The legislature is currently deliberating on a draft law drawn up by the Cabinet that addresses long-term care. The bill only seeks to regulate what kind of training caregivers, who now number more than 180,000, should receive. However, the scope of the draft is not enough to solve the many problems that have been generated by having two systems — foreign migrant caregivers and long-term care services — operating in parallel. Only by actively integrating overseas migrant home care workers into the long-term care system can the government ensure care quality and safeguard the labor rights of migrant workers.
According to current regulations, people who employ foreign caregivers in their homes are not eligible to use -government--subsidized long-term care services. This has resulted in a twin-track system in which Taiwanese are forced to choose between foreign migrant caregivers and the official long-term care system.
Taiwan started legally admitting foreign migrant workers in 1992. Since then, the shortage of long-term care services has made employing caregivers from overseas a necessary option for many people. Originally seen as “supplementary” help, the number of foreign caregivers has grown from 306 in 1992 to more than 180,000 this year. In contrast, although the government has worked on developing a long-term care system that employs Taiwanese, the number of workers in the official system is only 13 percent of their migrant counterparts.
Most licensed caregivers are paid by the hour and provide home care service only during the day. If they had to provide care outside of normal working hours, the strain might be more than many of them could bear. In contrast, foreign caregivers are expected to be on hand 24 hours a day. From the employer’s point of view, foreign workers undoubtedly have the advantage because of their highly flexible work hours.
Institutional care is generally seen as a last resort in Taiwan because it means that those receiving care are separated from their homes, families and friends, and children who place their elderly parents in institutions are often accused of being unfilial. Employing a migrant caregiver allows families to adhere to the tradition of filial piety by keeping the elderly at home.
It is ironic that existing long-term care policy excludes families who employ foreign caregivers from the official long-term care service system, resulting in these families and their foreign employees bearing the full burden of caring for those who can no longer care for themselves.
Consequently, the conditions under which foreign workers provide care are exploitative and contrary to labor laws and regulations. The great majority of foreign caregivers live in the same room as the people they care for, so it is hard for them to get enough rest. It is also common for migrant caregivers to be asked by their employers to provide tubing care — inserting and removing breathing and feeding tubes, urinary catheters, etc — which they are not legally qualified to do.
Such abuses of migrant caregivers’ services inevitably cause the quality of care to fall. For example, overworked and exhausted caregivers may fail to stop the people they are caring from accidentally falling down and hurting themselves. Depriving foreign migrant workers of their labor rights indirectly undermines the quality of care received by those they are caring for and it also tarnishes the nation’s human rights record.