In the Netherlands, care and migration are usually treated as two separate policy domains. Migration is discussed in terms of origin, integration, and identity; care in terms of accessibility, quality, affordability, and staff shortages. This separation may seem logical, but it obscures what has long been evident in practice: care and migration are more than parallel stories. They are part of a single social field in which people, labour, and dependency constantly move across borders.
This entanglement becomes most visible in long-term care for older adults. Older adults are a rapidly growing group across Europe, including in the Netherlands, with highly diverse life histories, expectations, and care needs. This has led to increased attention to culturally sensitive and inclusive care. Yet the dominant perspective remains limited. Diversity is still mainly approached as a characteristic of the care recipient, rather than as a structural feature of the care system itself.
What receives relatively little attention is that care professionals themselves may have a migration history. This includes second-generation professionals born and trained in the Netherlands, as well as people who migrated later in life and seek a workplace in the Dutch healthcare system. Labour market analyses estimate that between 8 and 12 percent of care workers have a migration background. The meaning of these figures becomes tangible within everyday care relationships—where language, trust, and proximity are crucial—and where it becomes clear how care and migration shape one another.
Formal care work: Migration as a structural pillar
The Dutch care system increasingly relies on labour migration. Nurses from the Philippines and Indonesia, for example, are more frequently recruited through international programmes to address staff shortages. Their arrival is often presented as a solution to an urgent problem, yet their position is frequently precarious. Recognition of qualifications is slow, language requirements are demanding, and residence rights are directly tied to employment.
In practice, some of these professionals end up in prolonged uncertainty or move into informal care, where bureaucratic barriers are lower but protection is also weaker. Here, care and migration intersect at an uncomfortable point: the system depends on migrant labour, yet is insufficiently designed for their long-term participation and career development.
Similar patterns can be seen elsewhere in Europe, though in different forms. In Germany, nurses from Vietnam and other Southeast Asian countries have been working for years in long-term care for older adults. They often care for older people without a migration background and are recruited and trained in their countries of origin specifically for this work. Migration is explicitly organised as part of care policy, with investments in training and bilateral cooperation.
These examples reveal a core tension: care systems require mobility and flexibility from workers, while those workers must operate within nationally bounded rules, standards, and institutions.
Informal migrant care: Indispensable and invisible
The intersection of care and migration becomes even more pronounced in informal care. In many European countries, long-term care has become structurally dependent on migrant labour outside formal institutions. In Austria and Germany, thousands of live-in caregivers from Central and Eastern Europe provide round-the-clock support. In Italy, the badante—often from Bulgaria, Romania, or Ukraine—is a familiar presence in households with care-dependent older adults.
These caregivers live in the home, provide intensive daily support, and make it possible for older people to remain at home rather than enter institutions. At the same time, this care largely takes place beyond the reach of policy. Labour rights, social security, and rest periods are often unclear or poorly enforced. Care and migration meet here once again at a vulnerable point: care is relational and intimate, while a migrant status can amplify dependency and distance.
Older people who migrate for care
Migration within the care field does not only involve care workers. Older adults themselves also cross borders in search of care. A growing number of Dutch citizens choose to organise care in countries where it is more affordable and accessible, such as Hungary. Lower costs and more intensive support make this option attractive.
Yet this form of mobility is unevenly distributed. Those with sufficient financial resources, relatively good health, and supportive networks can move. Those without such resources remain dependent on a national care system under increasing pressure. Care-related migration thus becomes a new source of inequality among older people.
Retirement migration and returning for care
For retirement migrants—Dutch citizens who spend their later years in countries such as Spain or Italy—care often becomes a turning point. While they are healthy, life abroad functions well. Once care needs arise, however, language barriers, bureaucracy, and access to appropriate services become decisive.
Many of these migrants eventually return to the Netherlands when their need for care increases. A circular movement emerges: people migrate to live, but move back to receive care. Care does not automatically follow people across borders; people move in order to find care.
The Netherlands in the European care–migration landscape
The Netherlands occupies a central position in the European landscape of care and migration. The Dutch care system is relatively well organised, yet increasingly dependent on international mobility and on ways of dealing with diversity. At the same time, care and migration remain strictly separated in policy and public debate. Anyone who takes the future of care seriously can no longer afford this separation.
Care is now organised across borders of countries, households, and life courses. Migration is not a side issue in this process, but a structural component of how care in Europe is made possible. The core question is therefore not only who needs care, but who provides it, under what conditions, and with what consequences—here and elsewhere.
This leads to an uncomfortable question: what happens when care workers with a migration background themselves grow older and come to need care? If their labour is insufficiently protected today, they risk becoming care-dependent tomorrow in systems that never fully accounted for them.
In this contribution, I do not address unconscious discrimination in care—a topic I have discussed elsewhere—but without taking that issue seriously, a just and future-proof care system will remain out of reach.
