Only 3.5% of the elderly in Catalonia have a public caregiver at home

“We are facing an overflow of the containment function of social services. And the most necessary and complex service they manage is underfundedgive one derisory attention and submits its workers to the precariousness“, He says Natalia Rosettianalyst of Catalan Institute for the Evaluation of Public Policies (Iválua). It refers to the SAD, the Servei d’Ajuda a Domicili, a service of public carers offered by the municipalities to the dependent people who live at home but cannot care for themselves. Two years ago, the Generalitat commissioned Ivàlua analysts to evaluate this service. The report, to which he has had access THE NEWSPAPER, it is devastating. Despite being more than necessary than ever, it has serious shortcomings: very few hours of care, waiting listslack of resources, inequality between counties and job insecurity of its workers, mostly women. “There is a long way to improve”, summarizes Mireia Borrell, analyst and co-author of the report.

Near 70,000 dependent people in Catalonia open the door, every day, to a person who cleanthem kitchenthem help to make the purchase or them clean the housewith public resources: they They do not have to contract any external service, but rather it is organized by the municipal social services. A basic service, taking for granted the aging of the population and that most dependents want to avoid, as much as possible, having to enter a nursing home. But, according to Ivàlua’s report, only the 3.5% of people over 65 receive this care, although the Catalan social services law dictates that at least 4% coverage should be achieved. The first provisional data show that in 2020 not even 3% of people over 65 years of age were reached, and less than 20% of dependents.

half an hour a day

This home help service is financed mainly with money from the Generalitat and the central government, which provide the 66% of the financing, while the rest of the cost is assumed by the municipalities. In 2019, the SAD cost €172 million, of which the Generalitat contributed 92 million. Is he main service that Ministry of Social Rights finance the municipalities. But this contribution is insufficient. According to the latest data published by the Government, a user of this service receives on average 30 minute attention each day. The fork is between 20 and 40 hours per month, so those who receive the maximum benefit have two hours a day of caregivers. “It is derisory“Rosetti says.

“In order to offer continuous care we should multiply the budget by 17. The Generalitat does not have that money,” says Anna Palou, technique of the ‘conselleria’. “Here arises the problem of the economic inequality: whoever can afford it hires caregivers for the rest of the day. But, what happens to those who can’t?” asks Borrell.

Waiting list

The SAD is divided into two types of services. The one that is processed through aid and assessment by the dependency law (SAD dependency), and the one that obeys a social criterion, dictated by the social services (SAD Social). The first serves 60% of users. The report shows that, as the dependency waiting lists have increased, those served by SAD Social have increased by the number of people on the waiting list for the dependency SAD or for a place in a residence. This means, according to the technicians of the Generalitat and the Ivàlua report points out, that the SAD Social has lost its function, which is preventive and that it is not only aimed at the elderly or dependent people, but also at vulnerable families.

Abandonment in the villages

The report also denounces the territorial inequality. Rural, mountain, and more depopulated areas have a 46% less offer from the SAD and perceive, on average, four hours less attention weekly. Transportation to get to the homes of these people increases the cost of the service by 2.51 euros per hour. “When the mountain population increases by 1%, the intensity of the service falls in half an hour,” the study concludes. For example, Tarragonès, Vic, Palafrugell, Baix Empordà or the community of La Plana have the lowest rate of beneficiaries and hours of care. In Urgell, Garrigues, Segrià, Calafell, Baix Penedès, Blanes and Vall d’Aran, they do not reach 1% of those over 65 years of age.

“This inequality is worrisome,” says the study. “The SAD is the best service in these municipalities without resources for the elderly and with high rates of aging,” the report added. “The configuration of the SAD and its financing should address these situations: it is not fair“, he insists. The report also reveals that, although rural municipalities have less coverage, urban municipalities that serve more people, in turn, serve them fewer hours. “It is a game of balances between necessity and costsBorrell says.

Precariousness and subcontractors

This week the workers of the SAD in Barcelona protested the precarious conditions of their work. The report proves them right. “The quality of service is affected by outsourcingwhich can be a source of efficiency, but it also means a loss of control of the service and precarious working conditions”, say the analysts in the document. Only 8% of local entities provide the service directly. The remaining 92% is subcontracted or outsourcedeither totally or partially.

“There are many women in this service with part days that do not reach the end of the monthand the rotation in service is constant, so lack of training“, says Borrell. The Generalitat technicians recall that in 2020 the Government raised the price they pay for each hour of service, and they say that they have begun an accreditation process to prevent large multi-service companies from doing business at the expense of customer service the most vulnerable “We must pay better, strengthen and dignify the care system,” adds Rosetti.

gender blindness

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Iválua’s report uses the concept ‘gender blindness’ at various times. This home care service is practically female: 70% of the users are women, as are their workers. However, there is no public policy addressed to address this issue from this perspective. “We meet many women who They do not want the SAD because they have assumed that they are the ones who have to do these tasks, and therefore have fewer hours of service than men, when perhaps they need it equally. and there is also much rejection of jobs being done by menBorell explains.

telecare

Faced with this reality, the Government is working on a new home care system. The project bears the acronym ‘SAED’: Home Environment Help Service. The appearance of the word ‘environment’ is not trivial. “We are working on being able to strengthen the tele-assistance services of the Provincial Councils, which are already applying detection sensors and the use of artificial intelligence in homes, and complement it with SAD workers but also the environment of these people,” says Palou. . “This village store that knows all the elderspharmacies, the neighborhood… we cannot take a lady out of her house because the house is not adapted and take her to a new neighborhood where she doesn’t know anyone”, continues Palou. “Deep down, it’s about believing the Welfare State: care. We believe that this is just as important as health, education or pensions“, Rosetti insists.

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