Care and social integration in European societies 9781847421340

Table of contents :
CARE AND SOCIAL INTEGRATION IN EUROPEAN SOCIETIES
Contents
List of tables and figures
Preface
Notes on contributors
Part One: Care arrangements in European societies
Change in European care arrangements
Development paths of care arrangements
Part Two: New forms of informal, semi-formal and formal care work
Gender, labour markets and care work in five European funding regimes
Changing long-term care regimes
Migrants’ care work in private households
Part Three: Welfare-state policies towards care work
Comparative approaches to social care
Social rights and care responsibility in the French welfare state
Childcare policies of the Nordic welfare states
Informal family-based care work in the Austrian care arrangement
Part Four: The formalisation of care work and the labour market
Labour market participation of women and social exclusion
Women’s work between family and welfare state
Labour market integration of women and childcare in Slovenia
Family leave and employment in the EU
Part Five: Conclusions
Political actors and the modernisation of care policies in Britain and Germany
Welfare state and the family in the field of social care
Index

Citation preview

CARE AND SOCIAL INTEGRATION IN EUROPEAN SOCIETIES

Edited by Birgit Pfau-Effinger and Birgit Geissler

CARE AND SOCIAL INTEGRATION IN EUROPEAN SOCIETIES Edited by Birgit Pfau-Effinger and Birgit Geissler

Care and social integration in European societies

First published in Great Britain in September 2005 by Policy Press North America office: University of Bristol Policy Press 1-9 Old Park Hill c/o The University of Chicago Press Bristol 1427 East 60th Street BS2 8BB Chicago, IL 60637, USA t: +1 773 702 7700 UK t: +44 (0)117 954 5940 f: +1 773-702-9756 [email protected] [email protected] www.policypress.co.uk www.press.uchicago.edu © Birgit Pfau-Effinger and Birgit Geissler 2005 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library. Library of Congress Cataloging-in-Publication Data A catalog record for this book has been requested. ISBN 978-1-86134-604-9 hardcover Birgit Pfau-Effinger is Professor of Sociology and Director of the Globalisation and Governance Centre at the University of Hamburg. Birgit Geissler is Professor of Sociology of Work in the Department of Sociology at the University of Bielefeld. The right of Birgit Pfau-Effinger and Birgit Geissler to be identified as editors of this work has been asserted by them in accordance with the 1988 Copyright, Designs and Patents Act. All rights reserved: no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the prior permission of Policy Press. The statements and opinions contained within this publication are solely those of the editor and contributors and not of The University of Bristol or Policy Press. The University of Bristol and Policy Press disclaim responsibility for any injury to persons or property resulting from any material published in this publication. Policy Press works to counter discrimination on grounds of gender, race, disability, age and sexuality. Cover design by Qube Design Associates, Bristol. Printed and bound in Great Britain by Marston Book Services, Oxford.

ii

List of contributors

Contents List of tables and figures Preface Notes on contributors Part One: Care arrangements in European societies one Change in European care arrangements Birgit Geissler and Birgit Pfau-Effinger two Development paths of care arrangements in the framework of family values and welfare values Birgit Pfau-Effinger Part Two: New forms of informal, semi-formal and formal care work three Gender, labour markets and care work in five European funding regimes Clare Ungerson four Changing long-term care regimes: a six-country comparison of directions and effects Ute Behning five Migrants’ care work in private households, or the strength of bilocal and transnational ties as a last(ing) resource in global migration Felicitas Hillmann Part Three: Welfare-state policies towards care work six Comparative approaches to social care: diversity in care production modes Anneli Anttonen and Jorma Sipilä seven Social rights and care responsibility in the French welfare state Jeanne Fagnani and Marie-Thérèse Letablier eight Childcare policies of the Nordic welfare states: different paths to enable parents to earn and care? Guðný Björk Eydal nine Informal family-based care work in the Austrian care arrangement Margareta Kreimer and Helene Schiffbänker

v vii ix

3 21

49

73

93

115

135

153

173

iii

Care and social integration in European societies Part Four: The formalisation of care work and the labour market ten Labour market participation of women and social exclusion: contradictory processes of care employment in Sweden and Germany Hildegard Theobald eleven Women’s work between family and welfare state: part-time work and childcare in France and Sweden Anne-Marie Daune-Richard twelve Labour market integration of women and childcare in Slovenia Nevenka Č ernigoj Sadar thirteen Family leave and employment in the EU: transition of working mothers in and out of employment Anita Haataja Part Five: Conclusions fourteen Political actors and the modernisation of care policies in Britain and Germany Traute Meyer fifteen Welfare state and the family in the field of social care Birgit Geissler Index

iv

195

215

235

255

281

307

317

List of contributors

List of tables and figures

Figures 2.1 3.1 3.2 3.3 13.1 13.2 13.3

13.4

Care provision within the care arrangement 23 The ‘cross’ of ‘routed wages’ 54 Carers 56 Schemes for organising ‘routed wages’: types of payment 57 and time availability Women’s and men’s labour market situation by age in 2002 265 in Finland Female employment rates with the age of the youngest 267 child in 1997 The activity of mothers whose youngest child is aged under 270 1 year in 1983-2002 and the share of mothers on child homecare leave out of employment since 1995 in Finland (% of the population concerned) The labour market status of mothers whose youngest child 271 is 1-2 years and 3-6 years of age in Finland in 1995-2002 (% of population concerned)

