Almost a million and a half Spaniards have a recognized dependency. Another 131,000 are pending assessment to obtain the benefits —they can be economic, residence or home help, among others— that they need to be able to carry out their basic day-to-day activities. The dependency aid system is a basic pillar of the welfare state, and this was endorsed by the dependency shock plan approved in 2021 by the Ministry of Social Rights and the 2030 Agenda, which reversed the cuts carried over from 2012 and for which an increase in financing of 600 million euros was announced. But it is not the same to be a dependent in Murcia than to be, for example, in Castilla y León.
In 2022, the Government complied with the increase in the budget for the shock plan, and this has allowed 91,295 more people to be served than at the beginning of the year. This is stated in the report presented this Friday by the Association of Directors and Managers of Social Services, which analyzes, this year again, the latest official figures and information obtained through the transparency portal. However, 177,423 people were left on the waiting list to receive the aid and 131,810 are pending assessment. In total, 309,233 Spaniards have been neglected in 2022 and, waiting for one of these processes, 45,360 people died. The reasons, the report points out, are the eternal bureaucracy and the lack of commitment from some autonomous communities.
“The Ministry of Social Rights has managed to recover 90% of the cuts to the system that occurred after the financial crisis, but the budget increase is not the only thing necessary. And the effects of this have not been those expected in the reduction of the waiting list or in the improvement of benefits”, explains José Manuel Ramírez, president of the association, who describes the situation as “disastrous”. Last year, the waiting list was reduced by 15,923 people, and, added to the 38,807 in 2021, they do not even reach the 60,000 that the first year of the crash plan set as a goal. At this rate it would take 11 years to achieve full attention for all of them, without anyone new entering the system.
55 million without spending
Of the money that the autonomous communities receive from the ministry of Ione Belarra, not all of it is spent. The Government left 55 million euros of the minimum level budgeted for the Dependency Care System unexecuted. “What happens is that the autonomies return the minimum level of financing, which is capitative. The ministry transfers an amount to the autonomous communities as they attend to people in a situation of dependency and, if they don’t, you save that money. But we cannot afford to return money while, in Spain, more than 124 dependent people die every day without having received benefits or services”, Ramírez expresses.
In the first year of the shock plan, 10 regional governments “made cash” with the budget increase made by the General State Administration, according to the report. That is to say, they did not allocate all the money allocated to them from the administration to improve services. These regions were Aragon, the Canary Islands, Castilla y León, Castilla La Mancha, Extremadura, Galicia, the Region of Murcia, the Foral Community of Navarra, the Basque Country and La Rioja. The study reflects the great inequalities between territories with the grade scale that the association prepares annually: some pass with more than an eight, others fail with a three, and the national average passes with a scratched five.
The average waiting time to receive dependency care in 2022 was 344 days, 77 less than the previous year. “The bureaucracy is excessive, it is a spider web where thousands of dependent people are trapped. If something does not have a dependent person, it is time to wait, because 53% of the recognized dependent people are over 80 years old”, says Ramírez. And, again, it is not the same to wait in one community than in another. While La Rioja and Aragón have reduced the waiting list by over 40%, other communities such as Murcia, the Balearic Islands or Asturias have increased it by close to 30%. By regulation, the maximum period to resolve a file is 180 days, but there are only two regions that meet that margin in their average: Castilla y León and the Basque Country. “Those autonomies that work with local corporations are more agile, and the unification of evaluation criteria is also effective,” Ramírez develops to provide solutions. There are, however, autonomies that stand out for their evolution, such as the Valencian Community, which has gone from failing with a 1.2 four years ago, to approving with a 6.2.
Ramírez insists that there are unsustainable situations such as the one that occurs in Catalonia, which alone has 39% of the waiting limbo —the sum of people valued as dependents who have the benefit recognized, but are not receiving it, and those who are still pending assessment—of the entire national territory. “There were autonomous communities that made traps and they stopped evaluating so as not to have a waiting list, so we had to add the days it took for the evaluation to take place,” says Ramírez. “We also take into account that there are applications that citizens present, but the communities do not record well in the system and do not appear in those pending evaluation. And other regions seem to grant a benefit, they remove it from the list, but it is what they call ineffective provisionand the help does not arrive ”, continues the president of the association.
A system of expenses low cost
The report states that there are objectives of the crash plan that are not being met. “One of them was that attendance was a subjective right, but not even one in three is attended to. And the services that are provided do not match the needs of people in a situation of dependency,” denounces Ramírez. The benefits vary greatly depending on the service and the area, but the study criticizes that they are insufficient. The linked benefit to pay for a residential care space fluctuates around 500 euros per month depending on the degree of dependency. “The difference between this amount and the price actually paid by the person in a nursing home (which will easily triple that amount) constitutes a ‘second copayment’ or invisible copayment,” the report states.
Home help is received, on average and depending on the level of dependency, for about 15 hours a month for the most moderate degree, 37 hours a month for the medium degree and 57 hours for those who have recognized the most serious degree of dependency. “This is clearly insufficient if we understand that they are people who need support on a permanent basis”, state the authors of the report. And, throughout Spain, there are 53,905 dependent people who receive telecare as the only benefit. “It is absolutely reprehensible that a person with this benefit is admitted as cared for. Telecare must be a complementary benefit”. More than half of the people in this situation are in the Community of Madrid (18,967) and in Castilla La Mancha (10,178). “The system is reactivated, but based on low-cost services,” concludes Ramírez.
The Observatory for Dependency estimates that the global cost of the dependency care system exceeded 10,000 million euros in 2022, reaching 10,495 million. Ramírez points out that it is a “great public investment.” “For every million euros invested in the system, 41 direct, stable and non-relocatable jobs are generated, and the rate of return already amounts to 41.4%,” says the president of the association. Currently the dependency system employs 316,215 people.
