Squaring the care trilemma through twofold dualization. Institutional change and diversity in Italy and Spain

Abstract

This paper analyses the role of employment relations in squaring the care trilemma in Italy and Spain. These two countries exhibit similar welfare states and care models, characterised by familistic traditions alongside relatively strong industrial relations systems with encompassing, centralized collective bargaining structures. These institutions, which correlate strongly with labour power and good working conditions, haven’t precluded their deterioration in care provision, hence perpetuating a pattern of twofold dualization, where subsectoral differences between early childhood education and care (ECEC) and long-term care (LTC) services persist in addition to the longstanding public/private divide. Institutional and actor-based explanations should be considered when accounting for differences along the dualization axis. In particular, the fragmentation in trade unions and employer organisations, combined with outsourcing practices in the public sector, has contributed to maintaining the private/public divide in the two subsectors and countries. Finally, the article shows that, although both countries display a similar dualized pattern in addressing the care trilemma, the intensity of these divides varies between them.

Keywords

care trilemma ECEC Italy LTC Spain twofold dualization

Introduction

Care regimes across the EU are currently facing systemic challenges arising from the interaction of demographic pressures, fiscal constraints, and labour market shortages (Eurofound, 2023). While the intensity of these pressures varies across national contexts, all EU countries are currently experiencing a reconfiguration of their care systems, encompassing changes in provision, generosity, accessibility, employment levels, and working conditions (Ranci and Pavolini, 2015). These reforms reveal a complex interplay of demographic, economic, social, institutional, and cultural factors that shape the country-specific policy responses to the so-called ‘care trilemma’: balancing coverage of provision, fiscal constraints, and job quality (Iversen and Wren, 1998; Pavolini et al., 2013).

The literature suggests that these challenges are especially pronounced in the care regimes of Mediterranean welfare states, historically grounded in a universalistic approach to service provision but marked by persistent coverage deficits and a heavy reliance on informal family care and low-cost migrant labour (Ferrera, 1996; Simonazzi, 2009). Care systems in Southern Europe have undergone significant transformations over the past two decades, including retrenchment during the 2008 financial crisis − particularly in direct provision − and increased pressures on families, which remain a key source of support (León and Pavolini, 2017). In the specific case of Italy and Spain, care services have known, after two decades of expansion in public financing (especially in the early-childhood, education and care services), a phase of stagnation or even retrenchment due to fiscal austerity (Gori, 2019; Sánchez-Mira et al., 2021) that has accentuated their familistic character and the reliance on informal provision (Casanova et al., 2017; Léon and Pavolini, 2017). This pressure has compelled state authorities to reconsider the care trilemma and to identify a sustainable balance between fiscal constraints and the increasing demand for services. In pursuit of fiscal sustainability while maintaining existing levels of coverage, both countries have also relied more extensively on market-based mechanisms in care service provision, including contracting out (Dorigatti et al., 2020; Palomera and León, 2025).

Taken together, these dynamics are expected to have further entrenched the segmented nature of employment in the care sector, resulting in a resolution of the care trilemma that comes at the expense of job quality. Although studies focussing specifically on the care sector in Mediterranean care regimes remain scarce, the international literature provides valuable insights in this regard. Existing research documents that employment in the care sector across advanced economies is affected by the so-called ‘care penalty’: wage levels and working conditions are systematically lower than national economy-wide averages (Bailey et al., 2014; Folbre et al., 2021). From a different analytical perspective, the literature on the marketization of public services in Mediterranean countries suggests that outsourcing constitutes a key driver of change in work and employment regulation, producing a dualizing trajectory in which public sector employees retain stronger employment protections, to the detriment of private-sector workers (Mori, 2017; Palomera, 2024). Building on this literature, we expect that the processes shaping the care trilemma equilibrium at the expense of job quality in Mediterranean care regimes go hand in hand with an increasing dualization and a widening gap in working conditions not only between formal and informal forms of employment, but above all between the private and public sectors (Mori, 2017). Nevertheless, the existing literature offers no clear assessment of the role of industrial relations or the consequences of these dynamics for care work, despite their centrality in achieving a sustainable equilibrium within the care trilemma.

To fill this gap, this article examines how the care trilemma is reconfigured in Mediterranean care regimes, focussing on working conditions, and explores the factors accounting for these dynamics. Specifically, it addresses two main questions: (i) how are job quality and working conditions in the care sector shaped by the care trilemma equilibria reached in Mediterranean care regimes? and (ii) what factors explain these patterns? Drawing on the neo-institutionalist tradition in comparative employment relations, we first examine how country-specific configurations of collective bargaining institutions help to explain the dynamics observed in care services. Following recent scholarship, we then complement this institutional perspective with an agent-based dimension by analysing the constellation and role of social partners in the care sector (Mori, 2024).

To answer these questions, the paper investigates how the care trilemma configures in terms of working conditions in two similar countries belonging to the Mediterranean or Mixed Variety of Capitalism model − that is, Italy and Spain − in two specific labour-intensive subsectors of the care sector: the long-term care services (LTC) and early-childhood education and care services (ECEC).

