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PhD Defense 8 July 2004
Elements of a Theory of Care
in Contemporary Modern Society
Tine RostgaardOpen Door Talk,
Cork, 6 March 2006
Presentation of agenda
1. Place social care policies in the political agenda of the Adult-worker model
2. Research approach and questions3. Definition of social care 4. Evaluative criteria for theoretical approach to the
study of care:
• ChangeChange and transformationtransformation
• Relationships Relationships of gender gender and welfare welfare mixmix
• ComprehensivenessComprehensiveness
• Gendered consequencesGendered consequences
• MapMap
• MethodMethod
• ModelModel
Policy context:
•Employment rates of women and mothers have increased but still a strong potential for a further increase
• At the same time, fertility rates have declined
• Ageing of the population is likely to increase the number of years where care is needed
• Policies may alter the need for care
1. Placing care in the political agenda
• The emphasis on the adult worker model where women and men are assumed equally employable, has given impetus to a re-negotiation of formal and informal care responsibilities
• Care policy laggard has led to a caring deficit
• A map, a method and a model of social care policies for children and older people, in Denmark, Sweden, Finland, England, Germany, Netherlands, France and Norway, across a time-span of 20 years.
• ”The role of social science is to translate personal worries to general problems.”
(C.W.Mills, 1985)
• Mainstream analysis of welfare state regimes have tended to be ‘malestream’, and the study of social care has remained a dark continent within male theorizing
• How we as individuals organise, provide, pay for, and receive care should not be an individual problem, but a societal concern.
2. Basic research approach and questions
• Interdisciplinary (feminist sociology and welfare state research, political theory of neo-institutionalism, system theory and more hermaneutic such as social constructivism)
• Comparative (across time and countries)• Policy-oriented (in the focus on shifts in
configurations of care policies)• Gender matters, context matters and politics
matters.
Research questions
Overarching research frameworkframework:
• Who organises? • Who pays?
• Who delivers?
• Of what quality and for what cost for the user?
• Chosen 8 countries, which all represent one of
Esping-Andersen’s regimes: Denmark, Sweden, Norway and the Netherlands (The Social-democratic regime), Germany and France (the Conservative model) and England (the Liberal model).
The care benefits included are service and cash benefits for pre-school children: day care institutions and nursery education, family day care and leave schemes, and for older people: home help, institutional care and care allowances.
• What constitutes the social care policy area? How may we establish a methodological methodological and conceptual conceptual frameworkframework for the comparison of social care policies?
• What is the institutional design of care policiesinstitutional design of care policies - the care architecture - in terms of the structure of policies, principles, logics and institutional instruments?
• How do policies institutionaliseinstitutionalise and underpin underpin certain care relationshipscare relationships and definitions of care care obligationsobligations, be it family, state or market oriented?
• What are the gender consequencesgender consequences of the care policy logics?
DimensionsDimensions of research questions:
•as labourlabour includes formal/informal as well as private/public signification
•as a conceptconcept is situated in a complex normative framework of obligation and responsibility
•as an activityactivity with both financial and emotional costs
•as policiespolicies cover formal and informal, paid and unpaid, public and private, services and cash transfers
•for both childrenchildren and older peopleolder people
3. Definition3. Definition of social care:
4. Evaluative criteria of utility of the theoretical approach of
social care
OutcomeOutcome
Relationships of gender and welfare
mix
Change and
variation
Comprehensiveness
Content
ContentPr
oces
s an
d
Proc
ess
and
rela
tion
ship
s
rela
tion
ship
s
Gendered consequences
4.a. ContentContent of design of care policies (care architecture)
• “The comparative approach offers a degree of rigour and breadth of explanation, as concepts and explanations travel across a number of national borders.” (Daly, 2000, p.35)
• How to identify the social care field and the development of a common framework for analysing social care?
