1. Introduction
In the past two decades, in response to growing social needs, a large private market for long-term care has significantly expanded in many European countries (Pavolini and Ranci, Reference Pavolini and Ranci2008; Shutes and Chiatti, Reference Shutes and Chiatti2013). Scholars have mainly explained this process on the basis of functional arguments related to the search for greater efficiency and effectiveness (Le Grand, Reference Le Grand2009) or institutional theories focused on welfare retrenchment (Grootegoed and van Dijk, Reference Grootegoed and van Dijk2012) and an increasing gap between care needs and shortage of public provision (Pavolini and Ranci, Reference Pavolini and Ranci2008). However, few studies have empirically considered the important role played by ideas and beliefs in this process (see Daly and Lewis, Reference Daly and Lewis2000; Burau et al., Reference Burau, Zechner, Dahl and Ranci2016): a surprising fact if long-term care privatisation is to be considered a paradigmatic policy change (Hall, Reference Hall1993), involving the framing and diffusion of new ideas concerning the quality of care work and the attribution of care responsibility among the State, the market and households.
In an attempt to fill this gap, this paper assumes that care privatisation entails not only a new public regulation but also an ideational process whereby a new cultural frame is defined to provide the public with new concepts and rationales (Beland, Reference Beland2015; Burau et al., Reference Burau, Zechner, Dahl and Ranci2016). In this process, the public debate about what care is, what the main contents of care work are, and what the social role and human characteristics of care workers are, is crucial if people are to accept a major policy change by which expectations and new notions concerning social rights and responsibilities are to be shared.
Our interpretation of the role of ideas in policy change is based on the assumption that new policy paradigms (Hall, Reference Hall1993) do not only reflect policy aims and values, but they also provide a new definition of the problem which policy change is aiming to solve. Third-order policy change (ibid) depends on the capacity of a new paradigm to be recognised in the public arena and to obtain a general consent. Therefore, our research question is: What has been the process through which care marketisation has entered the public discourse and obtained general consent?
Beland (Reference Beland2015) recently proposed to use Kingdon's agenda setting approach (Kingdon and Thurber, Reference Kingdon and Thurber1984) to reconstruct the complexity of such an ideational process. According to Kingdon, agenda setting is a process by which various policy actors – including policy makers, public interest groups, experts and media actors – contribute to ideologically framing a public discussion about a specific social problem and drive the general public to accept a specific problem definition and consequent policy solution. Three main streams have been identified by Kingdon in the agenda setting process linking public discourse and policy making process together: a ‘problem stream’, through which the public becomes aware of specific problems presented as being of public interest and waiting for a policy solution; a ‘policy stream’ where various alternatives are discussed in terms of their specific contents by experts and competent actors; and a ‘political stream’ where political entrepreneurs play an active role in linking problems to policy solutions given specific institutional opportunities. Even though policy ideas are often rooted on previous institutional settings and ideological beliefs, the framing process by which problem definitions and policy alternatives are publicly discussed in a multiple stream setting is characterised by an ideational dynamic by which a new policy paradigm is proposed, accepted and developed in specific policy decisions.
Adopting this approach, in this paper we reconstruct how care marketisation is the result of a public discussion through which specific problem definition and policy solutions are framed and obtain a large public consent. It is through this process that not only the institutional design of the care market is legitimised, but also actors operating in the care market, including care workers, are recognised as ‘adequate’ by policy makers, technical actors and the general public. In a policy field where service quality and effectiveness mainly depend on human relationships (Williams, Reference Williams1999; Daly, Reference Daly2002), the role and characteristics assigned to care workers are indeed crucial aspects (Lewis and West, Reference Lewis and West2014; Leon, Reference Leon2014).
The case of Italy is very interesting in this respect for many reasons. First, elderly care in Italy has long been rooted in a familialistic regime (Bettio et al., Reference Bettio, Simonazzi and Villa2006) implicitly supported by public cash-based programmes, and it has suddenly turned to privatisation in less than a decade. Secondly, this turn has been strongly favoured by a massive inflow of migrants from poor countries: a new phenomenon for the country that has required a strong and difficult cultural re-orientation to the values of diversity and multi-ethnicity (Bettio and Solinas, Reference Bettio and Solinas2009; Leon, Reference Leon2010; Da Roit et al., Reference Da Roit, Ferrer and Moreno Fuentes2013; Ranci and Sabatinelli, Reference Ranci, Sabatinelli and León2014). Finally, as public elderly care policy has been markedly inert (Costa, Reference Costa, Ranci and Pavolini2012; Ranci and Pavolini, Reference Ranci and Pavolini2012), the shift to the market has mainly occurred through a bottom-up process driven by spontaneous dynamics of supply-demand matching. This sharp change towards care marketisation has involved an animated public discussion not so much on the role and responsibility of the state and family in providing care as on the social status and suitability of migrant care workers (MCWs).