Although both Mediterranean countries feature strong industrial relations systems and high levels of collective bargaining coverage, their dualized public–private structure is expected to produce a similar pattern of deteriorating working conditions, in line with the literature on dualization, which highlights inequalities along this divide. Accordingly, this paper examines dualization in care-sector working conditions in Italy and Spain by situating its argument at the intersection of dualization theory and actor-centred institutionalism. While the most recent dualization literature focuses on labour market segmentation between insiders and outsiders (Emmenegger et al., 2012; Rueda, 2005), its extension to feminized and welfare-related sectors − such as LTC and ECEC − requires a closer look at how institutional mechanisms shape working conditions, collective representation, and actors’ strategic behaviours within sectors (Mori, 2024). In fact, Mediterranean industrial relations systems are characterised by fragmented collective representation on both the union and employer sides, uneven union power, and yet high levels of collective bargaining coverage. At the same time, collective bargaining remains relatively centralised in core public services but weakly developed in outsourced and informal segments of the care sector.

The paper is structured as follows. Section 2 introduces the care trilemma and welfare regime context in Southern Europe and outlines the drivers of labour market dualization, particularly in care-related sectors, and the role of industrial relations. Section 3 details the methodological approach. Section 4 presents empirical findings on employment conditions and industrial relations in LTC and ECEC in Italy and Spain. Section 5 offers a comparative discussion, followed by conclusions.

Theoretical framework

The solution of the care trilemma in Southern European regimes: familism, informality, and fragmentation

Care regimes in Southern Europe exhibit some distinctive traits and challenges in relation to other European countries that should be assessed considering the different demographic dynamics and welfare state institutions. First, Southern Europe faces lower fertility rates and higher life expectancy, resulting in a rapidly ageing population that increases demand for LTC while simultaneously reducing the pool of potential caregivers.

Another defining feature of Southern European care regimes is their historical reliance on informal care, deeply embedded in familial norms and supported by the availability of low-cost migrant labour (Simonazzi, 2009). Unlike the universalistic and state-driven models of the Nordic countries, Southern systems have traditionally relied on unpaid family caregivers − mostly women − for both LTC and ECEC. This trait has been further exacerbated by ad hoc reforms that have implicitly or explicitly promoted a familistic orientation. In Italy, for instance, pension policies such as the ‘Woman Option’ scheme have played a significant role in this regard. By allowing women to retire earlier than men, albeit with actuarial penalties, the measure has functioned as an indirect care policy, encouraging women’s withdrawal from the labour market to take on caregiving responsibilities within the family. Similarly, in Spain, despite the introduction of the Dependency Law aimed at expanding public care provision, implementation gaps and austerity measures have limited its transformative potential. Rather than promoting de-familialisation, these policy trajectories have contributed to the institutionalisation of familism, reproducing gendered inequalities and embedding care responsibilities within households. Moreover, both countries have actively promoted home-based care through a combination of migration policies, targeted legislation, and fiscal incentives. Rather than expanding public service provision, governments have facilitated the outsourcing of care to households by enabling the recruitment of migrant care workers − through regularisation schemes or migration channels tailored to domestic work − while simultaneously subsidising their employment via tax deductions and reduced social contributions. The different configurations and embeddedness of care systems within broader social models explain why the care trilemma manifests differently in Southern Europe compared to Northern Europe. The so-called care trilemma, building on the service economy trilemma originally formulated by Iversen and Wren (1998) and subsequently adapted to care services by Pavolini et al. (2013), captures the competing objectives that governments must balance within country-specific contexts: service coverage, job quality, and fiscal sustainability. Within this framework, countries are typically compelled to trade off at least one of these priorities.

The equilibrium to this trilemma, thus, reflects different socio-economic and institutional configurations. In Southern Europe, limited public spending combined with a strong reliance on informal labour and a familistic care tradition has generated a highly stratified care system, marked by insufficient coverage and poor service and job quality (Greve, 2016). Consequently, accessibility and familial involvement are often maintained at the expense of job quality and working conditions. Care work is largely performed by migrant carers in precarious jobs, with low wages and limited access to training, especially in LTC (Da Roit et al., 2013; Moreno et al., 2016). Post-2008 austerity policies have further exacerbated these trends by tightening public budgets and promoting low-cost, low-quality solutions through market-based mechanisms, especially outsourcing (León and Pavolini, 2017). By contrast, Nordic countries pursue a ‘de-familialised’ approach, offering universal access and high-quality services, albeit at high fiscal costs. Continental regimes balance public provision with a strong non-profit sector and generous care allowances, effectively managing the trilemma through hybrid public–private partnerships. Thus, Southern European countries are caught in a persistent bind, attempting to expand access without the fiscal or political means to ensure quality and sustainability, resulting in a chronic imbalance in the trilemma, at the expense of job quality.

Cross-country differences should be analysed alongside sectoral differences between LTC and ECEC, as the two subsectors are subject to distinct pressures and trajectories in Southern Europe. Thus, in LTC, demographic ageing and traditional family expectations lead to a predominance of informal care. Whilst public provision is growing, there remain significant coverage gaps, especially in rural areas. Consequently, job quality in this sector tends to be poor, especially in the private informal part, characterised by unregulated migrant labour and limited professionalization. In contrast, ECEC has seen modest improvement, particularly in the 3–6 age group, where public provision is more standardized. The coverage for children aged 0–2 is medium in Spain and medium to low in Italy, 50,5% and 40,8% in 2024, respectively, thus indicating a systemic undersupply of affordable options. Moreover, there are also differences in governance: ECEC is often more centralized and tied to educational policy, while LTC remains siloed in health and social policy domains. Thus, while ECEC shows gradual alignment with EU goals on gender equality and social investment, LTC lags behind, trapped in a residual, familistic model in Southern Europe.