Content
Content
Functional equivalenceFunctional equivalence
• Comparison of social care provision should be built on a perspective of functional functional equivalenceequivalence in adopting a cross-sectional, cross-benefit approach of comparison:
– Taking into account all relevant care provisions (eg both education/social welfare), cash as well as service benefits, including private as well as public
– - Enables comparisons where high or low coverage is not directly translatable to being either good nor bad C
ontent
Content
Tendencies
• Expansion
• From standard to individually adapted services
• From client to consumer
• More rights
• More welfare mix
Content
Content
• Reorganisation of social care in regards to the cash/service nexus, the welfare mix, and a changed distribution of costs between public and recipient of care.
• Paradigms of efficiency, marketisation, and consumerism have entered the political arena.
• Universalization, collectivisation and monetization of care.
Content
Content
4.b. The processprocess and relationshipsrelationships of social care policies
• How are care relationships and care responsibilities createdcreated and underpinnedunderpinned by the institutional design of social care policies?
– Ex: Variation in social care policies can reveal how the ideology and social constructions of the role of the mother and father differ Denmark and Sweden.
Proc
ess
and
Proc
ess
and
rela
tion
ship
rela
tion
ship
– Sweden: Fatherhood and the modern father stand very strong. Conception that each parent contributes with something special in the care relationship
– Denmark: sharing of care work and abolishment of father’s quota. The conception of parenthood as neutral gender relations.
Proc
ess
and
Proc
ess
and
rela
tion
ship
rela
tion
ship
• How are processes of informalisationprocesses of informalisation of care set in motion by changes in social care policies, leading to different combinations of care relationships?
• Ex: is home help given mainly to elderly without informal care ressources? – Overall, the use of home help is related to the
availability of a partner in the household – Denmark: Implicit informalization of care where
formal and informal care is provided concurrently. – Norway: a more explicit degree of informalization
ever present and informal care resources are of great importance.
Proc
ess
and
Proc
ess
and
rela
tion
ship
rela
tion
ship– Sweden: high degree of informalization suggests that informal carers increasingly have to operate in isolation in the care provision
Home help, % of elderly 65+, Denmark, Norway, Sweden, 2002
0,0
5,0
10,0
15,0
20,0
25,0
30,0
1982 1985 1988 1991 1994 1997 2000
Denmark
Norway
Sweden before Ädel
Sweden after Ädel
Proc
ess
and
Proc
ess
and
rela
tion
ship
rela
tion
ship
• Variation in underpinnings of social policy lead to variation in degrees of informalisation
• Plasticity (Anttonen, Baldock and Sililä, 2003) or complementary nature of social care?
(Motel-Klingenbiel, 2003; ter Meulen, Arts & Muffels, 2001, Künemund and Rein, 1999; Sundström, 1999)
• Different logics determine the quality, interests and rationales of care (Knijn and Verhagen, 2003), and even perception of what the social problem consists of
• Recast of the public-private nexus
Proc
ess
and
Proc
ess
and
rela
tion
ship
rela
tion
ship
4.c. The outcomeoutcome dimension
• What are consequencesconsequences of the changes in social care policies and how can we evaluate these? A genderedgendered perspective.
– The generalisation of the male worker model to women ignores women’s unequal position in the labour market and the unequal division of unpaid care work
– Men and women’s potential for exit/entry of family and labour market
– Choice as a central criterion– The Universal care-giver model - ”What then
might such a welfare state look like?”(Fraser, 1994, p.612)
OutcomeOutcome
• AvenueAvenue to full integration of women into paid labour and of men into care and of gender equality in division of paid work/unpaid care:
– High provision of high quality, subsidized (public) services will enable especially women to take up paid work and create the necessary job openings
– High compensatory cash benefits will, on the other hand, increase gender equality in division of unpaid care as men can afford exchanging a market income with a care income.
OutcomeOutcome
Figure 1: Day care provision in full-time places and
total leave entitlement,
maximum weeks multiplied by
compensation rates, 1996.
NL
ENG
F
DK
DSF
S
0
10
20
30
40
50
60
70
80
0 20 40 60 80 100 120Total leave entitlement (compensation rateXlength)
Day c
are
pro
vis
ion a
s %
of
pre
-
school age
NL
ENG F
DK
D
SF
S
0
5
10
15
20
25
30
35
0 20 40 60 80 100 120 140Care allowance compensation rate, % of former wage
% 0
f 65+
receiv
ing e
ither
hom
e h
elp
or
institu
tional careFigure 2: Home
help, institutional care and
compensation rates for main cash
transfers for care of older people,
1996
Feminist criticism of GEA
• Based on cash benefits such as pensions and unemployment benefits. Critique for overlooking the service aspects as being important elements in the institutional structure of welfare states.
