Affordability of care and quality of work: new trends in elderly care

The paper investigates the ways in which different countries have addressed the question of making market care affordable to families while keeping public costs under control. We first analyse the conditions regulating the care market and its division between regular and irregular work. The latter does not necessarily coincide with immigrant work. While in some countries the two figures coincide, this is not the case in others: we start from the premise that the extent of the grey care market is related to the employment regime, so that policies aimed at regularising care workers reflect the more general frame of employment policies. The first section analyses the issue of the cost of care, and Section 3 looks at the role played by migration in filling the gap between demand and supply. Section 4 focuses on the policies that have been implemented in order to make market care affordable to families. It distinguishes between policies aimed at encouraging the development of a regular care market and/or reducing irregular work in home care through subsidies, on the one hand, or the debasing of care labour on the other?. The final section assesses the different solutions available to overcome the cost/quality trade-off, arguing that some form/degree of subsidisation is needed if ‘low road’ solutions, based on either irregular or badly paid care work models, are to be avoided.