Although in Italy, as well as in other Mediterranean countries, the influx of migrant workers into the care field has been so massive that it has caused a substantial change in the entire elderly care system, MCWs have recently also played a relevant role in care marketisation in many other European countries. Marketisation has occurred in two main ways: through the growth of an organised social care market dominated by private professional agencies, and/or through the creation of an individual market where individual care assistants are directly hired by people in need of care. In both cases, the progressive increase in the number of foreign workers into the care field has been a crucial pre-condition because it has allowed a significant reduction of wages (and of related service fees) and greater flexibility in care delivery. Indeed, MCWs have become an important component of the care workforce in a number of European countries (Leon, Reference Leon2014). In the UK, recourse to MCWs has been promoted as a way to solve increasing difficulties in the recruitment of care workers for older people, and it has combined with greater recourse to private providers for home or residential care services (Cangiano et al., Reference Cangiano, Shutes, Spencer and Leeson2009; van Hooren, Reference Van Hooren2011; Shutes, Reference Shutes2012). In Germany and in Austria, unconditional public money transfers and deregulation of the labour market have jointly triggered a significant expansion of non-standard employment and a lowering of wages and quality standards in care provision strongly fostered by the emergence of a foreign care workforce (Theobald, Reference Theobald2012). Also in France, cash-for-care programmes for older people, together with rising unemployment, have favoured the participation in the care market of low-skilled people and unemployed people, with a high proportion of ethnic workers (Le Bihan and Martin, Reference Le Bihan and Martin2012). The Italian case, therefore, exemplifies trends occurring in many other European countries.
Our analysis of the Italian case will show that the shift to the care market is predicated on the incorporation into the labour market of MCWs in a subordinated social position. Moreover, we will demonstrate that this marginal role has been constructed on the basis of rationales and social representations produced and shared in the public arena, setting the stage for a specific problem definition and policy orientation (as supposed in Kingdon's agenda-setting approach).
While previous research has already reconstructed the policy making process through which MCWs and care markets have been regulated in Italy (van Hooren, Reference Van Hooren2008), this paper is focused on the agenda-setting streams through which care marketisation has been widely accepted by the public in Italy. It provides, at the same time, a clear legitimation of the subordinate role played by MCWs in this market. Therefore we have empirically analysed the ‘problem stream’ and the ‘political stream’. The former regards ideas expressed in public discussions concerning the relevance of care problems in the population as well as the need to provide MCWs, and families employing them, with a public regulation. The latter is related to political discussions which have taken place in the Italian Parliament whenever important official decisions about the issue have been made.
The first research was carried out through the content analysis of a huge set of articles (5,886) from the two main Italian newspapers – Repubblica and Corriere della Sera – covering the period from 2002 to 2012. The articles were chosen according to a chronological grid linked to the most significant normative acts concerning care policies and MCWs (especially amnesties and entry quota decisions). In order to follow criteria of relevance, we considered for the analysis articles published three months before and after these events. Analytical categories were built bottom-up through content analysis. Once categories were saturated, they contributed to build ideas and social representations of the care market and MCWs that have played a dominant role in the public discussion.
In order to reconstruct the ‘political stream’, we considered the debates held in the Italian Parliament (Chamber of Deputies) during the same period (2002–2012), taking into account speeches and official statements given by the most important and representative political parties at the time. The selection criteria used to collect the transcripts of the discussions (40 Parliament Acts) were the same as those adopted for the newspaper analysis.
The paper is organised in two parts. The first part briefly reconstructs the regulation of the care market in Italy, considering the role played by MCWs at the intersection of three different regimes: the care regime, the labour market regime, and the migration regime (Williams, Reference Williams2012). The second part reconstructs the social recognition of MCWs conveyed through the public discourse developed in the problem stream and in the political stream. Conclusions will draw together the main empirical and theoretical outcomes of this analysis.
2. The rise of the new care market and the role of MCWs in Italy
Italy, as well as other Mediterranean countries, has mainly relied on families for providing care to dependent older people. However, demographic and cultural changes have recently challenged this model: the ageing population and increased female participation in the labor market have caused more care needs and a reduction in the caring time of women (Ranci and Pavolini, Reference Ranci and Pavolini2012; Ranci and Sabatinelli, Reference Ranci, Sabatinelli and León2014). This growing demand for care has coincided with a lack of public provision of long-term care (LTC) services and enduring institutional inertia. The only national LTC programme is still a universal unconditional cash-for-care measure, introduced in 1980, while the provision of in-kind services is very limited and mainly delegated to local authorities (Ranci and Sabatinelli, Reference Ranci, Sabatinelli and León2014).