Tables 1.1 4.1 5.1 6.1 6.2 6.3 7.1 7.2

Formal and informal care work according to type of work relation, pay and sphere of the economy Number of older people receiving care in long-term institutions in the UK (1980-90) Quantitative dimension of female and male migration (1960-2000) The welfare mix of care production modes National patterns of social care in Finland, Japan, Germany, the UK and the US Childcare and elder care service provision in Finland, Japan, Germany, the UK and the US Public expenditure devoted to individualised childcare arrangements (1994-2000) (in units of Constant Million €) Subsidised childcare arrangements for children aged under three living with dual earner parents: breakdown according to the childcare arrangement

9 76 95 118 122 123 143 144

v

Care and social integration in European societies 7.3 7.4 7.5 8.1

8.2

8.3

8.4

8.5 9.1 9.2 9.3 12.1 12.2 12.3 13.1

vi

Activity rates of mothers according to number and age of children (1990-99) Proportion of women living with a partner and working full time and part time, evolution (1990-2002) Jobs in care services, evolution (1990-99) Percentage of total number of benefit days used by fathers in the event of pregnancy, childbirth and adoption during the year (2000-02) Children age 0-2 years enrolled in day-care institutions and family day-care. Percentage of all children in the age group 0-2 (1981/1990) and 1-2 (2002) Children age 3-6 years enrolled in day-care institutions and family day-care. Percentage of all children in the age group 3-6 (1981/1990) and 3-5 (2002) Nordic countries: breakdown of labour force, parental leave and children in day-care. Most recent information, 2000-03 Overview on indicators on the three sets of childcare policies among the Nordic countries Labour-force participation and caring responsibilities among Austrian women (aged 25-44 years) in 1997 and 2002 (%) Employment situation of mothers with child/ren under 15 years in 2002 (%) Employment situation of women one year after childcare leave (%) Employment situation after last maternity/parental leave (after last maternity/parental leave of partner) Proportion of children in childcare centres Care and education of children in hours per week (average) Female labour force (1,000 persons), labour force % of population (activity rate) and activity inside the labour force in 2002 (% of labour force)

146 147 148 162

163

163

164

166 176 177 178 239 245 247 266

List of contributors

Preface

This book is the outcome of a very interesting and fruitful cooperation between high-ranking experts in a working group of the COST Action A13, ‘Changing Labour Markets, Welfare Policies and Citizenship’. The purpose of COST Action A13 was to examine the effects of social security systems and welfare institutions on processes of social and political marginalisation.The Action was coordinated by Aalborg University, Denmark. COST is an intergovernmental programme funded by the European Union and the European Science Foundation for the coordination of scientific and technical research and the formation and coordination of networks on a European level between nationally funded research projects. Some 80 experts appointed by 17 countries participated in the COST A13 network, which remained in force for five years (spring 1998-autumn 2003). For more information see www.socsci.auc.dk/cost. This book discusses at a conceptual/theoretical level what it means to analyse changes in informal care work as well as processes of the formalisation of care work in a comprehensive conceptual framework. It aims to combine theoretical reflections on change in the role and structures of social care in Europe, with empirical results from crossnational research, and to contribute new insights into current processes of change in European societies. Also, suggestions for the further development of theoretical approaches to comparing care arrangements in a comparative perspective are made. Processes of change in two directions are examined: the formalisation (or informalisation) of care, as well as changes related to informal care and the social rights associated with it. Beyond this the creation of new, semi-formal forms of care in private households is examined, which – until now widely ignored in labour-market and social-policy research – have meanwhile become established in many European societies. Both developments are investigated in the context of new forms of social integration and their quality, and such changes are examined in international comparison from the perspective of change in private households and in the framework of welfare-state policies and labour markets. A further point of reference is the role of the social actors in this process. The way social care is organised is of basic importance for the production of welfare in European societies. The discussion of

vii

Care and social integration in European societies

theoretical concepts of care work and the presentation of recent empirical results contributes to a better understanding of change in European welfare states and employment systems from a general, as well as gender perspective. The majority of the contributions are based on papers presented at the workshops of the ‘Working Group on Gender Issues’ of the COST A13 Action programme; a few are additional. We thank all of the academics who took part in the workshops between 1999 and 2003; in the discussions we gleaned valuable stimulations for the conception of this book. In its theoretical and empirical focus on changes and new patterns of care work in labour markets and welfare states, the aim of the book is closely linked to the overall programme of the COST A13 Action programme ‘Change of Labour Markets,Welfare States and Citizenship’ of the EU. We thank the Chair of COST A13, Per H. Jensen, for his support and excellent work in coordinating the programme. Last but not least: a publication project always depends on diverse networks, including support in everyday working life. We would like to extend our greatest gratitude to our secretarial employees Mrs Dinter and Mrs Fischer for their tremendous patience in updating the texts and producing this volume and for the reliable communication with the employees of the publisher.

