1. Migrant Care Workers in the Italian Care Model Dr. Barbara Da Roit Department of Interdisciplinary Social Science, Utrecht University B.daRoit@uu.nl Expert Seminar at the European Academy of Regions “Domestic Support and CareBetween Quality Requirements and Costs” Frankfurt, 20-21 October 2008

2. Structure of the presentation • Brief background on long-term care in Italy • Care workers in home care • How do migrant care workers fit in the system? • Diffusion, profile and conditions • Policies • Debates, attempts, problems and perspectives

3. Background elements on long-term-care in Italy • Traditionally a “family matter”: • Unpaid daughters and wives • Legal obligations • National policies: • No explicit long-term-care policy • National care allowance (mid 1980s): • Initially meant for adult disabled, not older people • Flat rate (450 euro/month); not means tested • Very high dependency required • Paid both in institutions and at home • Low institutionalization rate (circa 2% of 65+) • Limited development (with regional differences) • Partial public funding (regional health care funds) • Very expensive for final users • Home care services: • Two separate systems of services: • health care (Regions and local health authorities) • Municipalities (social care) • Diverse regional and local situations, but scarce supply • Migrant care workers: • End of 1990s-beginning 2000

4. Domiciliary care for older peoplein Italy 4 separated (sometimes overlapping) sources of support for older people • Informal care • The health care system • The social care system • The private care market • Dimensions: • scale/diffusion • type of support provided • Care workers’ profile • Working relations • Working conditions • Professional profile

5. Scale

6. Services provided

7. Care workers’ profile

8. Working relations

9. Working conditions

10. Professional profile

11. The attitude of politics and society towards migrant care workers • Generalized acceptance of undeclared labour (not only in care) • Definition of migrant carers as a category of “deserving” migrants • Volunteer organizations in the area of migration • Migration legislation • Public opinion

12. Policy initiatives • Two separate lines of intervention • At the national level • (mainly) “migration issue” • At the local level • (mainly) “social care issue”

13. Policy initiatives at the national level • The “migration issue” • Mass regularization of migrant care workers (directly employed by families) • Quotas of migrant care workers • The “care market approach” • Tax incentives for people with disability employing carers • Problems and perspectives • Stop-and-go approach (Inability to regulate migration flows) • Low, unknown, non-effective tax incentives • The missing debate on long-term care: • Scan provision of long-term care services is not an issue • The national care allowance is one of the most important incentives in buying undocumented/undeclared migrant labour • Current arrangements (migrant carers) are likely to influence the direction of the debate

14. Policy initiatives at the local level • At the local level • Training • Registers of care workers • (Public) agencies for matching demand and supply of care • Care allowance conditioned to the emergence of undeclared labour • Problems and perspectives • Initiatives are territorially dispersed • Low take-up • Low incentives for families • Low incentives for migrant carers: • Expectations: better working conditions in exchange of professionalisation

15. Elements of conclusion • The long-term care issue has not (yet) been faced by policies • The “definition of the problem” occurs when the care migrant model is well established • Regulation difficulties • Between-policy-area tensions • National-regional-local tension • Consequences of regulation for public and private costs