In this context, the social pressure for greater care provision has been recently met through the development of a huge private care market, based on the supply of individual MCWs. Unlike what happens in many continental and Anglo-Saxon countries, in Italy the lack of organised care providers has led to a large proportion of domestic workers being employed by families. It has been estimated that 9 per cent of people aged 65+ employ an individual care worker (Gori, Reference Gori2012), and that private expenditure for employing care workers is more than twice as high as the total public expenditure in home-care services (Pasquinelli and Rusmini, Reference Pasquinelli and Rusmini2008).
The growth of this large care market has become possible thanks to the huge influx of migrant care workers (MCWs). Since 2001, the ethnic component of the care labour force has hugely increased (Da Roit et al., Reference Da Roit, Ferrer and Moreno Fuentes2013). In 2012, the MCWs were estimated to be 830,000 according to the most accurate calculation (Pasquinelli and Rusmini, Reference Pasquinelli and Rusmini2013). While foreign care workers in other European countries are mainly second– and third – generation migrants and consider employment in the care sector to be an opportunity for a professional career and stability (Rostgaard et al., Reference Rostgaard, Chiatti, Lamura, Pfau-Effinger and Rostgaard2011), in Italy care work is the main entry work for female first-generation migrants, providing them with a job and accommodation. In fact, in 2012 more than 50 per cent of the female foreign population in Italy was employed by households as in-house care workers.
The growth of this private care market has been explained on the basis of two different approaches: economic theories and institutional theories.
Economic theories have considered the mutual convenience of individual employers and migrant workers to create a transnational care market (Massey et al., Reference Massey, Arango, Hugo, Kouaouci, Pellegrino and Taylor1993). According to this approach, migrant workers accept employment in segregated labour markets on the basis of a transnational comparison of job opportunities and of their temporary migration status (Bettio and Verashchagina, Reference Bettio and Verashchagina2010; Riva and Zanfrini, Reference Riva and Zanfrini2013). On the one hand, migrants want care jobs while national workers are less attracted. On the other hand, families employing these care workers, often on an undeclared basis, can save on their total costs. Information asymmetry and cost disease problems (Esping-Andersen, Reference Esping-Andersen1999) preventing the growth of a care market can be therefore overcome thanks to the presence of a considerable migrant labour force accepting low wages and bad working conditions.
Institutional theories have considered rules and specific requirements with which migrant workers have to comply in order to provide care (Rostgaard et al., Reference Rostgaard, Chiatti, Lamura, Pfau-Effinger and Rostgaard2011; Shutes, Reference Shutes2012). In this perspective, authors have stressed that the lack of public provision of care services and the weak public regulation of the care labour market (Rostgaard et al., Reference Rostgaard, Chiatti, Lamura, Pfau-Effinger and Rostgaard2011; Chiatti et al., Reference Chiatti, Di Rosa, Barbabella, Greco, Melchiorre, Principi, Santini, Lamura, Troisi and Von Kondratowicz2013) have paved the way for the growth of the private care market, a solution considered as ‘a low road to care provision’ (Bettio et al., Reference Bettio, Simonazzi and Villa2006; Simonazzi and Picchi, Reference Simonazzi, Picchi, Bettio, Plantenga and Smith2013).
Nevertheless, two aspects of the Italian care market are not fully explained by these theories. First, since the 2000s the Italian policy on immigration has not been tolerant and low profile, but highly restrictive. The huge growth in numbers of MCWs occurred in a period in which the government was mainly held by a coalition of the conservative party and of the most xenophobic party in the country (Lega Nord). Electoral campaigns were won by this coalition in 2001 and 2008 through strong populist and racist calls against the illegal presence of migrants and requests for high limitations in their in-flows. Secondly, in the last decade LTC policies have seen a huge increase, and not a reduction, in the public spending basically focused on traditional cash-based benefits.
How do we explain that restrictive legislation on migration and an increase in LTC public spending have de facto facilitated care marketisation based on the permanence of undocumented/irregular migrant workers?
To answer this question we need to consider first how public regulation has been adapted to foster the growth of such a huge private care market. Quite paradoxically, LTC policies have played a less important role than migration policies. In the last two decades there has been a huge increase in the take up rate (up to 10 per cent) of Indennità di accompagnamento, the universal cash-based measure for totally dependent people, which has existed unchanged in Italy since 1981. Its unconditional character has implicitly encouraged households to use public cash to cover the costs of this market arrangement (Fujisawa and Colombo, Reference Fujisawa and Colombo2009; Da Roit and Le Bihan, Reference Da Roit, Le Bihan, Pfau-Effinger and Rostgaard2011).