Explaining the dualization pattern in the Southern European care labour market

One of the distinctive traits of labour markets and social policy in Southern Europe is its dualization (Afonso et al., 2022), referring to the growing divide between secure, well-protected workers and precarious, flexible workers. This phenomenon is particularly pronounced in Mediterranean countries, characterised by strong employment protection for some groups, clientelistic political traditions, and fragmented welfare regimes. The resulting configuration combines highly protected standard workers − especially in the public sector − with an expanding periphery of temporary, young, and migrant workers holding limited rights. Such dualization also typifies the Southern (or familistic) welfare regime, where low universalism and fragmented entitlements leave the most vulnerable workers with restricted or no access to social protection (Esping-Andersen, 1999).

Several factors explain the emergence and persistence of dualization in labour markets. Emmenegger et al. (2012) provide a structural account, linking the rise of dual labour markets to broader deindustrialization and liberalization trends, especially in societies lacking strong, inclusive labour market and welfare institutions (see also Petmesidou 2001). Other authors have linked dualization to the role of labour market actors. The insider–outsider theory developed by Lindbeck and Snower (1986) explains it by highlighting the unequal influence of different groups of workers in wage bargaining and employment regulation. Insiders are those workers who are already employed and protected by good contracts, employment protection legislation, and collective bargaining institutions, and have as a result greater bargaining power than ‘outsiders’ (unemployed, temporary workers, etc.). The former are able to defend relatively high wages and employment protections, whilst outsiders have little influence over wage-setting and therefore face greater risks of unemployment or precarious employment. Building on these ideas, Rueda (2005) argues that social democratic parties and trade unions have supported regulations protecting core constituencies, widening gaps with other workers and sectors. Political decision-making reinforces this dynamic: centre-left parties tend to avoid confronting insiders and instead pursue path-dependent reforms that deepen segmentation (Rueda, 2007). This pattern is particularly evident in Southern Europe, where clientelistic, party-centred traditions have contributed to weak enforcement and targeted benefits (Ferrera, 1996), while labour market reforms have produced protected insiders alongside a precarious secondary workforce, especially among young people and women (Bentolila et al., 2012; Eichhorst and Marx, 2011). These divisions intensified during the financial crisis and subsequent austerity phase, when Southern European governments introduced reforms in industrial relations and labour market regulations.

Finally, both institutionalist and actor-centred explanations emphasise the role that industrial relations institutions and actors may also play in shaping dualization dynamics, as multiple axes of dualization cut across employment relations and working conditions. A first factor explaining cross-sectoral differences concerns the distinct regulatory frameworks and institutional settings shaping industrial relations in the public and private sectors, often producing divergent working conditions (Mori, 2017, 2024). Public employees in ECEC and LTC are typically protected by statutory job security provisions and comparatively higher levels of social protection, whereas private sector workers are more likely to face flexible and less regulated arrangements. Legal frameworks thus institutionalise a divide between public sector workers with stable contracts – though temporary employment has also been growing in public sectors of Southern European countries after austerity policies and labour market reforms − and private sector employees in temporary or subcontracted jobs (Emmenegger et al., 2012; Gerber, 2014).

Differences in collective bargaining institutional configurations further reinforce these dynamics. Key dimensions include bargaining coverage, coordination, and centralisation, which tend to be higher in the public sector. Public sector bargaining is generally more centralised and coordinated and has historically functioned as an instrument of fiscal policy to stabilise domestic demand and promote social cohesion (Di Carlo and Molina, 2024). By contrast, wage-setting in the private sector is more exposed to market pressures and employer discretion. Although public sector negotiations may occur across regional or occupational lines, they are usually embedded in stronger vertical and horizontal coordination mechanisms.

Another dimension of industrial relations affecting dualization dynamics refers to the configuration of social partner representation and collective bargaining. The literature in comparative employment relations suggests that fragmentation in systems of interest representation and collective bargaining can generate significant variation in employment standards, particularly in sectors characterised by weak regulation and pluralistic bargaining structures (Burroni and Pedaci, 2022). When trade union and employer representation is more fragmented, coordination between bargaining actors becomes more difficult, reducing their capacity to establish common wage floors and uniform working conditions across firms or subsectors. This dynamic may also encourage competitive wage-setting, whereby employers adopt the least demanding collective agreements or negotiate with weaker unions, thereby exerting downward pressure on labour standards. Fragmentation may therefore translate into greater heterogeneity in working conditions, especially in labour-intensive and feminised sectors such as care services, where cost competition and public budget constraints are particularly salient. The consequences are amplified in institutional contexts where representativeness criteria for bargaining actors are absent or weakly enforced, allowing minority unions or employer associations to conclude agreements with limited legitimacy but significant regulatory impact, as shown by the Italian case (Lucifora and Vigani, 2021). In such cases, the proliferation of collective agreements can undermine coordination and generate downward competition, leading to an erosion of wages and employment standards. In comparative perspective, therefore, higher levels of fragmentation in trade union and employer representation are expected to be associated with greater disparities in working conditions and employment stability across sectors and institutional contexts.

A third factor concerns the characteristics, structure, and relative strength of actors in the two sectors, particularly trade unions, and the size and composition of their membership bases. Across most EU countries, unions remain comparatively strong among public sector and core industrial workers, but weakly represented among temporary, young, and informal workers, who constitute a large share of the private care workforce. Unions may therefore, albeit often tacitly, favour the preservation of differences between the public and private sectors. At the same time, important differences also exist within the private sector, as some segments are traditionally more unionised than others. Divergent configurations of interest representation further reinforce these divides: for instance, the presence of sector-specific public sector unions may limit inter-union coordination and thus exacerbate fragmentation (Mori, 2024). Moreover, unions’ power resources − structural power, associational strength, and mobilisation capacity − are generally higher in the public than in the private sector (Høgedahl and Jonker-Hoffrén, 2024). These dynamics are compounded by comparatively weaker employer organisations in private care, where the fragmented structure of LTC and ECEC provision produces heterogeneous and often fragile employer representation, undermining coordinated bargaining outcomes (Marques et al., 2025).

