Despite its name, the “Cura Italia” decree does not cater for those who perform care work: domestic workers and home-based caregivers are not included in the furlough provisions, nor are they protected against dismissals. Furthermore, domestic workers, caregivers and child minders with children of their own are not entitled to the “baby-sitter vouchers” introduced by the decree, nor are they provided with specific protection.
The position of caregivers, in fact, is very complex also as far as the risk of Covid-19 infection is concerned, as they are one of the categories most vulnerable to the pandemic. According to current legislation, if domestic workers, home-based caregivers and child minders are ill, their employers, and not the INPS – the National Institute for Social Insurance, must continue to pay their wages, and only for a limited time.
During the Coronavirus emergency, in instances when they have contracted the virus at work, caregivers have been given some protection, as the event is considered an occupational injury and as such is covered by INAIL (National Institute for Insurance against Accidents at Work) insurance. Moreover, if they are quarantined, or in isolation and have to abstain from work, the State will refund employers who pay their salaries (but further information about refund requests and procedures is still awaited).
With the exception of these limited measures, the question of what to do in other instances of infection is still unanswered. There are no clues on how live-in workers who have tested positive to Covid-19 but have not been hospitalized should behave with their employers: there is no plan to accommodate workers who, as live-ins, do not have their own homes or nearby relatives. In practice, they are supposed to remain in the same place as the people they are caring for, with obvious risks for the latter as well as their families.
However, if domestic workers and caregivers are unable to work because of illnesses other than Covid-19, employers are responsible for the payment of their salaries.
Other worries include the risk of job losses, which may happen, for instance, if the person cared for dies (in the pandemic, this is an ever more likely occurrence) or in cases of dismissal, since there is no protection against dismissals in this sector. In these instances, domestic workers and caregivers are only entitled to unemployment benefit (NASPI) or to the “last resort” income introduced by the decree (“Reddito di Ultima Istanza”).
Nowadays, the importance of care work is in everyone’s sight, thus making the exclusion of domestic workers and caregivers from legal and economic protection paradoxical. This looks like a precise political choice replicating a long standing tradition: throughout history, domestic and care workers have been left out of, or only partially included in, the protection measures introduced by legislation promoting workers’ rights. A major change of perspective is now required, both in the short and in the medium-long term, and even more so since Italy ratified the ILO189 Convention on domestic workers (2011), thereby committing to eliminate all forms of discrimination against these categories.
Many workers and their families feel lost: it is therefore urgent to develop at least some guidelines on what to do whenever an elderly person assisted by a home-based caregiver contracts Covid-19 but does not need admission to hospital, or vice versa, when a live-in caregiver tests positive to Covid-19. More generally, clarification is needed on how to manage employment relationships and care obligations to ensure the safety of both workers and care-receivers. As is happening in other areas of the health and social care professions, precise information, adequate support in terms of personal protection equipment (masks, gloves and such like) and psychological help if requested, are necessary to ensure these essential care activities can continue in safety.
As already pointed out, if domestic workers, caregivers and child minders are ill and unable to work, the “cost” is borne not by social security but by their employers. Now more than ever it is necessary to take the opportunity offered by the current emergency to amend current legislation and grant caregivers entitlement to permanent sickness cover. In addition, because of the economic crisis caused by the current health emergency, many employers’ families are facing – and probably will continue to face in the future –the hardship of the high cost of paying sick domestic and care workers’ salaries.
The crisis is forcing a number of families to dismiss their domestic and care workers. In many cases, these workers are replaced by (often female) family members who are at home, either unemployed or furloughed. This makes domestic workers particularly vulnerable to the risk of unemployment, all the more dramatic for those who have no home to go to or cannot return to their home countries. At the same time, it exposes vulnerable people to the risk of being infected by their family members who may turn into a source of contagion themselves, especially if they keep moving from one house to another. A dedicated voucher for caregivers (along the lines of the babysitter-voucher) could be part of a wider set of solutions.
