Health professions, the state and the family: a comparison of the governance of home care services in family-centred European countries
Department of Social and Policy Sciences Univesrity of Bath Bath, United Kingdom
One of the most topical and problematic issues to be faced by the European countries is their progressively ageing population. This process will incresingly require the establisment of well-designed long-term care systems in order to meet the needs of frail older people.
Only few studies have focussed on this topic, and a number of aspects are still underdeveloped, on top of this the role of the family as a key actor in the provision of home care.
This paper seeks to explore the governance of home care in two traditionally family-centred countries, namely Italy and Spain, focusing in particular on the functions performed by the family as primary informal caregiver and taking also in account the gendered dimensions of home care. Analysis of key policy documents and expert interviews carried out with providers and users of home care services in the two countries will serve the analysis.
The aim of the paper is two-fold: first, to explore whether the shared belief in the concept of 'family' as the main welfare provider in these countries is one of the key reasons of the scarce presence of the state in key areas of social policy, such as the home care services for the elderly; second, to illustrate the intersections between changing gender relations and governance arrangements, thus crossing the public-private divide embedded in the provision and the governance of home care.