While care policy has provided an indirect, though crucial, financial support to market development, the latter has been mainly regulated through migration policies. This fact has set the stage for the institutional construction of an illegal care labour market (Cangiano et al., Reference Cangiano, Shutes, Spencer and Leeson2009; Chiatti et al., Reference Chiatti, Di Rosa, Barbabella, Greco, Melchiorre, Principi, Santini, Lamura, Troisi and Von Kondratowicz2013; Shutes, Reference Shutes2012; Shutes and Chiatti, Reference Shutes and Chiatti2013; Sciortino, Reference Sciortino, Jurado and Brochmann2013). Here three main mechanisms, already identified by Anderson (Reference Anderson2010) in her analysis of the English case, have been at work.
First of all, a shadow channel of entry into the country has been created. The huge flow of migrants entering the country since the late 1990s has been controlled through two main policy instruments: recurrent amnesties and a yearly quota system (van Hooren, Reference Van Hooren2008). From 1997 to 2012 four general amnesties were established providing 750,000 MCWs with a legal status (Costa, Reference Costa, Ranci and Pavolini2012; Da Roit et al., Reference Da Roit, Ferrer and Moreno Fuentes2013; Pasquinelli and Rusmini, Reference Pasquinelli and Rusmini2013). Furthermore, a quota system was introduced to allow entry into the country of a limited amount of MCWs already provided with a work contract (Chaloff, Reference Chaloff2008; Shutes, Reference Shutes2012; Sciortino, Reference Sciortino, Jurado and Brochmann2013). The administrative procedure for entering the quota system was very intricate, requiring the job contract to be already signed before workers could obtain a residence permit (Fujisawa and Colombo, Reference Fujisawa and Colombo2009; Di Santo and Ceruzzi, Reference Di Santo and Ceruzzi2010; Riva and Zanfrini, Reference Riva and Zanfrini2013). As a consequence, only a low quota of MCWs was officially allowed to enter the country and the great majority of them entered illegally: according to estimates, 63 per cent of MCWs entered Italy with a tourist visa; 18 per cent did not have any sort of permit; 8 per cent had a seasonal work permit and only 4 per cent had a regular job contract as care assistant (IREF, 2007). This fact explains the high share of undeclared MCWs: according to Pasquinelli and Rusmini (Reference Pasquinelli and Rusmini2013) 26 per cent of MCWs were undeclared migrants and 36 per cent had a permit but worked with no contract; finally, even most of the MCWs with a work contract (36 per cent) were in a grey area, working more than they had been contracted to do.
Secondly, MCWs have been inserted into a marginal labour market. If care work was a chance for many migrants to enter the labour market, such a market did not give most of them standard employment (Rostgaard et al., Reference Rostgaard, Chiatti, Lamura, Pfau-Effinger and Rostgaard2011; Shutes, Reference Shutes2012). The care market was shaped as a secondary market typical of dual labor market regimes (Piore, Reference Piore1980), characterised by a lack of regular work contracts and widespread informality, low wages (the gross salary is very low when compared to other social or health care jobs, ranging from €800 to €1,100 per month), poor qualification and high risk of entrapment (Pasquinelli and Rusmini, Reference Pasquinelli and Rusmini2013).
Thirdly, work precariousness and restrictive access to legalisation have exposed MCWs to a permanent condition of uncertainty (Anderson, Reference Anderson2010). After four general amnesties, the majority of them are still undocumented or without a job contract. Regularisation, which implies the drafting of a regular work contract and obtaining the legal permission to stay in the country, is simply too costly for families, and administrative procedures are very complex and time consuming. Moreover, public controls are so weak that families have no great incentive to regularise MCWs. For workers, nevertheless, the overall impact has been the institutionalisation of a condition of subordinate integration (Ambrosini, Reference Ambrosini2013). This condition is due not only to a difficult regularisation, but also to the high risk of losing the status of declared migrant because of the short-term character of care work, the lack of professional recognition, and the difficulty of exiting from the care labour market.
To sum up, the regulatory regime emerging in Italy is built on the institutional construction of the MCW as an illegal and undeclared worker. Generous unconditional cash-for-care transfers to households, permanent use of the quota system to legalise workers already in the country, and the lack of a nation-wide definition of the professional profile of care work, have together played a role in building the social status of MCWs as characterised by illegality, precariousness, high flexibility and low costs. This is the social status which Italian families have come to accept as part of their everyday lives, and which is incorporated in the regulation here described. In the next section, we will show how this subordinated incorporation has been represented and gradually accepted in the public discourse and in the political discussion.
