The Spanish Long-Term Care System: Deployment, Restructuring Processes and Future Challenges
DOI:
https://doi.org/10.31211/interacoes.n39.2020.a1Keywords:
Spanish long-term care system, austerity mesures, economic crisis impactAbstract
Since the implementation of the Dependency Law in 2007 the nature of the Spanish long-term care system (LTCS) shifted from an assistance based-model to a universal one. Despite this undeniable legal improvement, it was not put into place effectively because of the general cutbacks and delays to access the rights. This article examines in-depth the Spanish long-term care system deployment, the restructuring processes undertaken owing to the 2008 economic “shock", the system’s shortcomings and its future challenges. It is based on case study analysis. The analysis of the changes focuses on four dimensions: the system`s nature and principles, the access to the rights, the services provision, and organisation, management and funding. The study scrutinises workers and recipes of public services, legislative reforms, and the social and institutional impact of the crisis according to interviews carried out to key informants. The outcomes display a double process of system expansion-contraction: the first, during the system’s deployment, which was followed by a second phase of retrenchment or contraction, centered on the cost containment restructuring process and the reinforcement of the family-based nature of the system, along with a process of re-familiarisation and re-commodification.
References
Anttonen, A., & Sipilä, J. (2005). Comparative approaches to social care: diversity in care production modes. In B. Pfau-Effinger & B. Geissler. (ed.), Care and Social Integration in European Societies (pp. 115-134). Bristol: Policy Press.
Jové, E. A. (2020). Impact of the economic crisis and contractions within the European long-term care systems [Manuscript submitted for publication]. Journal of International and Comparative Social Policy (date of acceptance, December 3rd 2020. Pending of publication).
Bettio, F., & Plantenga, J. (2004). Comparing care regimes in Europe. Feminist Economics, 10(1), 85-113.
Bettio, F., Simonazzi, A., & Villa, P. (2006). Change in Care Regimes and female migration: the ‘care drain’ in the Mediterranean. Journal of European Social Policy, 16(3), 271-285.
Carreras, A., & Tafunell, X. (2010). Historia Económica de la España contemporánea (1978-2009). Barcelona, Spain: Crítica.
Castells, M. (2014). La crisis económica europea: una crisis política. EuropeG. http://www.europeg.com/es/actualidad/noticias?start=30
Consejo de Europa. (1998). Recomendación Nº R. (98)9 del Comité de Ministros a los Estados Miembros relativa a la dependencia. http://envejecimiento.csic.es/documentacion/biblioteca/registro.htm?id=51023
Council of the European Union. (2003). Joint report by the Commission and the Council on supporting national strategies for the future of health care and care for the elderly. http://ec.europa.eu/employment_social/soc-prot/healthcare/elderly_en.pdf
Council of the European Union, European Parliament and European Commission (2017). European Pillar of Social Rights. https://ec.europa.eu/commission/sites/beta-political/files/social-summit-european-pillar-social-rights-booklet_en.pdf
Da Roit, B., & Le Bihan, B. (2010). Similar and yet so different: Cash-for-care in six European countries’ long-term care policies. The Milbank Quarterly, 88(3), 286-309.
Daly, M. (2012). Making Policy for Care: Experiences in Europe and its implications for Asia. International Journal of Sociology and Social Policy, 32(11/12), 623-635.
Daly, M., & Lewis, J. (2000). The concept of social care and the analysis of contemporary welfare states. British Journal of Sociology, 51(2), 281-298.
Decree 142/2010, § 5738, (2010, October 11). Approves the Social Services portfolio 2010-2011. https://portaldogc.gencat.cat/utilsEADOP/PDF/5738/1610152.pdf
Deusdad, B., Comas-d’Argemir, D., & Dziegielewski, S. (2016). Restructuring Long-term care in Spain: the impact of the economic crisis on social policies and social practice. Journal of Social Service Research, 42(2), 246-262.
Deusdad, B., Lev, S., Pace, Ch., & Vell, S. (2017). Care for older people in three Mediterranean countries: discourses, policies and realities of de-institutionalisation. In Social Services disrupted. Implications and challenges for a crisis-ridden Europe. London. UK: Edward Elgar publishers.
