Central and Eastern European

countries in the migrant care chain

Agnieszka Sowa-KoftaInstitute of Labour and Social Studies

Center for Social and Economic Research

Expert Group Meeting on “Care and Older Persons: Links to Decent Work, Migration and Gender”

December 5th-7th 2017

Ageing & care needs in CEEC

• Improvement in life expectancy, especially in CZ and PL between 1990-2017; lower improvementsin BG, RO, HU & othercountries

• Poor health status and chronic conditions: CVD, cancers, diabetes, muscosceletal illnesses

• High levels of functionalimpairments and disabilityin older population

• With low TFR and increasein LE, CEEC are entering theageing phase

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

EU-28 Czech Republic Bulgaria Poland Latvia

45-59 60-74 75+

Source: European health and social integration survey, 2012

Disability in older adult population

Old age dependency ratioToday still „young” populations will be among the „oldest”

Europeans in 40 years

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

Old age dependency ratio

2015

2060

Source: Eurostat, population projections

Migration from the CEEC

• CEEC - poorer countries under many economicand political pressures have been „sending” countries for many decades (XIX century, post IIWW, communist period)

• Due to historical and ethnic reasons strongermigration in some regions (i.e. South-WestPoland, East Romania – German minority)

• Entering EU in 2004 and freedom of labourmovement stimulated the last wave of economicmigration

Reasons for care migration

• Demand factors:

– Demographic change in Western European countries

– Shortages in care employment

– Changing family roles

– Stimulation by social transfers

• Supply factors:

– High poverty during the transformation period

– High unemployment (young people, women 50+)

– Low salaries and poor working conditions in nursing & care professions

Migration and care regimes

• Traditional perception of care duties and availability of unconditional care-related cash transfers (e.g. Germany, Italy, Austria) stimulates employment of low-salaried informal carers

(Simonazzi 2009, Fedyuk et al. 2014) � semi-regulated but politically and socially accepted segment of care

• Developed formal care and marked care-relatedcash transfers stimulates migrants’ employmentin formal care settings (e.g. France, UK, Sweden)

Employment of first-generation

migrants in the EU• health and social services are the main field of economic activity for

almost 10% of first generation migrant workers

• 7.4% of first generation migrants work in households and this share has

strongly increased between 2008 and 2014

First generation migrant care workers in the EU-28 by sector of employment

0

2

4

6

8

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12

14

16

18

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Source: EU Labour Force Survey 2008, 2014

Origin and destination countries in Europe

Source: Rodrigues et al. 2012

Care migration from CEEC

to Western Europe

• Employment in care remains an area un- or underreported in public statistics either of destination or in source countries (temporary work, cross-borderon circulatory basis, often non-registered)

• But:

– 316 thousand care workers in Italy (2002),

– 187.5 thousand care workers in Spain (2005),

– 60.6 thousand care workers in Austria (2017): 56% Slovaks, 30% Romanians

– Estimations show from 100 thousand CEEC care workers to over 200 thousand Polish care workers in Germany

CEEC - new destination countries

• In Poland, Czech Republic increasing migration of informal care workers from Ukraine (especially afterthe war in Eastern Ukraine) – up to 600 thousandmigrants seasonally, every 5th working in households’ & care

• Romania a host country for care migrants fromMoldova – 94 thousand migrants between 1991 and 2014

• Hungary a host country for care migrants of Hungarianethnicity living in other CEEC

• Slovenia a host country for care migrants from formerYugoslavia territory (Voivodina)

Registered care migrants in Poland

Number of registered statements of migrant employment in households’

activities and in human health and social work sector of economy in Poland

Source: Sobiesiak-Penszko 2015 after the Ministry of Family Labour and Social Policy

11564

7289

5796

12783

751 916541 428

0

2000

4000

6000

8000

10000

12000

14000

2011 2012 2013 2014

Activities of households as employers Human health and social work

Tensions in sending countries• Risk of workforce drain in the source countries,

especially in nursing and social care sector

e.g. Poland: 19.9 thousand professionalcertificates for nurseses issued between

2004 and 2016

• Inablity to assure adequate care in CEEC in times of rising care needs (high dependency & ageing) withunderdeveloped formal LTC services, migration and family changes

• Whilst in Poland, Romania or the Czech Republic migration might be mitigated by inflow of workers form other countries, this is not the case in poorer CEEC: Ukraine, Moldova

Problems with domestic nursing and

care work in CEEC• Low density of

nursing and

social care

workers in the

population,

• Low share of

workers in

total

employment

• Ageing of

workers in

nursing and

care sector

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

18.0

20.0

EU

-28

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nia

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Po

lan

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s

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lga

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nia

Share (%) of employment in human health and social work sector in

relation to the total employment, 2016

Gender, family and the risk of

exclusion

• Care is a female work, either as migrants ordemestically

– Redefinition of female role within family, women as breadwinners,

• Families better-off, but often socially deprived, a risk of family deconstruction

• High cost of emotional distress, social isolation, deprivation of own needs related to care work

• Financial independence of women sometimes allowsthem to build self-esteem, rebuilt their lives and reviselife goals (Wiatr 2017)

Social protection of migrant care

workers

Care migrants work in different work arrangements:

(1) Formal care settings � covered with socialprotection (UK, Sweden)

(2) Semi-formal arrangements (self-employment, cross-border temporary contracts) � labourbelow statutory minimum wage in destinationcountry, poor social protection, lack of labourstability (Austria, Germany)

(3) Informal care � lack of any social protection(Spain, Italy, Poland, Czech Rep.), typicallyworkers from non-EU countries working in the EU

Main policy issues

• Drawing attention to the problem of migrant care work(e.g. CEQUA LTC Network)

• Changing role of the CEEC countries needs discussionon the impact of migrant care work on supply of caredomestically (formal and informal), family relations & female roles

• A need to formally recognize care migrant work in most of the European countries (e.g. Austria), including CEEC

• A need for equal treatment of migrants care workerscompared to domestic worker & social protection of care workers