3. From migrants to ‘the new welfare’: the problem and political streams
Our analysis found a parallel between how the problem stream has been structured in the media discourse and how this has been reflected in the political stream. We identified three main phases through which the social and political representation of MCWs took shape. From the very outset, MCWs have been a sensitive topic. In the first phase, from 2002 to 2004, public opinion and institutional actors became aware of this presence and accepted it as a ‘spontaneous’ solution to the problem of ageing. The second phase, from 2005 to 2008, is characterised by a progressive assimilation of the private care market into a ‘new welfare system’. Finally, at the end of the decade (2009–2012), the subordinate position of MCWs was not only institutionally constructed, but also socially and politically supported.
3.1 The first phase: MCWs as a ‘natural’ solution
Our analysis moves on from 2002, when a new Migration Law (called Bossi-Fini Law after the names of the proponents) was enacted under the second Berlusconi government in order to regularise immigration flows by introducing more severe procedures for expulsions, residence permits based on employment conditions, and harsher penalties for human smugglers. These measures reflected the anti-migration orientation of the two main parties included in the government alliance together with Forza Italia (Berlusconi's majority party): Lega Nord, a xenophobic, autonomist party rooted in Northern Italy and led by Mr. Bossi, and Alleanza Nazionale, an extreme right-wing party with Mr. Fini as leader. This law had two relevant outputs: first, it introduced a regulation of immigration based on restrain rather than on reception; secondly, it implied the first explicit amnesty (sanatoria) providing regularization for MCWs having a work contract. This measure institutionalized the special status of MCWs compared to other migrants. While other migrants were targeted with restrictive measures, MCWs benefitted from a special treatment. This law provided a policy paradigm in the field of migrant care workers regulation that is still valid nowadays, though it has been criticised on many different accounts. Political debates concerning the Bossi-Fini Law were long dominated by the heated confrontation on the conditions and treatment of undocumented migrants, but they did not include MCWs, although most of them were undocumented and not regularly employed. The special treatment of MCWs was the only migration-related topic on which almost all of the political parties agreed. The topic came to the attention of the media and politicians as a social and economic problem (Beland, Reference Beland2015), not only because of its statistical relevance, but also because of sensational events involving migrant care workers and publicised by newspapers.
Before the approval of this law, many newspapers dedicated considerable attention to the figure of the migrant care worker, more commonly called ‘badante’ (‘No Limits for badanti’, Corriere della Sera, 13/07/2002), showing a growing awareness of their relevance for Italian families. They were often described as indispensable for families as well as for the structure of the Italian labour market: MCWs ‘rescue the female Italian labor force’ (Corriere della Sera, 13/07/2002) from being forced to stay at home caring for dependent family members. In this phase, both the problem and policy streams admitted the Italian families’ need for MCWs, without lingering on the causes: that is, the accelerated ageing of the population and the increase in female participation in the labour market.
MCWs were described as the almost perfect solution: the characteristics of these workers overlapped precisely with the needs of Italian families for care services. MCWs did not ask for regular contracts, they were cheap and willing to work as many hours as possible and live at their employers’ houses. In this phase, public opinion did not discuss the absence of any other solution proposed by the government nor the working conditions of MCWs. At the same time, institutional actors relegated the discussion on MCWs to debates on immigration, and did not connect the issue to the more general structural shortcoming of public care service provision. Simultaneously public opinion was more concerned with the ‘integration’ issue. MCWs were seen as unknown, invisible strangers, hard working but not easily integrated in the Italian society because of language and cultural distances (‘Badanti do not speak Italian and need to be sent to school’, Corriere della Sera, 08/12/2005). The lack of ad hoc policies, the paradoxical situation of MCWs as undocumented but welcomed migrants, and their often-inadequate working conditions, at this point were not considered within either the problem stream or the political stream.
After the debate and the approval of the law, newspapers demonstrated a growing curiosity for this population. MCWs were no longer considered a luxury good, but rather a necessity. Corriere della Sera (06/09/2002) described MCWs as ‘an army of men and women caring for children, doing the housework, taking care of older people and sick people’. The term ‘army’ implied an impressive amount of people, but a numeric estimate was not provided. Two aspects particularly attracted public opinion during this first phase: MCWs were mostly undocumented and/or irregular workers, and households often assimilated them as family members. La Repubblica titled an article (28/08/2002): ‘Le clandestine di famiglia’ (The family's illegal migrants). The choice of the term ‘clandestine’ was particularly significant: it usually indicates undocumented migrants and is easily connected to the idea of ‘criminal’. Placed together with the term ‘family’ it assumed a different meaning: it lost its pejorative connotation by virtue of the inclusion of MCWs into Italian families. MCWs’ illegal status was not only widely tolerated compared to the restrictive attitude towards irregular immigration, but it was accepted as a peculiar characteristic of these workers. Assimilating MCWs as family members implied that they could not be the target of restrictive measures like other migrants: their inclusion in the family gave them the right to be protected. Neither public opinion nor the press mentioned the convenience for Italian families of employing illegal workers. It is interesting to notice how this protection was accepted to the extent to which it was useful for Italian families: MCWs were protected from expulsion or penalties even if undocumented, but this right to a sort of protection did not include adequate working conditions. MCWs were therefore identified in the problem stream with characteristics perfectly consistent with the orientation that was prevalent in the political stream, which legitimised a partial, tolerant acceptance of the widespread presence of these workers in many Italian households.
