inflow and outflow of informal care workers in the case of poland labour market and public policy...
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Inflow and Outflow of Informal Care Workers in the Case of Poland
Labour Market and Public Policy Implications
Aleksander Surdej
Cracow University of Economics
Outline of presentation
Part I - Social Care System in Poland
Part II - Public Policy towards Social Care
Part III - Conclusions
Part I
Social Care System in Poland
• The need of care is felt in every third Polish household;
• The need is particularly strong in families with little children (69%) and among the elderly (65+) - 9%;
Demand for Care in Poland
Public Expenditures on Family and Children (% GDP)
Chart Public expenditure on family and children as % GDP in selected countries and EU 15, 1980-2001
0
0,5
1
1,5
2
2,5
3
3,5
4
4,5
5
1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Source: OECD (2004) Social Expenditure
% G
DP
Denmark
Finland
Germany
Poland
Spain
United Kingdom
EU 15
Institutions for Child Care in Poland
Number of crèches and kindergartens
1412
z
591
9350
428
8501
377
7746
15
1028
0
2000
4000
6000
8000
10000
12000
14000
1990 1995 2000 2004 Prywatne 2004
żłobki przedszkola
Kindergartens
Crèches
Number of Children in Crèches and Kindergartens
Year
Crèches Kindergartens
Total
For 1000
children aged
0-3
Total
For 1000
children
aged
3-6
1990 116,500 42 856,600 328
1995 68,400 23 773,200 356
2000 52,800 20 685,400 388
2004 45,900 20 644,100 416
Principles of Institutional Child Care in Poland
● Decentralized − responsibility of local governments for financing and managing child care
● Co-payment − parents pay approx. 30% of the costs of daily care
● Gradual privatization− private entities can create and run crèches and kindergarten
− parents in private crèches and kindergarten can get financial allowance from the local government
● Participatory management − the opinions of parents are an important factor in evaluation of the care performance
Structure of the Polish Society by Sex and Age in 2002 and 2030
Population of Poland will decrease by 2.5m by 2030, that is by 6%
Ageing of Polish Population
Dependency rate (number of persons aged (65+) for 1 person aged between (19-64)
year
Future trend
Forecast:
median
50% range prediction
80% range prediction
Source: Matysiak A., Nowok B., 2006
Number of persons aged 65+ will increase from 5m in 2004 to 8.5m in 2030
Care provision
0
20
40
60
80
100
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65+
age
%
Women Men
Source: Wóycicka I., Rurarz R., 2007, Ludność sprawująca opiekę, in: Kotowska I.E, Sztanderska U., Wóycicka I. (ed.) Aktywność zawodowa i edukacyjna a obowiązki rodzinne, Wydawnictwo Scholar.
Users of Different Types of Care Provision in Poland
Institutional care Care in Family Network
Care in Nuclear Family
People with higher education
Living in large cities
Living in one generational households (unitary families)
People with at most high education
Living in smaller cities and in the countryside
Living in a multifamily households and having in the household a person aged 50 and more
People living in small cities and villages
People with at most high education
People living in one family households
Current System of Care Provision in Poland
• Polish households (families) provide care in a do-it-your-self style – ¾ of households take exclusive care of children and 4/5 of the elderly;
• External care is provided chiefly by relatives. Members of closer and more distant family provide approx. 4/5 of the amount of child care and almost 95% of the elderly care;
• Voluntary support of non-relatives is of marginal significance;
• The services of care providing institutions account for 12-15% of child care and only 2% of the elderly care;
• Paid market care providers are almost non-existent,
Outflow of Care Workers
• Outflow of Legal and Qualified Care Workers(the monitoring of this type of migration to EU countries is made through registration of number given certificates about professional qualifications.)