Country selection and methodology

To examine how the care trilemma is configured in Mediterranean care regimes, focussing in particular on working conditions, and to explore the factors accounting for these dynamics, the analysis follows a most-similar case design (Eisenhardt, 1989), comparing two countries that belong to the Mediterranean or Mixed Variety of Capitalism: Italy and Spain (Amable, 2003; Molina and Rhodes, 2007). This research design allows for control over several contextual and independent variables, thus enabling the isolation of the influence of other factors (Eisenhardt, 1989). First, the two countries face similar demographic trends, and their care systems are accordingly exposed to similar challenges. Second, the two countries face similar fiscal and financial pressures since they exhibit high debt-to-GDP ratios and deficits, leaving them under strong pressure within the Stability and Growth Pact. Third, labour markets in the two countries have traditionally been characterised by high levels of non-standard employment and segmentation, with large shares of the workforce in low-paid jobs.

When it comes to industrial relations, although Italy and Spain are often clustered together under a Mediterranean model characterised by a fragmented system of interest representation and collective bargaining, high levels of industrial conflict, and limited employee involvement at the workplace level, they nonetheless exhibit some key differences. First, whilst the state plays a prominent role in regulating industrial relations institutions in Spain, its role is limited to public employment primarily in Italy − as exemplified, for instance, by the absence of a statutory minimum wage. Moreover, trade union density figures in Italy are significantly higher compared to Spain, where the automatic extension of collective agreements granted by law limits the incentives to join trade unions. Finally, the system of interest representation in Italy is more fragmented along ideological lines, whilst in Spain, the two most representative trade unions are ideologically aligned and maintain de facto unity of action.

In both countries, we examine two care subsectors − LTC and ECEC − excluding healthcare services. These are labour-intensive sectors that have experienced substantial employment growth in recent decades due to socio-demographic change and social policy reforms, and both have been shaped by marketization practices intended to address the care trilemma. While migrant live-in care workers play a central role in LTC provision in both countries, this study does not fully cover this segment, as its analytical focus is on formally organised LTC and ECEC services, where working conditions are more directly shaped by collective bargaining institutions and outsourcing practices, allowing for greater cross-country and cross-sector comparability.

To explore the configuration of working conditions in the two care subsectors and the determinants underlying emerging patterns across Italy and Spain, this article draws on a comparative analysis of the two national cases. The study is based on documentary analysis of secondary sources − including extant literature, policy reports, collective agreements, legislation, and internal documents of actors involved − complemented by semi-structured interviews with key informants selected based on their direct involvement in LTC and ECEC services. We identified a total of 40 interviewees (22 in Italy and 18 in Spain), well-balanced between the two subsectors and affiliations (union or employer side) in each country. The interviews, carried out between 2021 and 2022 − audio-recorded, transcribed verbatim, and content analysed − were based on a semi-standardised set of topics related to: (i) the configuration of pay and employment conditions over the last decade; (ii) the configuration of collective bargaining institutions and their degree if centralization, coordination, and coverage; (iii) the characteristics and structure of the main social partners involved in the two subsectors.

Employment and working conditions in Italy and Spain: Main evidence

The case of Italy

Although some improvements have been observed in recent years, working conditions in LTC and ECEC services in Italy remain comparatively very poor when compared to those prevailing in other service sectors (including healthcare), as also reported by interviewees (Mori et al, 2022). This work devaluation is particularly pronounced in the private segment, which has expanded in response to the growing reliance of local authorities on market-based mechanisms − particularly outsourcing − to deliver the majority of services, especially in LTC, where around 77% of services are contracted out.

The increasing resort to private providers for publicly funded services has generated a marked dualization in working conditions between public and private care, which differ along two main dimensions: the degree of uniformity versus fragmentation of working conditions and the level of protection established by NCAs (National-sectoral Collective Agreements). Overall, working conditions set by NCAs in public care sectors − that is, the Local Authorities (for LTC) and Education (for ECEC) agreements − are systematically more favourable than those applied in the private care sector, both non-profit and for-profit. The erga omnes application of a single sectoral agreement ensures several benefits to workers, including homogeneous working conditions, equal treatment for comparable occupational profiles, employment stability, predictable wage progression, and more advantageous standards regarding wages, working time, shift organisation, and career regulation (Interview FP-CGIL).

By contrast, the private care sector is characterised by higher levels of contractual fragmentation and weaker protections. Private-sector agreements generally establish a working week of 38 to 40 hours (compared with 36 in the public sector), combined with flexible monthly scheduling and variable daily shifts. Moreover, a substantial share of care workers − especially in LTC services− hold part-time contracts, typically between 20 and 30 hours per week. This reflects the fragmentation of service hours, often concentrated at specific times of the day, and undermines income stability, as working time is unpredictable and pay is calculated solely on hours worked. Work intensity is generally higher in the private sector, where NCAs provide for longer weekly and monthly working hours and fewer days of leave. This is particularly evident in LTC services, where persistent structural staff shortages require the existing workforce to cover extended shifts. In addition, private facilities have higher worker-to-user ratios, translating into increased workload and faster work pace, as confirmed by an interviewed union official.

