EMCC European Monitoring Centre on Change
Law to support care of dependent people, Spain
On 1 January 2007, the Personal Autonomy and Dependent Care Law (39/2006) came into effect in Spain. It guarantees public support for people who cannot lead independent lives for reasons of illness, disability or age. The diversity of care arrangements covered by the bill will lead to the creation of formal employment and to a regularisation of previously undeclared employment, which is rather common in the field of domestic care.
Up until 2007, care services for dependent persons were imbalanced. On the public side, such care depended on social security, public health services and many dispersed social services. However, it also depended on the private activities of families and charities. Above all, the domestic care of dependants has been the responsibility of families, particularly of women, and sometimes through domestic workers. Two thirds of these workers have no social security.
The Ministry of Labour and Social Affairs (Ministerio de Trabajo y Asuntos Sociales, MTAS) published a White Paper on the care of dependent persons in Spain in 2004. According to the White Paper, some 1,125,190 elderly people and/or persons with severe disabilities could not attend to their basic daily needs. Of this number, 826,551 (73%) were over 65 years old. Furthermore, some 1,657,400 persons needed some type of support for certain activities of daily life. In total, this amounted to 2,782,590 people – or 6.44% of the Spanish population.
Overall, 83% of the carers of these dependent persons are women – with an average age of 52 years – who are related to the dependant: generally, mothers, daughters or wives. They do not receive any remuneration and are not included in labour statistics. The proportion of immigrant female carers has also increased significantly.
Thus, the main actors in the application of Law 39/2006 on Personal Autonomy and Dependent Care (Ley de Apoyo Para el Cuidado de Personas Dependientes), known as the Dependency Law, are people in need of care, due to illness, disability or age. However, a second large group is also involved: those providing the assistance to the dependants as non-professional or professional carers. Another group affected by the new law is at institutional level – that is, the public administration authorities responsible for the services, benefits and other activities when applying the law, as well as social entities and private companies.
The primary objective of the Dependency Law, which came into force on 1 January 2007, is to offer services to people who need support, due to illness, disability or old age. However, one of the most important and explicit secondary objectives is the creation of employment and the regularisation of undeclared work.
It is estimated that the new law will contribute to the creation of between 300,000 and 500,000 formal jobs – including the 115,000 existing informal carers of elderly people – over an eight-year period; the law is coming into effect on a gradual basis. By 2010, the employment creation and regularisation could generate annual returns of €2 billion through unemployment benefit savings and social security contributions. Other returns will also accrue through value-added tax (VAT), corporate tax and income tax.
The Dependency Law recognises some new universal and subjective social rights for citizens, according to the different types of dependence and circumstances. It is expected that most of the assistance is to be made available through public services that can be carried out through social entities or private companies. Such is the case for day and night care centres, telecare, assistance at home and residences. The increase in these services will lead to an expansion of employment, most of it formal, because the new law requires the beneficiaries to register and take part in evaluations to control the effectiveness of the services and costs. In addition, the law provides for information and training for workers, which contributes to encouraging formal employment.
The new law also establishes three other forms of support which should increase formal employment rates and regularise other forms of employment that previously were informal.
- First, when the available services are insufficient or inadequate to meet the needs of certain dependants, financial help can be offered for the provision of formal services.
- Under certain circumstances, the government will pay a grant to enable dependent persons to receive care at home. In that case, the main carer must be registered in the social security system.
- Another form of assistance concerns ‘major dependence’. In these cases, the state envisages the need of a carer for the dependent person. The dependant – or his or her legal representative – can choose the person in charge of the care and the caring methods.
Evaluation and outcome
Achievement of objectives
The Dependency Law began to be applied in 2007; it is scheduled to come into force gradually over an eight-year period, starting with cases of severe care needs. At present, it is still difficult to evaluate the levels of employment created or regularised as a result of the new law. The Poliwelfare Research Institute (Centro de Investigación Polibienestar) at the University of Valencia calculates that total employment creation in this regard in 2007 amounted to 77,604 people, and to 125,987 persons in 2008.
Obstacles and problems
The new law requires a complex coordination between the central government and autonomous regions. Between both levels of administration, some discrepancies have arisen concerning competences and financial obligations. At the same time, the provision of financial resources has encountered two obstacles: the forecasts of needs were undervalued, and the current economic crisis is contributing to a reduction in public income.
These factors have led to a certain delay in the application of the law, mainly in some autonomous regions. However, the central government has increased its financial contribution.
Care for dependent people has great potential for employment creation. In order to be effective, it is necessary to increase the demand through the application of the law, and through the supply of qualified carers and professionals. The Spanish state is rather decentralised, and therefore makes the application of the Dependency Law very complex, because it requires the collaboration of 17 autonomous communities, the state and local communities.
By 1 October 2008, some 606,466 requests of assistance had been received, equivalent to 1.34% of the total population. So far, the recognised beneficiaries amount to 378,378 persons; these people fall into the category of severe dependants. The number of employees in proportion to that population group seems to be about 80% of the number of dependants – in other words, about 300,000 workers. The statistics do not indicate how many employees previously worked for these dependent persons. As noted, the Polibienestar Research Institute calculates that the total employment creation in this area in 2007 was 77,604 people, and was forecasting 125,987 new jobs in 2008.
Data are scarce on the subject. Some 16,132 applications have been accepted for the new social security agreement for non-professional carers. Concerning the financial resources applied, the contribution of the state in 2008 was slightly over €240 million. It is estimated that, on the whole, the state contributions are similar to those of the autonomous communities.
The experience seems to be transferable. Care for dependent people would have some similar characteristics among different countries of the European Union. The differences may derive from the degree of administrative decentralisation that applies.
Main organisation involved: Institute for Older People and Social Services (Instituto de Mayores y Servicios Sociales, IMSERSO)
Alter Chen, M., Ihabvava, R. and Lund, F., Supporting workers in the informal economy, Geneva, International Labour Organization (ILO), 2002.
Casado, D. (ed.), Respuestas a la dependencia, Madrid, Central Catequética Salesiana (CCS), 2004.
IMSERSO, Atención a las personas en situación de dependencia en España, Libro Blanco, Madrid, Ministry of Labour and Social Affairs, 2004.
Pérez Díaz, J., ‘Consecuencias sociales del envejecimiento demográfico’, Papeles de Economía Española, No. 104, 2005, pp. 210–226.
Women’s Institute (Instituto de la Mujer), Cuidados a personas dependientes. Valoración económica, Madrid, 2008.
Esteban Villarejo and Joseph Maria Rojo-Pijoan, CIREM Foundation