National Carers’ Framework: opportunities and challenges for cooperatives

13 May 2016

A new state-run framework entitled the Sistema Nacional Integrado de Cuidados (SNIC) (National Integrated Carers’ Framework, in English), is being implemented in Uruguay. The framework has been designed to nationalise the care sector, making it a public service, and regulating private care providers. The scheme offers significant opportunities for the formation of worker cooperatives dedicated to providing care.

A law was passed in November of last year recognising care as a social right, and with that comes a guarantee of effective care. The scheme aims to improve the current system by introducing a broader range of services. It should also formalise people’s roles who already work in the sector and provide further training opportunities to current and potential care workers .

Alicia Martínez, a member of Caminos Grupo Cooperativo (a cooperative dedicated to the care of the elderly) and ex-secretary of education for the Federación de Cooperativas de Producción del Uruguay (FCPU) (Federation of Cooperative Producers, Uruguay, in English), has since 2011 been taking part in a national debate organised by the Inter-institutional Commission in charge of the SNIC’s design.

An FCPU document put forward during the debate discussed how women have always been designated the role of carer: of children, the elderly, sick, and disabled. But far from this being considered ‘work’, they have been expected to carry out duties as a result of their reproductive capacity. But the extra responsibilities women take on (on top of other household duties) adds a significant amount of time to their working day and represents a major source of gender inequality. In the absence of any sort of public policy, many families turn to the private sector. The SNIC is quite justly proposing to regulate the sector – creating a wider range of services and a more egalitarian provision.

Alicia Martinez sees the SNIC as a means of giving opportunities to women whose age prevents them from getting into the job market. It also offers the possibility of a move towards the cooperative model – which already has a proven track record in the field. “In cooperatives, the people are the main focus – in any work/capital equation, work is prioritised. Our management model allows us to see carers as more than a commodity. They can give humane treatment and adapt to each individual’s needs.”

The ILO recently released the results of a worldwide study on the provision of care by cooperatives. Amongst other conclusions, it found that cooperatives are emerging across the world as an innovative alternative to traditional private providers. They guarantee a better quality of care and have decent training opportunities as enjoyed by cooperative members in all sectors. The results also showed that cooperatives give care workers better working conditions – especially women. Jobs are more stable and salaries are higher.

Last October, the Social Development Minister for the SNIC signed an agreement with the Instituto Nacional de Cooperativismo(National Institute of Cooperatives, in English) aiming to promote cooperative care providers, but concrete proposals have yet to be put in place. Other regions have successfully integrated cooperatives into the care sector: in Quebec in the 1990s non-profit care providers were encouraged. Although it didn’t get rid of profit-making organisations, the state did introduce significant subsidies for the first cooperatives to take part.

Economist Andrés Dean discussed the issue in La Diaria article in March this year . In it, he pointed towards the ease with which self-managed businesses can work in the care sector: they require very little initial investment and there are no economies of scale; “allowing medium-sized enterprises to be run efficiently”. What’s more, he says, “carers in Uruguay are working in a sector which has already seen an increase in the number of self-managed businesses in the last decade”. These are all favourable conditions in which new cooperatives will be able to flourish under the new SNIC framework.