Overall, higher public–private differentials and greater fragmentation of terms and conditions are observed in LTC than in ECEC services. This reflects several interrelated factors. First, the LTC sector displays a higher degree of fragmentation in both collective bargaining and collective representation, as discussed in the next section. Second, the extensive reliance on market-based mechanisms for service provision in LTC fosters race-to-the-bottom competition among providers on labour costs, resulting in the application of a wide range of NCAs, including ‘pirate’ agreements. Consequently, LTC wage setting reflects a market-driven logic, shaped by public procurement mechanisms that favour the lowest-cost bidders. In recent years, however, labour shortages in both care sub-sectors have prompted some improvements in pay levels within private NCAs during the last renewal. This is notably the case for the Social Cooperatives agreement (applicable to both sectors) and for FISM and AGIDAE, the two main NCAs applied in ECEC services. As a result, these pay increases have primarily benefited ECEC personnel, while LTC caregivers continue to lag behind. Third, a substantial share of LTC services is delivered by informal migrant live-in assistants in domestic settings, which often remains outside collective regulation (interview FILCAMS-CGIL). Despite unions’ recent efforts to reach these workers, structural barriers − language, irregular status, and turnover − limit their associational inclusion.

The case of Spain

Following the trend seen in Italy, some improvement has also been observed in Spain in recent years, although working conditions in LTC and ECEC services remain poor, especially when we compare private LTC and ECEC with other private service sectors, with a trend towards the marketization and outsourcing of care services (Molina et al., 2022).

Spain’s LTC sector has suffered from chronic underfunding as public LTC spending stands below the 1% threshold. Austerity policies following the 2008 economic crisis have severely undermined service expansion and working conditions in the sector. Public LTC jobs are typically more secure, with formal contracts and better union representation. However, long waiting lists and capacity shortages have led to the growing role of the private sector, which now delivers around 70% of residential care services (Deusdad et al., 2016). Private LTC employment is marked by job insecurity, low wages, and informality, especially in home-based care. Migrant women are heavily represented in this sector, often under informal or undeclared arrangements that limit access to legal protections and career advancement (Moreno et al., 2016). The COVID-19 crisis exposed systemic fragilities, particularly in private nursing homes, where mortality rates were high, prompting renewed debates on the quality of service.

Spain’s ECEC has evolved from a welfare function into an educational model over the last three decades. The system is split between 0–2 years (mostly fee-based and managed by local authorities) and 3–5 years (free and integrated into the public education system). National education laws (2006 LOE, 2020 LOM-LOE) emphasize universal access and public expansion, with an increase in per capita expenditure that nonetheless remains below EU averages. Public ECEC jobs, particularly in the 3–5 age group, are generally full-time, more stable, and with above-average wages. Municipalities often manage the 0–2 provision, where workers may face more precarious contracts (in terms of poorer wages, longer working hours, or less training actions). Although qualified public sector staff enjoy higher wages and better protections than private workers, hiring restrictions since the 2008 crisis have curtailed workforce renewal and increased job demands. Private ECEC services, especially for 0–2 year-olds, fill the gaps left by limited public provision. They operate under various models – fully private, State-subsidized, or in partnership with local authorities. In general terms, private ECEC employment is often precarious, characterized by temporary contracts, lower pay, and limited bargaining power. According to some interviewees, outsourcing is a key contributor to these disparities, though recent efforts at re-municipalization aim to reverse this trend and improve job quality (Molina et al., 2022). These public–private differences in employment and working conditions between LTC and ECEC are also related to the collective bargaining structure in both sectors, as well as the social partners involved in them.

Industrial relations in LTC and ECEC: Institutions and actors

The case of Italy

Italian employment relations in the LTC and ECEC sectors mirrors the dualized structure of its labour market, rooted in a long-standing public–private divide. Such division produces two distinct bargaining systems that coexist with no coordination.

In the public care sector, a single sectoral NCA with de facto erga omnes validity applies to all employees. The low level of bargaining fragmentation reflects a legislative framework designed to ensure homogeneous wage levels and working conditions across the Italian public administration within each branch or activity. In LTC, the NCA for Local Authorities regulates the employment conditions of care personnel working in public residential and domiciliary services. In the public ECEC sector, educators and pre-primary teachers are covered by two main NCAs: the Local Authorities NCA, applying to municipal services for children aged 0–2, and the Education and Research NCA, covering pre-primary teachers in services for children aged 3–5 under the Ministry of Education. This country-wide sectoral standardisation of employment terms and conditions is achieved through the statutory definition of the actors entitled to negotiate public NCAs: on the union side, organisations recognised as representative following a verification of representativeness; and on the employer side, exclusively ARAN a technical agency which compulsorily and monopolistically represents all public administrations. Thus, in the LTC sector and in the 0–2 ECEC services, negotiations take place between a limited number (despite the existence of hundreds of registered unions) of representative public sector unions, primarily the confederal ones − FP-CGIL, FP-CISL, and FPL-UIL − and ARAN, while in the 3–5 ECEC services, ARAN negotiates with the representative unions in education (still the confederal ones: FLC-CGIL, CISL Scuola, UIL Scuola RUA). Accordingly, fragmentation among bargaining actors in the public care sector remains structurally limited.