Period 2004-2008 – 6,000 medical doctors and approx. 8,000 nurses;
• Outflow of Illegal and Mostly Simple Care Workers
It is estimated that in the care services in old EU-15 works approx. 15% of 1m seasonal, (commuting and temporary) emigrants
Table Occupational situation and education of migrants to Great Britain -2006)
2000-2003 2004-2006** 2000-2003 2004-2006** 2004-2006** 2004-2006**
i 20,5 20,6 19,3 18,6 20,7 20,2
13,4 13,6 12,8 11,9 14,2 14,2Managers/ specialists%) 9,0 10,4 9,2 7,1 42,4 68,3
Średnio- Skilled workers
zawody (%) 43,2 14,9 27,7 15,3 23,2 14,6Semi-routine
occupations (%) 19,8 33,2 17,7 24,5 15,9 9,8Routine
occupations (%) 27,9 41,6 45,4 53,1 18,5 7,3* Czechy, Estonia, Litwa, Łotwa, Słowacja, Słowenia i Węgry.** Obejmuje okres od III kwartału 2004 do III kwartału 2006
Poles Other migrants from Central Europe
Source: Drinkwater et al., (2006)
Age of completing education
Migrants from other Europe
From English speaking countries
Average years of education
Medical and Care Personnel Shortages in Poland (as of 2008)
Free vacancies for care specialists:– 4 113 – medical doctors;
– 3 541 – nurses;– 312 – midwives;– 86 – dentists
Number of nurses per 1,000 inhabitants in 2007
Poland – 4.9;
Norway – 14.84
Great Britain – 12.12
Sweden – 10.24
Ireland – 15.12
Hungary – 8.85
Preferred Care Givers to the Elderly Institution TOTAL For Respondents who do
NOT have children alive For Respondents who
DO have children alive Social Assistance Institutions
57.6 48.9 58.5
Family 54.1 54.0 54.1 Social organisations 21.3 18.4 21.6 Church 15.4 10.4 15.8 Someone else 5.5 4.0 5.6 Difficult to say 7.2 13.3 6.5
Source: Czekanowski, P., Rodzina w życiu osób starszych i osoby starsze w rodzinie (The family in the lives of the elder and the elder in the family) in Synak, B.(ed.), Polska starość, Wydawnictwo Uniwersytetu Gdańskiego, Gdańsk 2003, p.170.
Expectations with Regard to Elderly Care
Institutional Elderly CareInstitutions of Elderly Care in Poland in 1990-2000
1990 1995 1998 2000 Item
Number of stationary care centers in Poland
Elderly Care Center and Houses
(TOTAL):
629 831 960 936
- For the elderly 100 157 201 199
- For durably ill 308 346 259 217
- For mentally ill 218 278 418 405
Inhabitants of the elderly care center
and houses
65,760 76,487 81,950 80,634
Posts for 10,000 persons 17.8 20.7 21.6 21.1
Number of persons on the waiting
list
13,426 10,453 12,378 9,372
Daily Elderly Care Centers
Houses 200 223 191 236
Posts 9,603 11,898 10,032 12,883
Źródło: Rocznik Statystyczny, Warszawa 1998, s 265 Warszawa 1999, s 294, 502: Rocznik statystyczny, Warszawa 2000, s 271-272, 486; Rocznik Statystyczny RP, Warszawa 2001, s 280-281,497 za Trafiałek, 2003, str. 238 .
Immigrants on the Polish Labour Market
• Foreign workers account for less than 1% of all employed;
• Dual labor market:– Legal employment – approx. 20 thousand
(linked to the presence of foreign companies);– Illegal employment – from 50,000 to 0.3m
(concentrated in construction, agriculture, home care and palliative care)
Public Policy towards Social Care
• Sector of child care– Attempts to extend institutional child care to rural
areas;– More generous and longer financing of maternity
leave;
• Sector of elderly care– Failed attempt to introduce an elderly care tax;– Quality control of an increasing number of „elderly
social care houses”– Modest financing of rehabilitation elderly care
Directions of Change in Elderly Care
1. Development of alternative forms of local care especially in rural areas – neighborhood care, social cooperatives etc.),
2. Increasing role of local governments;3. Support for training of nurses and the development of quality
certification system) 4. Subsidizing costs in order to reduce financial access barrier
Care insurance Support for development of local social services
At Crossroads: the Future of Arrangements of Care in
Poland• Uncertainty about the capacity of Polish
families to provide the care (although it is socially preferred care provision model)– Factors of change: ageing of society, transformation of
family, labor market mobility;
• Incomplete institutionalization of (especially) elderly care with confusion about the instruments of public responsibility– Government as provider, government as payer, government
as quality guard.