Spain

Working within health and care in Spain

According to the Disability, Impairment, and Health Survey carried out by the National Statistics Institute (INE, 1999), there are over 3.5 million disabled people in Spain, representing approximately 9% of the total population. Government coverage of this dependent population takes many forms, from institutionalization in residences and homes to home hospitalization by means of home help. Experts in gerontology and EU policy maintain that it is necessary to expand the range of mechanisms available which allow elderly people to be cared for in their own home (National Institute of Social Services, INSERSO, 1993; Institute for the Elderly and Social Services, IMSERSO, 2005). Consequently, since the 1990s home help has been promoted in the political sphere.
What level of coverage is offered in Spain? Statistics on the number of places available for people in need of care and the coverage achieved by home help reveal that only a low level of coverage is achieved by health and social services when it comes to caring for the elderly. If we take into account only those people with a degree of dependency (those who require personal assistance in order to be able to carry out daily tasks), we can see that institutions cover the needs of 48.2% of this group. Due to this absence of a public care network, the family becomes the basic care provider for elderly people; in turn, women are the main carers within this category. There are still very few Spanish families that have taken the decision to delegate this care to someone outside of the family, although there is a growing tendency to outsource this service. An immigrant carer is only hired if no native Spanish person willing to carry out the task can be found. Therefore, if it is impossible to find a Spanish carer, the solution is to hire an immigrant.
Care of the elderly has become a new employment market for female immigrant workers, and in the majority of cases it is also combined with domestic duties. However, there is no specific data available to calculate the number of foreign women who care for the elderly. There are various reasons for this. Firstly, these are predominantly black market jobs. Secondly, when this kind of work is "legal", it is included in the category of "domestic help", and so the differences between housework and the emotional work of the carer are not taken into account.

Conclusions

The phenomenon of aging, together with other factors related to social policy, the integration of women into the labour market, and the lack of balance in the distribution of housework between the sexes are creating new fields of employment related to personal services such as care of the elderly. The demand for people who carry out this activity coincides with an era of intense migration which has some very specific characteristics. The migratory flow is predominantly female and of Latin American origin. These two characteristics - "Latin American and female" - are the two most important requisites of Spanish families when it comes to choosing a carer for their elderly relatives. The motivation for migration is not only generated in the country of origin, but also in the host country, which needs or selects workers with certain characteristics. This is the case in Spain as well as in southern European countries as a whole (with the exception of Portugal) which are characterized by a very specific healthcare system and migratory model which eventually complement each other.

The care of the elderly: a link between immigration and old age
Panorama Social, 2, 2005, pp. 85-97
Raquel Martínez Buján
Carlos III University