By contrast, the private care sector displays a very high degree of fragmentation in both collective bargaining structures and systems of interest representation, especially in LTC and, to a lesser extent, in ECEC. Collective bargaining follows a voluntary model, whereby employers’ associations may freely choose their union counterparts and conclude their own NCAs. This institutional setting encourages strong associational pluralism and a proliferation of bargaining actors, resulting in a multiplication of NCAs. These agreements are formally applicable but legally binding only on employers and workers affiliated with the signatory organisations, given the absence of erga omnes extension mechanisms. Moreover, bargaining parties frequently conclude minority (non-representative) agreements and so-called ‘pirate agreements’ signed by organisations of questionable representativeness, which typically set even lower wages and working conditions. This landscape fosters downward competition among NCAs and enables care providers to engage in ‘contractual shopping’ to circumvent the most representative agreements and instead adopt those establishing lower labour standards. Fragmentation is particularly pronounced in LTC, where 38 NCAs are currently registered, compared to 20 in the ECEC sector (CNEL, 2023), and is further exacerbated by the structural relevance of domestic work performed by live-in care assistants for older people. The domestic work sector alone counts 30 registered NCAs − 21 concluded since 2016 − most of which qualify as ‘pirate agreements’ (Interview FILCAMS-CGIL). The impact of fragmentation on the private/public divide is further accentuated by the lack of both formalised and informal mechanisms of inter-sectoral horizontal coordination between the private and the public care sector, as well as by the absence of institutionalised forms of intra-sectoral horizontal coordination between private care NCAs (Interview FP-CGIL).

A key factor underpinning fragmentation is the plurality of employers’ associations which follows functional and ideological lines. In the LTC sector, the main employers’ organisations include the three cooperative federations − Legacoop-Sociali, Confcooperative–Federsolidarietà, and AGCI-Solidarietà − which jointly sign a single NCA. By contrast, all other major organisations − around 40 in total − negotiate separate agreements, often with several different autonomous and non-representative rank-and-file unions (21 out of 30 qualify as pirate agreements). These NCAs establish different wage scales, working time arrangements, and occupational classifications, generating substantial heterogeneity in employment conditions across the sector. Among the most relevant associations are UNEBA, ANASTE, ARIS, AIOP, AIAS, and ANPAS. By contrast, employers’ pluralism in ECEC is comparatively more contained. In addition to the three cooperative federations, the main bargaining actors are FISM and AGIDAE, which, in the most recent NCA renewal, have introduced substantial improvements − particularly in wage scales − aimed at narrowing the pay gap with the public-sector agreement. Furthermore, coordinated bargaining positions among trade unions in ECEC services facilitate the development of unified sectoral strategies. Most NCAs are signed by two main union coalitions − the confederal unions and a stable group of a few autonomous unions − while only a minority are negotiated by other rank-and-file organisations. As a result, while fragmentation is not absent, the scope for inter-agreement competition appears more limited than in LTC.

The case of Spain

Spanish employment relations in LTC and ECEC are characterized by a dualized configuration along the public–private divide, with limited coordination between them. In the Spanish case, territorial disparities should also be considered, given the regionalised collective bargaining structure in both sectors.

In the public LTC sector, collective bargaining is highly decentralized, with sectoral or regional agreements negotiated between sub-national governments and the main trade unions representing public employees and civil servants. Despite the 2006 Dependency Law (LAPAD), aimed at professionalizing care work and establishing a national framework for dependency services, chronic underfunding and decentralized implementation have produced persistent territorial disparities among LTC workers. Public LTC employment guarantees civil-service-level job stability, standard working time, and access to training. However, austerity measures after 2008 curtailed wage growth, froze public hiring, and reduced staffing levels (Torns et al., 2012). The widespread outsourcing of residential and home-based care has blurred the boundary between public and private employment.

In the public ECEC sector, differences between the 3–5 and 0–2 stages must be considered. The 3–5 stage is integrated into the public education system and provided free of charge, with quasi-universal enrolment, while 0–2 provision is characterized by a more marketized and decentralized structure (Vélaz De Medrano, 2020). This stage is mainly municipal or privately managed, often with public subsidies, shaping employment relations and labour standards. At the 3–5 level, teachers and educators are public employees covered by national or regional education agreements, ensuring relatively stable and standardized working conditions. For municipal 0–2 services, bargaining occurs at the local level, with variability in pay and staffing depending on municipal budgets. Even so, public ECEC employment is generally well protected, although austerity-era budget cuts led to hiring freezes and increased workloads.

Thus, there is a minimum level of standardization of working conditions at national level, with some regional disparities. In ECEC, this results from stable representation in collective bargaining between the main sectoral trade unions (CCOO, UGT and CSIF for civil servants) and the Ministry of Education. Each regional government replicates this system with regional education ministries and sectoral union federations, as well as other regional unions depending on the region. Comparing these regional agreements allows unions to exert pressure to improve working conditions (Interview CCOO, public ECEC).

In the private sector of LTC and ECEC, industrial relations are characterized by fragmented multi-level bargaining, weak employer coordination, and significant regional variation, particularly in LTC. The multiplicity of bargaining arenas and outsourcing have maintained the public–private gap in employment quality.

The private LTC sector is governed by a combination of national and local collective agreements. The most relevant NCA, the National Dependency Collective Agreement (Convenio Estatal de la Dependencia), establishes minimum standards for pay, working time, and staffing ratios, but enforcement is weak and often undermined by local pacts offering less favourable conditions. Fragmentation is reinforced by numerous regional or company-level agreements. Pay in private LTC is typically 20–30% below the public sector, and a large share of employment is part-time or temporary (Barrera et al., 2021).

