Councillors and Regional Ministers in the Decade of Care

When I speak about ageing and longevity, I like to do so through the lens of optimism, because I am one of those people who believe there is still room to get things right. However, today’s column is a pause in that optimism, because I sincerely believe that there are two professions that, unless the governance of ageing improves dramatically and quickly, none of us will want to pursue ten years from now. They will become high-risk professions.

You have probably already guessed which ones. I am referring to municipal councillors responsible for older people and regional ministers for Social Affairs in Spain. My intuition tells me that these will become some of the most thankless, stressful and complex positions in the entire public sector.

I do not write this to criticise those who currently hold these offices. On the contrary, I do so with the utmost respect for their role and with a warning that I believe society needs to hear: we have a system that is not prepared to sustain what lies ahead, a population with exceptionally high life expectancy combined with the ageing of the largest generation in Spain’s history, the baby boomers.

Let us look at the numbers. In 2026, Spain has 49.6 million residents, of whom 21.1% are aged 65 or over, approximately 10.5 million people. Projections from the National Statistics Institute suggest that this group will continue to grow in the coming decades. These are conditional scenarios rather than fixed predictions, but all indications are that by 2035 and 2050 older people will account for a substantially larger share of the population. Meanwhile, birth rates remain at historic lows: Spain’s fertility rate stood at 1.10 children per woman in 2024, one of the lowest figures in the European Union. There is no sign that this trend is about to reverse.

The CENIE study The Right to Care and the Care Economy in Spain illustrates this reality very clearly. It estimates that the care gap, meaning the difference between the number of people over 65 with severe limitations and the public support they receive, has already reached 63.1%.

The combination of these two trends, many more older people and a working-age population growing much more slowly, is already placing unprecedented pressure on care and social protection systems. And that pressure will fall, in a direct and often brutal way, on the political leaders closest to citizens.

Consider this. The councillor responsible for older people in a town of 50,000 inhabitants will have to face families searching for a place in a nursing home or day-care centre. In June 2026, Spain’s Dependency Care System was supporting 1,707,328 people, yet 142,887 were still waiting for benefits, with an average processing time of 314 days. The waiting list has fallen by 21% over the last year, and the national government has approved an additional €6.2 billion in funding for 2026 and 2027, both signs that improvement is possible.

However, unless demographic change is accompanied by a profound transformation of the model, that councillor could find themselves dealing with waiting lists that are twice or three times as long as they are today, families requiring urgent assistance that the system cannot provide quickly enough, and budgets growing far more slowly than demand. They will also have to do so with an ageing workforce, because caregiving, as it is currently structured, remains an unattractive profession for younger generations.

At this point, it is important to clarify who is responsible for what. Regional governments assess and recognise dependency situations, approve individual care plans, allocate benefits, plan and manage care networks, coordinate social and healthcare services, and inspect and evaluate the system. Municipal governments, meanwhile, operate on the front line of community services: identifying needs, informing and supporting families, promoting prevention and community networks, and providing or coordinating local services such as home care, telecare and day centres where regional legislation assigns these responsibilities.

As a result, councillors will have to confront families’ needs directly, while regional ministers will be responsible for ensuring assessments, benefits and an adequate network of services, delivered within timeframes compatible with the urgency of each case. If anything, the latter will face an even harder task. Their desks will become the meeting point of multiple crises: long-term care shortages, the partial collapse of home care services in less-resourced areas, pressure from hospitals unable to discharge more patients, demands from health and care professionals for better pay and working conditions, and a citizenry increasingly aware of its rights and determined to defend them.

All of this will occur while resources, at best, grow linearly, whereas demand continues to expand exponentially.

This is not a catastrophic scenario. It is the mathematically inevitable outcome of three decades of postponed decisions, partially funded dependency strategies and care models that have failed to evolve at the pace demographic change required. Spain’s Dependency Act will mark its twentieth anniversary on 14 December 2026, with more than 140,000 people still waiting to receive benefits.

So what needs to happen?

First, we must invest far more in prevention, helping people understand the importance of preparing properly for later life.

Second, we must acknowledge the scale of the challenge without the anaesthetic of electoral convenience.

Long-term care is not an expense to be minimised. It is an investment in social cohesion and economic productivity. The CENIE study estimates that every euro invested in dependency benefits generates around €1.60 in GDP impact, because every person cared for at home or in an appropriate setting frees a family member, usually a woman, to participate in the labour market.

Third, we must urgently professionalise and dignify the care sector. Without well-trained and fairly paid carers, no ageing policy can succeed.

Fourth, we must redesign care models, moving away from the paradigm of mass institutionalisation and towards community-based approaches, collaborative housing and advanced home-care services supported by technology.

And fifth, perhaps most urgently of all, we must recognise that this challenge cannot be addressed one electoral term at a time. We need agreements, strategies and institutions that transcend political cycles and turn the response to population ageing into a true State policy rather than the programme of a single party.

Otherwise, ten years from now, I fear that the positions of councillor for older people and regional minister for Social Affairs will either remain vacant because no prudent person will wish to assume them, or they will belong to those tasked with managing a crisis that could have been avoided.

And the question citizens will ask them, day after day, quite rightly, is a simple one:

Why did you not act sooner, when there was still time?

I fear we already know the answer.

Authored by: María Jesús González Espejo