This article analyses the long-term effects of privatisation and marketisation on the Italian regional health and social care systems. The research focuses on three Italian regions – Lombardy, Veneto and Lazio – which are representative of three different models of governance in these sectors. We examine the effects of privatisation and marketisation on the health and social care system by discussing how the regional health-care systems have managed the impact of the COVID-19 pandemic. We also shed light on the dramatic consequences of the pandemic crisis on employment levels and working conditions.
The social investment approach emerged as a new welfare paradigm, aimed at reconciling the traditional functions of the welfare supply with a productive social agenda, designed at preparing people to confront the ‘new social risks’, whether they be related to the problem of balancing paid work and family responsibilities, upgrading the skills, preventing inequalities and promoting the availability of in-kind services. In order to achieve these objectives, especially those related to care needs and work-life balance, the adoption of social investment-based strategies necessarily implies an expansion of the jobs related to health and social care services. In more recent years, many studies have analysed the limitations of the social investment policies because of their different redistributive impacts on social groups. Several studies have found a higher use of these policies for high-income families. Another source of criticism on social investment is that spending on these policies would seem to crowd out more traditional passive social expenditures. In this article, we examine another question related to the widespread of this approach: what are the effects of the social investment policies in terms of direct job creation? In fact, one of the more controversial issues, related to social investment policies, is their direct contribution to the labour market in terms of both quantity and quality of work within welfare services. The article analyses these issues focusing on Germany and Italy, two countries that represent not only two different care regimes but also two distinct models regarding job creation strategies in the care sector. In doing so, particular attention will be paid to long-term care policies, as they represent one of the pivotal areas of the social investment approach, both in terms of social services, to address new social risks, and new jobs related to welfare service
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