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Informal care and public decision making: the case of Lombardy local welfare

2012 Conference Presentation

Informal care Italy

6 September 2012

Informal care and public decision making: the case of Lombardy local welfare

Andrea Rotolo, Università Bocconi, Italy
Ornella Larenza, Università Bocconi, Italy
Giovanni Fosti, Università Bocconi, Italy


Informal care provision is a relevant phenomenon within Italian social care sector, in that it covers public deficiencies in social care supply, especially concerning old people. The hypothesis this work aims at testing is that Public Organizations may fail to include informal care presence when planning resource allocation in social care sector, thus social interventions in a territory. Furthermore they hardly manage to include resources circulating in both informal and also in part formal care sector in integrated inter-institutional planning at local level. Public organizations involved in social care planning in Italy are more and more required to include knowledge and impacts of the overwhelming migrant care workers’ presence assisting impaired elderly across the country, if they intend to carry out effective planning in social care sector.

This paper focuses on the case of Lombardy Region, where one sixth of the Italian population lives and peculiar social dynamics occur and magnify the ones occurring in the Country (Lombardy accounts for the highest immigration rate in Italy). Using data from regional, municipal and provincial accounts, as well as estimates on households’ expenditure for informal care, we outline the perimeter of total resources circulating in Lombardy social care sector and point out actual weight of informal care market and public administrations’ failure in considering this relevant phenomenon in social care integrate planning. Data on Lombardy social expenditure in 2009 were collected from different sources and analyzed with the help of regional officers so to reconstruct the whole picture of total financial resources for social care. Lombardy Region, municipalities, provinces, local health authorities, the National Institute for Pension (INPS) and social care interventions’ beneficiaries were recognized as the actors mobilizing resources within the territory. Data were mainly drawn from public accounts and reports whereas esteems were used for beneficiaries’ expenses. Eventually, data were presented to a limited number of local public managers involved in social care planning in their communities in order to receive suggestions on their interpretation, since many data derived from public accounts were produced by the same officers.

Our study demonstrates that public decision makers, especially in times of economic crisis and wide-ranging decline of resources available should open up their look on the outside world and avoid just focusing on their traditional perimeter of service provision. This is consistent with the new role of network management that local governments are asked to play since the outbreak of outsourcing trends in social care sector that constantly reduce the relevance of public actors as service providers.