3.2 The second phase: the public acceptance of the ‘new welfare’
In the years following the approval of the Bossi-Fini Law, two topics were especially emphasised in the agenda setting process:
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a) The substantial economic effort that families had to sustain to regularize MCWs, claimed especially by the small, though highly influential, Catholic party (UDC) included in Berlusconi's government;
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b) The lack of public care services: according to many experts, making the status of MCWs legal should not have been the only measure employed by the government to deal with the ‘older people emergency,’ and the government should have provided a public integrated system of care services.
However, the government (still led by Berlusconi and his coalition) did not substantially satisfy the demand for new welfare measures. Apparently, the pressure of the demand for new care service measures was not as compelling as in other countries, since the migrant labour force already answered families’ needs (van Hooren, Reference Van Hooren2011).
In March 2004 an important report on the social situation of the country (CENSIS, 2004) brought the issue of public welfare shortcomings to the forefront again. A new phase started: MCWs were recognised as the ‘new’ welfare system, in place of the traditional welfare state. The media were divided mainly into two camps: on the one hand, they disseminated statistical data and experts’ commentaries and, on the other hand, they reported stories about dependent people experiencing hardships connected to care service shortcomings. Heated criticism against public welfare characterised conservative comments in this period. An article from Corriere della Sera (13/06/2004) was titled ‘MCWs, the new private welfare. They help older people and the government economizes.’ The debate shifted gradually towards the role of the government, which seemed to have taken advantage of this private market, even though it was mostly illegal. While the government, after promulgating the regularisation in 2002, remained quite silent about this topic, anti-government newspapers fostered the debate. La Repubblica (25/01/2005) started to warn against the dangers of considering MCWs a never-ending resource. This labour force was, in fact, a non-controlled resource motivated by migratory international trends exposed to change. The central point of this debate was that: ‘The issue of public investments in care provision for older people is never faced because there is always someone who solves it privately’. While public opinion exposed the government's detachment, political parties in the government, especially the Catholic one (UdC), addressed the topic by publicising the economic strain on families of assisting their dependent members. The main claim regarded the economic burden on families paying for private care services. This narrow approach led the government to focus its attention only on the ‘Indennità di accompagnamento’, the cash-for-care measure mainly used by families to pay MCWs, and to neglect any innovation in the public care system. On the working conditions of MCWs they still remained silent.
However, MCWs started to be considered as the cornerstone of the new Italian care system. A clear recognition of this fact occurred in 2005, when the 2006 Budget Law introduced many financial cuts in the public assistance system and, at the same time, a new migration quota dedicated to MCWs was defined by the right-wing party Alleanza Nazionale as ‘a measure of welfare policy’ (24/01/2006). Some scholars spoke of a transition from a ‘family’ to a ‘migrant in the family’ care model (Bettio et al., Reference Bettio, Simonazzi and Villa2006).
At this point, estimates of this presence appeared in the press. Milan, for example, was depicted as completely dependent on MCWs, given the high number of dependent people and the increasing number of working women. La Repubblica (11/05/2006) reported a statement by Caritas experts: ‘If MCWs went on strike, the country would stop’. This evidence introduced a feeling of fear in the problem stream: the fear of depending on a foreign population for an essential need, and the fear of foreign cultures entering Italians’ homes. Articles reporting episodes of mistreatment and violence against older people appeared in newspapers, while MCWs’ integration seemed to become a utopic goal. The press often highlighted linguistic and cultural difficulties and some politicians suggested a sort of integration pathway for MCWs, including not only Italian language classes but also, for example, Italian cuisine lessons in order to meet the specific needs of Italian older people. At this point, the collective representation of MCWs was twofold. On the one hand, they were depicted as ‘angels’ saving Italian families and even government from high costs in providing social care services while, on the other hand, they were labeled as ‘criminals’ or ‘scroungers exploiting older people's weakness’.
3.3 The third phase: the social construction of the uncertain status of MCWs
With the onset of the financial crisis in 2008, many political parties suggested a restriction on the entry flows of migrants into Italy, proposing the adoption of a so called ‘linea dura’ (term used by Lega Nord), meaning a less tolerant attitude toward migration flows. Once again, MCWs were saved from this restriction. Despite the new waves of xenophobia caused by the shortage of employment opportunities and public resources, MCWs were not considered to be in competition with Italian workers. Instead other migrant workers were accused of stealing jobs from the Italians, not paying taxes or working illegally. Accusing MCWs of evading taxes or working without a regular contract would have had direct consequences for Italian families as employers, and would have forced the government to promote unpopular measures. The silence on these conditions supported families and the government in promoting the status quo.
