The Economic and Social Council warns of "insufficient public funding" for dependency

The Economic and Social Council (CES) welcomes the draft bill to reform the laws on Personal Autonomy and Care for Dependent Persons and the General Law on the Rights of Persons with Disabilities and their Social Inclusion, although it highlights the "insufficient public funding" for the System for the Promotion of Personal Autonomy and Care for Persons in Situations of Dependency (SAAD).

This is evident from the opinion issued by this advisory body, which is overall "favorable" and describes the reform as positive. In fact, it concludes that the draft bill represents "a notable advance in consolidating and guaranteeing the rights of people with disabilities and those in situations of dependency ," although it provides a number of observations and clarifications.

The opinion analyzes the amendments relating to disability and the SAAD separately, although it does appreciate that both laws are "addressed jointly and in an integrated manner for the first time." Regarding Autonomy and Dependency Care, the CES finds it appropriate that, "after almost twenty years of experience," the law seeks to promote a model of care and support for people in dependent situations "based on the promotion of personal autonomy and social inclusion and centered on the person, both in the residential setting and in the family environment."

Specifically, it highlights "the elimination of administrative barriers and incompatibilities between benefits"; the definition, expansion, or creation of new benefits; and all measures aimed at improving the system's responsiveness.

However, it warns of the " insufficient public funding that the system is experiencing," an aspect it considers "relevant" in a reform "of this magnitude." According to the opinion, public funding for the SAAD represents 0.8% of GDP, "below that of neighboring countries and below what is necessary to guarantee coverage and quality," which is why it states that it "remains insufficient."

The CES found it "paradoxical" that, with "a diagnosis of prior underfunding" and given the declared intention to expand "the scope of the support and care system for dependency," the explanatory report points to " little or no budgetary impact for the General State Administration (AGE) of some of the new benefits or their expansion."

In fact, it highlights the "insufficient participation" of the General State Administration (AGE) in the financing of the model and proposes "a definition of more specific objectives and a reasonable timeline, which guarantee a level of public funding sufficient to satisfy in all cases the realization of the subjective rights " recognized by the future regulation. The opinion also points to "the persistence of problems such as waiting lists, delays in care, or lack of accurate data, which limit the effectiveness of the system as a whole.

Caregivers

The CES did agree with the regulation on the desirability of the SAAD providing support mechanisms for non-professional caregivers , the vast majority of whom are women, although it lacked "greater specification of the rights contemplated in the draft." The text merely states them, "without further precision," it lamented. "It would be desirable for some of them, such as the one related to receiving support and training for caregiving and self-care, to be included as benefits in the catalog of services," it indicated.

Likewise, it warns of some risks that "could arise from the drafting of the scope and new configuration of some SAAD benefits in the Draft Law," which could "lead to formulas of non-professional care ." In this regard, it expresses doubts about measures such as the expansion of the cases in which the economic benefit for care in the family environment can be recognized; the formulation given to the new provision of care and support services in housing through a benefit ; the lack of definition of the content of the care and support service in housing, as well as that of benefits in the community setting. To avoid this, it urges guaranteeing a professional care service, with the quality standards required by the regulations, duly accredited and with prior authorization from the competent authorities.

Finally, he emphasizes that while the goal of promoting autonomy through a deinstitutionalization approach—as long as the environmental and material conditions allow it—is very positive, this " should not lead to a stigmatization of the residential system as a whole." In his opinion, this remains "necessary." Therefore, he insists that "it is essential to evaluate its weaknesses and strengths" and to effectively incorporate "the approach that the draft bill promotes of person-centered care and the promotion of personal autonomy."