By Kai Leichsenring, Heidemarie Staflinger, Annette Bauer
The Covid-19 outbreak is highlighting the fragility of European Long Term Care (LTC) systems at all levels. In Austria, where live-in migrant care workers significantly contribute to safeguarding the LTC system, all levels of government are currently struggling to address the delicate balance between legal and social issues related to this type of care arrangement. Although live-in migrant care is a widespread phenomenon across Europe, Austria is indeed the only country that has tried to regulate the system of so-called ‘24-hour care’ on a legal basis as of 2007, including the status of ‘Personal Carers’, working conditions, social security and some minimum standards, training and competences (see Winkelmann et al., 2014; Schmidt et al., 2014). In the meantime, about 33,000 people in need of LTC (about 6% of total) are making use of this arrangement. It is based on fortnightly shifts of migrant carers – originally from the neighbouring Slovak and Czech Republics, now in their majority from Romania and Bulgaria. More than 60,000 of them are registered as self-employed personal carers at the Austrian Chamber of Commerce, although most of them are cooperating with specialised 24-hour-care-agencies in their country or in Austria. In most cases, personal carers are replacing or complementing family carers who remain involved particularly in administration and supervision.
The COVID-19 crisis is now exposing the entire sector to moments of truth – closed borders and travel restrictions are challenging the entire model of ’24-hour care’. While most of those personal carers who were in Austria for their ‘first shift’ in March could be convinced to exceptionally stay for a second shift, while their counterparts remained in their home country, the situation gets tough now that the restrictions are likely to be extended beyond April. Regional governments have therefore started to forge strategies to sustain families and personal carers with the additional budget of 100€ mio. provided by the Federal Government. First, on Monday, the regional government of Lower Austria organised and paid for an exceptional charter flight for about 250 carers from Bulgaria and Romania to Vienna. The carers were directly transferred to a hotel in Lower Austria, where they will be in quarantine for two weeks, funded by the Lower Austrian Chamber of Commerce. In the ensuing weeks they should serve as backup for those personal carers who will need to be replaced. Second, the regional government of Upper Austria announced on Tuesday that they plan to offer a premium of 1,000€ per month to those personal carers who continue to stay in Austria over the coming weeks. Other regional governments have expressed intentions to follow either the example of Lower Austria (Burgenland) or Upper Austria (Vorarlberg). Finally, in the evening of 1 April a solution was found at federal level to ensure an equal regulation across the country and to avoid competition between regions: all personal carers who stay in Austria will receive a bonus of 500€, paid from the recently established 100 mio. € LTC safeguard fund. Moreover, a hotline has been established to coordinate 24-hour care across the regions. An informal support network is using social media (with already more than 1,600 members) to mitigate the drop out of personal carers. This initiative is supported by interest organisations (Federation of Nurses, Union, Carers organization etc.), 24-hour care agencies, and personal carers themselves.
The desperate activities to keep up the 24-hour care arrangements certainly deserve to be supported, but they can hardly conceal the downside of this model not only in times of COVID-19. Personal carers are basically a functional equivalent to family carers and thus are facing the same physical and mental stress of a one-to-one care relationship. On top of this, they are often socially isolated, which might be compensated ‘in normal times’ by the fact that they can return to their families after a fortnight, but also by a chat with neighbours or meetings with other personal carers in the vicinity. During the COVID19 outbreak, with extended limitations to leave the house, social isolation becomes even more wearing – extra income alone cannot compensate for the additional burden. With the extension of travel restrictions it will also become critical for those who are currently living in their home countries without any income. In a mid-term perspective it will depend on the impact of the recession on labour markets and wage differentials in the different countries, whether the ‘24-hour care’ model in Austria will continue in its current framework.
By 2018 it was for the first time that Romanian carers outnumbered carers from Slovakia, who had been in the majority hitherto. Also, the Slovak government has been trying to entice care workers back to their home country as the lack of labour force in the national health system is getting more and more critical. With larger distances, the original model of biweekly shifts that guaranteed some kind of continuity in family and social life of migrant carers at home, is being undermined – causing also legal, health and safety concerns about working time regulations. It will therefore be necessary to broadly discuss these issues in the context of the ‘major LTC reform’ that has been started by the new government, but is currently on hold due to the Covid-19 crisis.
- The Austrian LTC system is relying to a significant degree on live-in migrant carers from neighbouring Slovak and Czech Republics, but increasingly also from Romania and Bulgaria
- The travel restrictions are challenging this model to a degree that drastic interventions have been taken by regional governments to safeguard the continuity of care at home by migrant carers.
- Further debate about the model of ’24-hour care’ by live-in migrant carers in Austria is needed.
- Also in a European context the issue needs to be addressed, as most countries are using the model without any regulations, thus compromising working conditions and social security of care workers and eventually the safety of people in need of care.
29/03/2020: ORF online (Austrian Broadcasting): 281 migrant care workers will be flown to Austria through an initiative of the Regional Government of Lower Austria and the Regional Chamber of Commerce, https://noe.orf.at/stories/3041337/
The regional government of Upper Austria tries another strategy: €1000 premium for migrant carers who choose to stay for a longer period: 30/03/2020: https://www.nachrichten.at/politik/landespolitik/land-zahlt-1000-euro-praemie-fuer-24-stunden-betreuerinnen;art383,3246011
Winkelmann, J., Schmidt, A.E., Leichsenring, K. (2015) Regulating migrants as a low-cost solution: The formalisation of a dual care labour market in Austria, pp. 172-195 in N. Morel and C. Carbonnier (eds.) At your service? The political economy of household services in Europe. Basingstoke, Palgrave Macmillan.
Schmidt, A.E., Winkelmann, J., Rodrigues, R., Leichsenring, K. (2016) Lessons for regulating informal markets and implications for quality assurance – the case of migrant carers in Austria, Ageing & Society, 36(4), 741-763. https://doi.org/10.1017/S0144686X1500001X
Leichsenring K, Staflinger H, Bauer A (2020) Report: The importance of migrant caregivers in the Austrian Long Term Care system highlighted by the Covid-19 outbreak. Article in LTCcovid.org, International Long-Term Care Policy Network, CPEC-LSE.
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