Even the xenophobic party Lega Nord, which had promoted the hardest measures against undocumented migrants, showed a completely different attitude toward MCWs. The new leader of the party Maroni stated ‘All clear for MCWs: one who works is different from one who breaks the law’ (Corriere della Sera, 18/05/2008). Families’ needs ‘even overrule anti-immigrant sentiments or labor market considerations’ (van Hooren, Reference Van Hooren2011: 73).
Obviously, the crisis exacerbated criticisms against the State, especially concerning the provision of adequate help for families to support care costs. After 2008, the concern about the economic burden on families due to their employees became a major issue in the problem stream. Although previous regularisations implied high costs for families, the press claimed that it was a benefit both for migrants and families: ‘MCWs are not the only ones to deserve the regularization; Italian families deserve it as well’ (Corriere della Sera, 18/06/2008). These criticisms led politicians, especially the Minister of the Interior, Maroni, (Lega Nord) to plan a new amnesty in 2009, calling it ‘regolarizzazione’ (legalisation) in order to distinguish this intervention from the previous ‘sanatoria’ (amnesty). The pivotal difference introduced was that the ‘sanatoria’ had provided stay permits based on residence on Italian territory, while the ‘regolarizzazione’ linked the regularisation to a work contract. By modifying the name, the government wanted to present the new Amnesty Law as a turning point. While the ‘sanatoria’ was seen as an old-fashioned last-minute measure to legalise the status quo, the ‘regolarizzazione’ was intended to provide fair work conditions to migrants and families. Despite this intention, the amnesty was reported as a failure by the press, considering the low amount of migrant workers who were regularised: 150,000 MCWs against an estimated 300,000.
Newspapers also reported the vivid debate among political and social forces regarding the destiny of illegal MCWs. They highlighted in particular how the opinion of Lega Nord (still in the government) on the regularization of MCWs had changed due to the pressure of public opinion. After reporting declarations such as ‘MCW's regularization: Lega says no’ (Corriere della Sera, 06/07/2009), some days later newspapers emphasised the change of mind in the government: ‘Regularization will be selective: it will concern only family workers’. The role of Catholic social forces was quite incisive: they described the MCW population as the ‘best face of immigration’ (Corriere della Sera, 07/07/2009). Although the traditional family's structure had changed hugely with the entry of women into the labour market, the idea of the traditional family was still one of the pillars by which the rhetoric justified the shift to the market.
In the debates preceding the 2009 regularisation law, MCWs were never addressed in Parliament as ‘clandestini’ (aliens), irregular or undocumented, despite their illegal conditions. Their status of irregularity did not coincide with the representation that was dominant in the political stream. The distinction thus was not between undocumented and documented migrants, but rather between ‘good’ immigrant workers (where good meant useful to Italian society) and ‘bad’ migrants. The fact that some of the MCWs were still undocumented was described as the result of shortcomings in the migration policy.
After 2009, the topic of MCWs was slightly neglected by the policy stream, apart from a few political actors such as the Lega Nord Party. Representations of MCWs became more complex, exploring multiple aspects of their lives. The topic of MCWs became more and more related to various issues: it was not only linked to migration policies, but it was increasingly connected to welfare and labour policies. Nevertheless, this opening towards the MCW population in order to foster their integration was counterbalanced by xenophobic attitudes enhancing fear and worries. For example, in May 2012, Lega Nord reported the phenomenon of marriages between care workers and the cared for with an alarming tone and depicted MCWs as ‘scroungers’. At the same time, studies on MCWs were spreading a wide range of stereotypes and descriptions. MCWs were depicted as victims: ‘illegal, underpaid and invisible. Italian welfare falls without them’. In other cases, they were described as opportunist and avid: ‘they earn a lot and don't pay taxes’. They were recognised as ‘a crucial component of our familialistic welfare’ (Repubblica, 23/05/2009) though sometimes unfaithful (‘the gang of unfaithful badanti’, Repubblica 24/01/2010, ‘was accused of stealing from elderly people’, but ‘we still need them’ Repubblica, 17/05/2012). This double image justified the ambiguous attitude towards MCWs: negative descriptions functioned to remind Italians that MCWs, despite their special status, were still migrants. They were well accepted in the Italians’ homes, but their reputation was constantly under judgment.
This dependency is one of the pieces of the puzzle composing the collective representation of MCWs: this shared image was constructed in the problem stream and institutionalised by specific regulations with the specific aim of legitimising a private and mainly illegal market of care provision, where illegal practices as well as inadequate working and living conditions are accepted.