Esping-Andersen, G. (1990). The three worlds of welfare capitalism. Princeton: Princeton University Press.
Esping-Andersen, G. (2000). Fundamentos sociales de las economías postindustriales. Barcelona: Arial.
European Commission. (2007). Comunicación de la Comisión al Consejo, al Parlamento Europeo, al Comité Económico y Social Europeo y al Comité de las Regiones.
Ferrera, M. (1996). The ‘Southern Model’ of welfare in social Europe. Journal of European Social Policy, 6(1), 17-37.
Flaquer, L. (2002). Familia y estado de bienestar en la Europa del sur. In L. Flaquer. (ed.) Políticas familiares en la Unión Europea (pp. 175-208). Barcelona, Spain: ICPS.
Greve, B. (2012). Editorial Introduction: Overview and conclusion. In B. Greve. (ed.). The Times They Are Changing? Crisis and the Welfare State (pp. 1-6). Oxford: Wiley-Blackwell.
Hall, P. (1993). Policy paradigm, social learning and the state: The case of economic policy in Britain. Comparative Politics, 25(3), 275-296.
Institute for the Elderly and Social Services (IMSERSO). (2005). White Paper on Care of Dependency. https://www.imserso.es/InterPresent2/groups/imserso/documents/binario/libroblanco.pdf
Institute National Statistic (INE). (2016). Projection of the Spanish population by age group and from 2031 and 2066. Press Releases. https://www.ine.es/prensa/np994.pdf
INE (2020a). Life expectancy at birth by sex indicator. Retrieved December 12, 2020 from https://www.ine.es/jaxiT3/Datos.htm?t=1414#!tabs-tabla
INE (2020b). Population Structure Indicators. Retrieved December 12, 2020 from https://www.ine.es/jaxiT3/Tabla.htm?t=1488
Kodate, N., & Timonen, V. (2017). Bringing the Family in through the Back Door: the Stealthy Expansion of Family Care in Asian and European Long-Term Care Policy. J Cross Cult Gerontol 32, 291-301.
Care Act 39/2006. (2006, 14th December). Promotion of Personal Autonomy and Care for Dependent Persons. Jefatura del Estado. BOE Nº 299, BOE-A-2006-21990. http://dixit.gencat.cat/ca/detalls/Article/20061214LLEI392006
Leitner, S. (2003). Varieties of familism: The caring function of the family in comparative perspective. European Societies, 5(4), 353-375.
Marbán, V. (2012). Actores sociales y desarrollo de la ley de dependencia en España’, Revista Internacional de Sociología, 70(2), 375-398.
Martínez, R. (2006). El cuidado de ancianos: Un nicho laboral para mujeres inmigrantes y un reto de gestión para las entidades del tercer sector. Revista Española del Tercer Sector, (4), 145-173.
Organisation for Economic Co-operation and Development (OECD). (2011). Help wanted? providing and paying for long-term care. Paris: OECD. https://doi.org/10.1787/9789264097759-en
OECD (2017). Social spending (indicator). http://doi.org/10.1787/7497563b-en (accessed August 9, 2017).
OECD (2017). Long-term care recipients (indicator). Retrieved October 28, 2017 from https://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_LTCR OECD
OECD (2019), Life expectancy. Society at a Glance 2019: OECD Social Indicators, OECD Publishing, Paris. https://doi.org/10.1787/5d08dbc5-en
OECD (2020), Elderly population (indicator). https://doi.org/10.1787/8d805ea1-en
Oso, L., & Parella, S. (2012). Inmigración, género y mercado de trabajo: Una panorámica de la investigación sobre la inserción laboral de las mujeres inmigrantes en España. Cuadernos de Relaciones Laborales, 30(1), 11-44.
Österle, A. & Rothgang, H. (2010). Long‐Term Care. In F.G. Castles, S. Leibfried, J. Lewis, H. Obinger, & C. Pierson (eds), The Oxford Handbook of the Welfare State. https://doi.org/10.1093/oxfordhb/9780199579396.003.0026
Pavolini, E., & Ranci, C. (2008). Restructuring the Welfare State: Reforms in long-term care in Western European countries. Journal of European Social Policy, 18(3), 246-259.
