Fri, Sep 08, 2023 page8

• Think holistically on caregivers

  • By Cheng Ya-wen, Yeh Ming-jui 鄭雅文、葉明叡
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  The Ministry of Labor in June significantly increased quotas for migrant workers in four employment sectors, namely manufacturing, construction, agriculture and institutional care. More recently, Chinese Nationalist Party (KMT) presidential candidate Hou You-yi (侯友宜) has announced a long-term care workforce policy that would allow people older than 80 years old, or between 70 and 79 with cancer at stage 2 or above, to apply to employ a foreign home caregiver. As soon as Hou proposed this policy, the Democratic Progressive Party (DPP) government followed suit by promising similar reforms. One stance that the KMT and DPP have in common is that of bringing in larger numbers of cheap and useful foreign migrant workers.

  It is not uncommon to hear about migrant workers in Taiwan being exploited and deprived of their rights. This is especially true of home caregivers, who live in their employers’ homes all the time, making it difficult to monitor whether labor regulations are being followed and to intervene if necessary. These foreign caregivers are paid less than the going rate for Taiwanese long-term caregivers and are subject to labor conditions that Taiwanese workers would find unacceptable. Foreign workers are also burdened with high agency fees. Some of them are even abused by their employers, have their movements restricted and are subject to hardships due to language barriers. When it comes to elections, migrant workers have no right to vote and are not in a position to speak out. However, a society that ignores migrant workers’ rights cannot be a truly equal one.

  For families in need of home care, the relaxation of application criteria might seem to be a great boon, and it might indeed be a short-term solution. However, if migrant labor quotas are drastically expanded, over the long run the ultra-low cost of their services will inevitably depress the employment opportunities and labor conditions of Taiwanese caregivers.

  In recent years, the Ministry of Health and Welfare has instituted policies aimed at improving the pay, conditions and social status of care service workers, such as by providing them with diversified training channels, salary increases, enhancing their professional image and strengthening their career development.

  However, hastily relaxing the application criteria to employ foreign caregivers makes these efforts look like mere window dressing.

  Along with the social and economic development of migrant source countries and the increasing pull of other countries that need migrant labor, such as Japan and South Korea, Taiwanese society must eventually face the reality of a tighter supply of migrant workers. We must face up to the real cost of the longstanding distortion and underestimation of the demand for long-term care service personnel.

  No matter whether Taiwan continues to fund long-term care through taxes or whether it starts funding it through social insurance instead, we must consider the fairness, accessibility and affordability of long-term care services.

  Since 2017, the government has been promoting its Long-term Care Plan 2.0, with a focus on the development of community and home care, and the past few years have indeed seen a significant improvement in the provision of public services. Of course, we must keep up our efforts to build service systems and make them more efficient to cope with the challenge of a rapidly aging population, especially with regard to the care of moderately and severely disabled people.

  However, the policy direction has already been shown to be feasible and sustainable, so we should not take the retrograde step of relaxing application criteria for private foreign home care.

  Taiwan’s demographic structure means in the future there will be a shortage of workers not only in long-term care, but also in all other labor-intensive industries. The way we think about migrant labor policies needs to shift from “importing cheap labor” to “allowing necessary immigration.” Migrant workers should receive equal treatment with Taiwanese, and their human rights protections should be improved. Migrant workers should receive professional training and go into jobs that match their skills and aspirations. They should be able to start their own families and careers and ultimately become naturalized Taiwanese.

  After all, Taiwan is already a society of immigrants. At different times, people from different places have come here in pursuit of a better life and opportunities.

  Governments should welcome immigrants and protect their labor rights along with those of everyone else. By helping one another and by standing in solidarity, we can work together to build a diverse and free democratic country.

  Cheng Ya-wen and Yeh Ming-jui teach at the Institute of Health Policy and Management at National Taiwan University.

  Translated by Julian Clegg
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