On 10 June 2025, the Institute of Public Finance hosted a roundtable entitled “Who will care for older people? Croatia and Slovenia in the global care chain”. The discussion focused on the similarities and differences between the Croatian and Slovenian long-term-care (LTC) systems and the possible solutions to the labour shortages in the sector in both countries. Introductory presentations were given by Majda Hrženjak, a researcher at the Peace Institute – Institute for Contemporary Social and Political Studies in Ljubljana, and Marijana Bađun, a senior research associate at the Institute of Public Finance.

Traditionally, family members have played key roles in providing LTC. However, due to the increasing employment rate of women, changes in family structure and population ageing, the need for formal care is growing, primarily provided by nurses and personal care workers. Most developed countries are now suffering from labour shortages in LTC, a gap that is often filled through immigration, that is with foreign workers. As a result, LTC workers worldwide become part of a global care chain in which wealthier countries attract carers from poorer ones, leaving older people in less-developed countries without the care workers they also need.

Both Croatia and Slovenia are experiencing a “care drain” but at the same time can be attractive destinations for nurses and personal care workers from other countries. In Slovenia, LTC has long been on the margins of political interest. Privatization policies, low labour costs, and individualization of care financing have resulted in worsening working conditions and amplified staff shortages. In response to these challenges, Slovenians often employ migrant women workers in both formal and informal care, primarily from the former Yugoslav republics. Majda Hrženjak and colleagues conducted a qualitative study in which they interviewed migrant women employed in the public institutional care network in Slovenia. Their research revealed numerous structural problems: high migration costs, lengthy administrative procedures, non-recognition of foreign qualifications, housing insecurity and difficulties reconciling work and family life due to long working hours.

Slovenia is introducing a new LTC system that includes LTC insurance, expansion into a broader range of services and additional openings for human resources. The government is tackling the staffing crisis through scholarships, digitalization, volunteer involvement and special integration programmes for migrant workers. However, these measures do not address the LTC sector’s core structural problems – low pay and inadequate labour standards (including the required staff numbers and working hours) – which continue to make care work overly demanding and undervalued.

Unlike Slovenia, Croatia’s LTC sector is still not a policy priority, and workforce shortages receives scarce political attention. Marijana Bađun presented the findings of a qualitative study in which she interviewed experts from academia, NGOs, the competent ministry, professional associations, residential care homes and the Zagreb Office for Social Welfare about the potential role of immigration in alleviating Croatia’s LTC labour shortage. There was broad consensus amongst the interviewees that using immigration as a source of workers in the sector is inevitable. However reducing the emigration of Croatian nurses would be the preferred solution.

The respondents stressed that Croatia should offer foreign workers opportunities for professional development, good language training, and opportunities for social integration while making their former qualifications easier and less costly to be recognized in Croatia. They stressed that wages in LTC should be higher, working conditions better and housing more affordable. Some expressed concern about possible negative attitudes toward foreign workers among care recipients, and noted that Croatia might serve merely as a “way-station“ en route to richer countries. Because Croatia lacks a migration strategy, the government should adopt one urgently. Future research should also devote more attention to the effects of migration on the quality, affordability and accessibility of LTC.

During the roundtable discussion which followed, it was pointed out that the Slovenian Long-Term Care Act, which came into effect last year, took more than 20 years to be developed and adopted. Some of the measures and forms of care defined were compared with measures used in Croatia, such as the status of caregivers and the differences in compensation for that form of care between the two countries. A large part of the discussion concerned the distribution of care costs between the social and health care systems, and between users' out-of-pocket payments and governmental subsidies. Given that the roundtable included representatives of the Zagreb City Office for Social Welfare, the Ministry of Labour, the Croatian Employers' Association, and researchers in the field of LTC, some practical solutions were proposed that could address worker shortages in LTC occupations. The need for a national workforce development plan and evidence-based policies was pointed out as key. All participants agreed that connecting the health and social systems is necessary, and improving quality monitoring in LTC.

Majda Hrženjak’s presentation was based on the results of the research project Transnationalisation of eldercare – diversities, recruitments, inequalities, financed by the Slovenian Research (ARRS). Marijana Bađun presented her article published in the journal Revija za socijalnu politiku, made within the research project Social Protection, Taxation and Social Welfare in Croatia. The latter project and the roundtable were financed through funds from the National Recovery and Resilience Plan 2021–2026 (NextGenerationEU).