Regarding private ECEC, provision includes for-profit centres and outsourced publicly funded centres (many of them faith-based schools). The two main sectoral agreements are the Collective Agreement for Private Educational Institutions (a) Fully or (b) Partially Funded with Public Funds, and the National Collective Agreement for Early Childhood Education and Care Centres, which covers most private nurseries and early education centres (0–2 stage). Wage levels and job security in the private ECEC sector – especially for educators covered by the NCA of private nurseries – are considerably lower than in the public sector, with salaries often near the minimum wage and widespread temporary contracts. Many educators, particularly in the 0–2 segment, hold vocational qualifications rather than university degrees, limiting professional mobility (Molina et al., 2022).

These poorer working conditions are accompanied by a fragmented representation landscape. The NCA in LTC is signed by CCOO and UGT with employer associations AESTE, LARES, and CEAPS others. Employer representation mirrors this heterogeneity: AESTE represents large for-profit companies, LARES the non-profit religious sector, and CEAPS a mix of smaller providers. Despite national agreements, competition based on labour costs persists due to procurement rules emphasizing price over quality (Aguilar-Hendrickson, 2020). Unions have mobilized around campaigns for ‘decent care’ and stronger public oversight, linking employment quality to service quality (Interview FSS-CCOO).

In the private ECEC sector, the main NCA (for 0–2 services) is negotiated mainly by CCOO, UGT, USO, CIG, and FSIE with employer confederations ACADE, CECE, EyG, FCIC, and SALVEM 0–3. This diversity reflects differences in interests and ideology: ACADE represents non-religious private providers, while CECE and EyG represent faith-based schools. Wage levels and job security negotiated in this NCA remain considerably lower than in the public sector, with salaries near the minimum wage and widespread temporary contracts. Unions have pressed for harmonization of professional standards and inclusion of 0–2 educators within public education frameworks (Interview CCOO, private ECEC), and opposed outsourcing practices that erode job quality and pedagogical standards. Nonetheless, regional decentralization and the diversity of private providers limit unions’ capacity to coordinate bargaining strategies. Employer associations, particularly CECE and other faith-based organizations, have resisted stronger public regulation, emphasizing their autonomy and financial vulnerability (Interview CCOO, private ECEC).

Explaining the twofold dualization: A cross-country comparison

Despite similar welfare traditions and industrial relations institutions, Italy and Spain exhibit persistent and multi-layered dualization between public and private care sectors, and between LTC and ECEC. This dualization stems from both institutional configurations − the structure of collective bargaining, the degree of decentralization, and extension mechanisms − and actor-based dynamics, including trade union and employer representation as well as the role of the state. Both countries maintain parallel regulatory systems: more centralized and coordinated in the public sector but fragmented in the private one. Trade union structures mirror this divide, with strong associational and institutional power in the public sector and weaker organization and representation among private care workers. This divide is particularly pronounced in Italy, where the separation between ARAN-based public bargaining and the voluntaristic private system prevents coordination or pattern bargaining. The absence of erga omnes extension and representativeness criteria in the private sector has fostered a proliferation of agreements and competition among unions and employers, weakening labour standards. In Spain, by contrast, a more regulated system of collective bargaining, including stricter representativeness rules, reduces the gap between sectors. However, welfare decentralization across regions and municipalities generates territorial fragmentation. Overall, Italy displays stronger institutional dualism, while Spain exhibits functional dualism linked to administrative decentralization.

In both countries, public procurement reinforces these divides. Cost-based tendering in LTC, and to a lesser extent in ECEC, incentivizes providers to adopt lower-cost collective agreements with inferior wages and conditions (León et al., 2019; Mori, 2017). The state’s dual role as regulator and client thus reproduces rather than mitigates dualization. This interaction also explains cross-national variation: in Italy, a fragmented bargaining system − partly due to weak representativeness rules and the spread of ‘pirate’ agreements − facilitates cost competition in outsourcing.

Furthermore, the expansion of informal care arrangements has institutionalised an additional axis of dualisation between formal and informal care sectors. Rather than being eroded, the familistic legacy has been actively reproduced through reforms in both countries that directly or indirectly sustain this care regime. These policy trajectories have contributed to the consolidation of a dualised care market, characterised by differentiated patterns of access, working conditions, and regulation. Yet dualization varies across sectors and countries due to differences in interest representation and state intervention. Italy’s employer landscape is more fragmented and ideologically divided than Spain’s, where national associations provide limited but effective coordination. This constrains encompassing bargaining in Italy, especially in LTC, where over thirty NCAs coexist. In Spain, state-wide agreements, such as the Nationwide Dependency Collective Agreement, establish a basic wage floor and contain internal competition.

Second, the internal structure of trade union representation also differs. Italian main confederations are divided into numerous sectoral federations with limited inter-sectoral coordination, whereas Spanish unions maintain more integrated federations encompassing public and private care workers. This latter facet facilitates unified bargaining strategies and cross-sector solidarity in Spain, especially within the education system, whereas in Italy, fragmentation hampers cohesive action across LTC and ECEC.

Additionally, the configuration of public sector governance influences the reach of collective regulation. Italy’s strong national frameworks for public employment contrast with Spain’s regionally decentralized model. As a result, Spain’s public/private gap is mitigated by regional variation but remains wide in LTC, while Italy exhibits sharper dualization within each region due to the rigid separation of bargaining domains.