It is well known that, in Italy, most domestic workers and caregivers for the elderly come from abroad: losing their job, or having their working hours cut, jeopardizes the renewal of their residence permits. The current crisis may result in an increase in undeclared employment, already widespread in the domestic and care sectors and more generally in the Italian economy.
In order to avoid this kind of scenarios, domestic and care workers should not be left in the shadows by emergency measures currently being implemented: why should they be excluded from enjoying the babysitting vouchers? Entitling them only to “Last resort” income or unemployment benefit (NASPI) in case of dismissal is discriminatory and narrow-minded. On the contrary, it is imperative to make sufficient arrangements to support the income of this category of workers. The postponement of social security contributions until June 2020 is not enough. Specific protection should be granted, in particular, to live-out workers whose activity has been suspended due to the restrictions to freedom of movement introduced to reduce the spread of Covid-19.
If we think of the crucial work performed by domestic and care workers, the importance of introducing the measures suggested becomes even more apparent. Over the past few weeks, some experts have stressed that we need to move from a hospital-based, patient-centred care model, which has allegedly increased the spread of the disease, to a community-centred model, based on a community’s commitment to caring for vulnerable people. Caregivers have a key role in the accomplishment of this transformation, but such an important task demands visibility: the recognition of their rights today (their right to health, first and foremost) is the basis of a future where families, communities and healthcare facilities can support each other. The first step must be the extension to caregivers of the protection measures already enjoyed by other employees, starting with public funds to pay their salaries during sickness absence from work.
At the same time, we should also devote our attention to undeclared work (black and grey work), introducing measures aimed at turning it into declared work. During this time of emergency some families are regularizing their domestic and care workers in fear of the restrictions imposed on free movement and of checks by the authorities. It is essential, however, to impose greater control in “ordinary” times as well, at the same time providing incentives to families, especially lower income ones, to fight undeclared work and promote practices involving widespread fairer salaries and more dignity for domestic and care workers.
Many families will certainly suffer financially as a consequence of this emergency and aid is needed to insure current legal employment relationships can continue: these might be forms of tax exemption; on the other hand, the widespread delegation of care to families, in a kind of “do-it-yourself” family welfare, should cease once and for all. Public welfare must be conceived in inclusive terms, through all-embracing provisions, overcoming the current regional and local fragmentation in terms of rights and provision for those living in different parts of Italy.
In addition to measures to be taken at national level, it is also fundamental to take a further step towards stronger European integration and towards a European community able to develop policies aimed at protecting people’s health and well-being, and the environment, itself the basis of healthy living.
Due to the dramatic ongoing situation, balancing so many different interests is not an easy task. However, the need to introduce a set of laws to counteract the Covid-19 emergency quickly should be seen as an opportunity to bring about changes towards greater social justice and wellbeing. Missing this opportunity may mean that a society which is already split by profound inequalities will become even more polarised. The pandemic is forcing us to rediscover (or discover for the first time) the importance of a solid, public and universal health system, since not caring for some individuals may subsequently turn into lack of care for the whole community. This crisis is bringing to the fore the importance of having governments, parliaments, the European Union and other political decision-makers able to elaborate a long-term vision. Giving way to the rivalries and selfishness of market mechanisms will not help us to overcome this crisis. This exceptional moment may make very few people richer but many poorer: if we wish to avoid being overwhelmed by social conflicts, we have to come up with fairer mechanisms of distribution of resources.
Finally, we have to move towards new forms of democracy with a passionate collective effort; forms of democracy where care – for people, for relationships and for the environment – is a crucial element. This means re-considering and re-assessing the silent and unrecognised work of those who, unpaid and every day, care for family members, friends and neighbours, as well as the work of those who professionally carry out these activities as housekeepers, caregivers and child minders. This effort entails new ways of filling the gap between public and private services, between families and institutions, promoting both individual and collective well-being: in short, a truly caring democracy.