership with the accessional countries’ governments to ensure that individuals are informed about the realities of life in Britain, and that those who do come are signposted to the right services on arrival.

➔ More at www.broadwaylondon.org

This article appeared in the 26 July issue under the headline “Poles apart”