The distinct institutional and organizational logics characterizing the two care sub-sectors further reinforce patterns of inter-sectoral dualization. ECEC in both countries benefits from higher professionalization, tighter regulatory oversight, a more limited role of informal care, and greater union embeddedness in education federations, leading to relatively better conditions and smaller public–private gaps. LTC, in contrast, is more exposed to market pressures and demographic pressures, leading also to a widespread resort to informal arrangements, with a weaker professional identity and more fragmented actors, resulting in deeper dualization.

The persistence of dualization in both Italy and Spain thus results from the interaction between institutional dualization and actor fragmentation within a supported familistic care policy legacy. In both contexts, encompassing industrial relations institutions coexist with weak horizontal coordination across sectors and insufficient state enforcement in the private care market, including the informal segment. While macro-institutional design helps account for differences between formal and informal care markets, overall variation is better explained by how actors organise and operate within these institutional frameworks. Spain’s unions have maintained stronger cross-sector coordination and achieved minimal national frameworks for collective bargaining, while Italy’s highly pluralist and voluntary system has perpetuated wage dispersion and organizational fragmentation.

Concluding remarks

This paper examines how industrial relations institutions and actors mediate the ‘care trilemma’ in two Southern European countries − Italy and Spain − characterized by similar welfare traditions but distinct institutional architectures and trajectories of reform. The analysis answers two interrelated questions: (i) how are job quality and working conditions in the care sector shaped by the care trilemma equilibria reached in Mediterranean care regimes? and (ii) what factors explain these patterns? By comparing the industrial relations institutional configurations and actors in LTC and ECEC in the two countries, the paper has revealed how the institutional design and the configuration of actors jointly shape divergent paths within the shared constraints of the Mediterranean welfare model.

The above evidence confirms that both countries remain caught in a chronic imbalance between the three poles of the care trilemma (León and Pavolini, 2017). Despite reforms aiming to expand coverage and formalize provision, both countries have addressed fiscal constraints through market-mediated solutions − primarily through outsourcing and mixed public–private governance − while simultaneously sustaining and expanding informal care arrangements embedded in a familistic care legacy. These strategies have expanded service availability without delivering improvements in labour standards, thus resolving fiscal pressures at the expense of job quality. This results in an asymmetric equilibrium: both systems achieve partial coverage expansion but reproduce segmentation and precariousness in the workforce. The outcomes, however, differ across subsectors. ECEC, embedded in the education system, benefits from higher professionalization, stronger public oversight, and more cohesive collective bargaining, resulting in better working conditions and a narrower public–private gap. LTC, by contrast, remains peripheral − situated at the intersection of social and health policy, with diffuse governance and weak professional boundaries − therefore more exposed to market competition and informal provision. Thus, the trilemma weighs more heavily on job quality in LTC than in ECEC since fiscal constraint and rising demand have generated systemic underinvestment and a growing reliance on low-cost labour, often migrant and informal.

Yet, behind a similar path, we can find some relevant differences between the two countries. Despite similar structural pressures linked to balancing the ‘care trilemma’, Italy and Spain illustrate two distinct mechanisms of adaptation within the Mediterranean model: Italy’s path of institutionalized fragmentation, where voluntarism and actor pluralism sustain deep public–private divides, and Spain’s path of decentralized coordination, where regional governance and negotiated frameworks mitigate, but do not eliminate, dualization. Both reveal the limits of traditional industrial relations institutions in addressing the care sector’s structural inequalities and the enduring tension between fiscal discipline, labour protection, and social investment. The comparison thus refines dualization patterns by showing that similar macro-institutional models can yield distinct trajectories depending on actor strategies and governance arrangements.

The broader implication of this study is that strong industrial relations institutions alone are insufficient to counter the structural pressures of the care economy. In both Italy and Spain, encompassing unions, centralized bargaining, and high coverage coexist with precariousness, informality, and wage compression in care services. The traditional instruments of labour regulation struggle to reach the peripheries of feminized service work shaped by outsourcing, informality, and fiscal austerity. This points to the need for renewed forms of coordination that integrate public procurement, funding mechanisms, and collective bargaining in a single regulatory framework.

Footnotes

ORCID iDs

Oscar Molina

Anna Mori

Joan Rodríguez-Soler

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Employment, Social Affairs and Inclusion (VS/2020/0242).

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Author biographies

Oscar Molina is associate professor at the Department of Sociology and researcher at Centre d’Estudis Sociològics sobre la Vida Quitidiana i el Treball (QUIT) and Director of the Institute for Labour Studies (IET), Autonomous University of Barcelona. He holds a degree in Economics (Pompeu Fabra University) and a PhD in Social and Political Science (European University Institute). His research focuses on the comparative analysis of industrial relations and collective bargaining, trade unions, labour markets and comparative political economy.

Anna Mori is associate professor in economic sociology and employment relations at the Department of Social and Political Sciences (SPS), University of Milan. Her research interests concentrate on comparative employment relations, with a particular focus on the public sector, care services, and trade union representation strategies in nonstandard segments of labour market (multiple jobholders, independent professionals). She has extensively worked on the impacts on employment relations and working conditions of outsourcing in public services from a comparative perspective.

Joan Rodríguez-Soler is lecturer at the Department of Sociology and researcher at the Centre d'Estudis Sociològics sobre la Vida Quotidiana i el Treball (QUIT) and the Institute for Labour Studies (IET), Autonomous University of Barcelona. His research interests focus on youth employment trajectories, social capital and labour market inequalities, comparative industrial relations, gender inequalities, and research methods, especially qualitative methods.

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