• Only focusses on how the welfare state helps you inf you loose your market income (principle of de-commodification)
• Overlooks dependency on family
OutcomeOutcome
• De-commodification as an expression of citizenship for social rights can be critisized for overlooking how important are other forms of welfare, especially for women’s independency of both family and welfare (O'Connor 1993).
• Not possible to analyse sociaol care benefits only from a decommodification aspect – eg service benefits make people able to participate on the labour market through taking over the care responsibilities.
• Women are both direct and indirect users of care services. It is therefore often the dependency of care provisions which decides if women – and men – can participate in the labour market. Care provisions commodify!
OutcomeOutcome
• A care regime is conceived as a given organisation given organisation of social care policiesof social care policies for children and older people which supports specific interventions, values and interventions, values and normsnorms, and which presupposes a gender hierarchygender hierarchy and a gender divisiongender division of unpaid and paid work.
• Consequently the policy logic of a care regime priviledges certain principles of entitlements and principles of entitlements and responsibilitiesresponsibilities, implicitly and explicitly expressed as care rights and care obligations.
• Rights and obligations may be described specifically in the lawlaw but most often the conception of a right or an obligation will develop in conjunction with one’s notion of reciprocity, reciprocity, fairness and reputationfairness and reputation.
Definition of care care regimeregime
Outset
• Women’s access to the labour market and men’s possibilities to devote themselves to caring will be strengthened by providing affordable, affordable, available and high quality care servicesavailable and high quality care services as well as care allowancescare allowances which are flexible and with a high compensation flexible and with a high compensation raterate
Female care giver model
Country England, Germany, the Netherlands (children), France (elderly)
Ideology (state, market, family)
High degree of gendered care work. Provision of services from market
Predominant form of benefit
Cash
Generosity Low compensation rates, few day care services for young children; universal but part-time provision for older children; few services for older people
Entitlement Labour market associated rights. Universal provision of nursery education
Employment commitment
Considerable spells out of the labour market for women, full-time male breadwinner
Degree of choice working/caring
Low
Adult Worker ModelCountry Sweden ( elderly - budget), Denmark
Ideology (state, market, family)
High support for state provision
Predominant form of benefit
Services
Generosity High compensation rates but short leave periods; abundant and affordable service provision
Entitlement Citizenship based but limited supply may restrict access. Men may be barred from benefits
Employment commitment
High female and male full-time labour force participation
Degree of choice working/caring
Middle
Family-Work ModelCountry France (children), Sweden (children), the
Netherlands (older people – budget model), Finland (elderly - budget, children - budget)
Ideology (state, market, family)
Moderate familism supported by state provisions
Predominant form of benefit
Cash/services
Generosity High compensation rate of cash benefits; abundant and affordable services
Entitlement Citizenship based benefits; equal rights for women and men
Employment commitment
Flexible work conditions for men and women
Degree of choice working/caring
High
• LessonsLessons from analysis of care regimes:
– No straight-forward trade-off between services and cash
– Context dependency; countries may belong to more than one model
– Allows a more comprehensive approach (Cash/services, children/elderly, men/women)
OutcomeOutcome
Relationships of gender
and welfare mix
Change and
variation
Comprehensiveness
Content
ContentPr
oces
s
Proc
ess
Gendered consequences
Elements of a Theory of Care in Contemporary Moden Society
Individual preferences and power
Regional differences
Class and race
Central and Eastern European countries
Consumerism
A Map, a Method,
and a Model of
Care
• IndicatorsIndicators of gender consequences of change to social care: (Chapters 4 and 8)
– generosity of care (levels of provision and quality of care services; compensation levels and time to be off work in care cash benefits)
– the cash/service combinations – social rights of entitlement – and the employment commitment.
OutcomeOutcome