Pavolini, E., & Ranci, C. (2013). Reforms in long-term care policies in Europe: An introduction. In C. Ranci & E. Pavolini (Ed.), Reforms in long-term care policies in Europe (pp. 3-22). New York: Springer.
Pierson, P. (2001). Coping with permanent austerity, Welfare State restructuring in affluent Democracies. In the New Politics of the Welfare State (pp. 410-456). Oxford: Oxford University Press.
Rodríguez Cabrero, G. (2007). El marco institucional de la protección social de la dependencia en España. Estudios de Economía Aplicada, (25)2, 341-372.
Rodríguez Cabrero, G. (2009). El desarrollo de la política social de promoción de la autonomía y atención a las personas en situación de dependencia en España (2007-2009). https://www.researchgate.net/publication/237031975_El_desarrollo_de_la_politica_social_de_promocion_de_la_autonomia_y_atencion_a_las_personas_en_situacion_de_dependencia_en_Espana_2007-2009
Rodríguez Cabrero, G. (2011). Políticas sociales de atención a la dependencia en los Regímenes de Bienestar de la Unión Europea, Cuadernos de Relaciones Laborales, 29(1), 13-42.
Rodríguez Rodríguez, P. (2005). El apoyo informal a las personas mayores en España y la protección social a la dependencia. Del familismo a los derechos de ciudadanía. Revista Española de Geriatría y Gerontología (40)2, 5-15.
Royal Decree 174/2011, § 3174, (2011, February 11). Approves the scale of assessment of the situation of dependency established by Act 39/2006, of 14th December, on the Promotion of Personal Autonomy and Care for Dependent Persons. https://www.boe.es/diario_boe/txt.php?id=BOE-A-2011-3174
Royal Decree-Law (RD-L) 8/2010, § 126, (2010, May 24). Adoption of Extraordinary Measures for the Reduction of the Public Deficit. https://www.boe.es/eli/es/rdl/2010/05/20/8/dof/spa/pdf
RD-L 20/2011, § 315, (2011, December 31). Urgent Measures in Budget, Tax and Financial Subjects for the Correction of the Public Deficit. https://www.boe.es/boe/dias/2011/12/31/pdfs/BOE-A-2011-20638.pdf
RD-L 20/2012, § 168, (2012, July 13). Measures to Ensure the Budgetary Stability and Promotion of the Competitiveness. https://www.boe.es/boe/dias/2012/07/14/pdfs/BOE-A-2012-9364.pdf
Sánchez, M. A., & García, F. (2011). Crisis económicas y cambio institucional en España: de la gran depresión a la crisis de 2008. http://www.ugr.es/~teoriahe/RePEc/gra/fegper/FEGWP211.pdf
Spasova, S., Baeten, R., Coster, S., Ghailani, D., Peña-Casas, R., & Vanhercke, B. (2018). Challenges in long-term care in Europe. A study of national policies, European Social Policy Network (ESPN), Brussels: European Commission.
Urgerson, C. (2005). Gender, Labour market and care work in five European Funding Regimes. In B. Pfau-Effinger & B. Geissler (ed). Care and Social Integration in European Societies. Bristol: Policy Press.
Vaughan-Whitehead, D. (2015). The European Social Model in times of crisis: An overview. In D. Vaughan-Whitehead (ed.) The European Social Model in crisis: Is Europe losing its soul? (pp. 1-65). Geneve: Edward Elgar Publishing and ILO.
Vis, B., van Kersbergen, K., & Hylands, T. H. (2011). To what extent did the financial crisis intensify the pressure to reform the Welfare State? Social Policy & Administration, 45(4), 338–353.
World Health Organization (WHO). (2007). Global age-friendly cities: a guide. https://www.who.int/ageing/publications/Global_age_friendly_cities_Guide_English.pdf?ua=1
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Esther Albesa Jové
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The copyright of published works is retained by the author who grants Interações the original publication right. The published article can be used freely for educational, non-commercial purposes, in accordance with the Creative Commons License - Attribution-Non-Commercial 4.0 International, provided that the author, the title of the article, the title and number of the journal are cited together with the URL or DOI of the article.