4. Conclusions
The present Italian care regime is the result of a political and social construction by which not only are MCWs permanently incorporated in a subordinate role, but also a peculiar care market has been progressively introduced and socially accepted. Regardless of their legal status, MCWs have secure rights to permanent residence in the country, where they are allowed to work and to be paid, to use basic welfare services (health, school for their children, etc), and eventually obtain a temporary residence permit. On the other hand, their uncertain legal status paves the way for informality, the absence of a work contract and related welfare benefits, low salaries, high exposure to unemployment and poverty, and lack of individual independence (Lutz and Pallenga-Mollenbeck, Reference Lutz and Palenga-Mollenbeck2012). The market-based solution to the care deficit problem in Italy has been therefore based on the social construction of a subordinate inclusion regime, allowing the presence of almost one million new residents with limited access to basic citizenship rights.
MCWs’ status has been increasingly supported in the public debate through a distinction between them, considered good migrants, and other migrants, usually described as illegal, unwilling to integrate, inclined to crime. Nevertheless, their difficult working and living conditions have never been considered as a public issue (Burau et al., Reference Burau, Zechner, Dahl and Ranci2016).
The dominant family-oriented culture in Italy has played an important role in this public discussion. The centrality of family values has consistently deemed solutions for caring that do not imply a role for the household as unacceptable. This assumption justifies MCWs as the best possible solution to the care issue (van Hooren, Reference Van Hooren2011). Political parties, regardless of their orientation, have not been urged to provide alternative solutions but rather to sustain families in paying MCWs. The centre-right government, ruling the country throughout most of the time under consideration, has been partially legitimated in not providing a structural reform of the welfare system as ‘the new welfare’ already exists and is more financially convenient than any other form of care provision.
Our research proves that the subordinate inclusion of MCWs has been pursued by policy makers of different political orientations, on the basis of a large social agreement supported by the media discourse. This accord has emerged primarily in the problem stream, where MCWs were described by the media as a fundamental resource for families dealing with urgent care needs. Once this perception became widespread among the public, even the most radical xenophobic positions of the Lega Nord Party and right-wing parties turned into claims concerning the functionality and deservingness of ‘badanti’, paving the way for a clear acceptance of the crucial public role played by such workers in the Italian welfare system. From undesirable migrants they were increasingly recognized as the cornerstone of the new social care market.
A convergence even in the political stream therefore became evident: left-wing parties increasingly accommodated themselves to the care market solution as opposed to the traditional claim for an extension of the public LTC system; and the Catholic party always supported this solution as a way to protect the fundamental values of family and familial solidarity. This bi-partisan acceptance can be therefore considered part of a larger strategy of the Italian political class aimed at maintaining and supporting the existence of a low-cost private care market based primarily on migrant labour force, and the avoidance of any further increase in public expenditures for LTC programmes.
A main general conclusion can be drawn from this analysis. In the last decade the harshening of the care deficit problem and the parallel increase in austerity measures have paved the way for extensive programmes of privatisation across Europe. In many countries, MCWs have played a crucial role in this process as they provide a low-cost and flexible labour force that allows the overcoming of market failures. Our analysis shows that, in a country where MCWs have become the crucial component of social care markets, a system of public regulation and the social and political legitimation of such workers are likely to be produced. Legitimacy is indeed a crucial aspect in these contexts because the efficiency of such markets rests on the subordinated, while generally accepted, social role played by MCWs. In social care markets MCWs play a crucial role as ‘functional workers’. Their functionality, and therefore the correlated efficiency of the care market, is actually guaranteed by a complex regulatory and legitimacy system, composed by a specific public regulation, collective recognition of their role, and public silences about the most problematic aspects of their conditions. It is through this complex system that the working conditions initially accepted by these migrant workers have remained unchanged for a long time (Burau et al., Reference Burau, Zechner, Dahl and Ranci2016).
In Italy, as well as in other countries, the public construction of the social role of the migrant care worker has been central to the shift from a familialistic to a market-based care system. The problem stream (Kingdom and Thurber, 1984) has been characterised by the diffusion of new ideas and beliefs, which have provided social legitimacy to the new care market arrangements. These ideas have not only supported a new shared definition of the situation, but have also paved the way for a new political agenda, by which a peculiar regulatory setting has been provided to allow the subordinated incorporation of such workers into the Italian labour market. Policy makers of all political orientations, including xenophobic parties, supported this solution and contributed to the creation of widespread public consent through arguments stressing the functional role played by these workers and their utility for the Italian population. The social care market has been, therefore, not only the product of the free dynamics of supply and demand, but also the effect of a sophisticated ideational construction.