viii

List of contributors

Notes on contributors Anneli Anttonen is Professor at the Department of Social Policy and Social Work, University of Tampere. Her research interests centre on welfare state theory, feminist scholarship on social policy, comparative welfare state research (in particular, comparative social service research), and social care services. Ute Behning is Head of the Research Group ‘European Welfare Politics’, Institute for Advanced Studies inVienna, Austria, and currently Visiting Researcher at the Centre for Social Policy Research at the University of Bremen. Her main fields of research include European integration, comparative politics, policy sciences and gender studies. Nevenka Černigoj Sadar is a Senior Researcher and Professor of Social Psychology at the Faculty of Social Sciences, University of Ljubljana. Her main areas of research include changing life patterns, gender divisions in paid and unpaid work in relation to social policy measures, and quality of life in various life spheres. She participated in several international comparative researches. She is coordinator of the Slovenian part of the international EU 5th Framework research project on ‘Gender, Parenthood and the Changing European Workplace: Young Adults Negotiating the Work-Family Boundary’. Anne-Marie Daune-Richard is Researcher at the Centre National de la Recherche Scientifique (Laboratoire d’Economie et Sociologie du Travail, Aix en Provence). Her research deals with gender issues focussing on work and employment. She has published articles on the conceptualisation of gender relations as on the relationship between family and employment careers. She has carried out comparisons of part-time work and childcare between France, the UK and Sweden. Guðný Björk Eydal is Assistant Professor of Social Work, Faculty of Social Sciences, University of Iceland. She is writing her PhD at the Sociological Institution at Göteborg University. She has published in the field of comparative social policy, mainly on care policies, child and family policies. She currently participates in two comparative Nordic research networks: ‘NordBarn’ on childhood research, and the project,‘Welfare Policy and Employment in the Context of Family Change’.

ix

Care and social integration in European societies

Jeanne Fagnani is Research Director at the Centre National de la Recherche Scientifique (CNRS/MATISSE, Paris). She has conducted comparative research projects, funded by the European Commission. She has recently made a comparative analysis of family policies in Germany and France and highlighted their impact on their respective fertility level and mothers’ employment patterns. She is currently the French partner of the European ‘Transitions’ team (funded by the European Commission), which is conducting a three-year crossnational comparative research. Birgit Geissler is Professor of Sociology of Work in the Department of Sociology at the University of Bielefeld. She has published in the fields of women’s labour participation and gender specific forms of employment, working-time flexibility and individuals’ orientations concerning the life course and life planning. Recent research centres on modernisation of gender relations and on public and private household services. Anita Haataja is a Senior Researcher at the University of Turku. She has conducted a research project, ‘Gender, family structure and social policy: changes in the gender system of the income transfer institution in Finland in the 1990s’,which is financed by the Academy of Finland. Her permanent vacancy as senior adviser and researcher is located in the Gender Equality Unit in the Ministry of Social Affairs and Health in Finland. She has published both comparative and national research on social insurance and income distribution; labour market and gender; social security, taxation and gender issues. Felicitas Hillmann is Assistant Professor, Department of Geography, Free University of Berlin. Her research has for many years been in the field of migration, gender and employment, and she has published widely, specifically on the relationship between migration, diaspora and development with a focus on the gender dimension; ethnic business as a strategy for social and regional innovation. Margareta Kreimer is Assistant Professor for Economics in the Department of Economics at the University of Graz, Austria. She completed her PhD in 1997 at the University of Graz. Her research interests include labour market theory and policy, the economics of the welfare state, feminist economics, discrimination theory, and economic policy.

x

List of contributors

Marie-Thérèse Letablier is Research Director in the Centre National de la Recherche Scientifique (CNRS/Centre d’Études de l’Emploi, Paris). Her main research interests include work, family and gender issues from a European and comparative perspective. She has been involved in several European Research Networks, on social and family policies, on women’s employment and on work and family balance. Traute Meyer is a Senior Lecturer in Social Policy at the University of Southampton, having previously taught at the Free University of Berlin. Her research focuses on current changes of European welfare states, and she is a member of two six-country comparative projects, ‘Private Pensions and Social Inclusion’ and ‘Formal and Informal Work’, each funded by the EU. Birgit Pfau-Effinger is Professor for Sociology and Director of the Globalisation and Governance Centre at the University of Hamburg. She has published in the fields of comparative sociology, sociology of labour markets, sociology of welfare states, family sociology and social care, gender studies and sociology of transformation. She was working group coordinator in the COST A13 programme, ‘Changing Labour Markets, Welfare Policies and Citizenship’ of the EU. She is also coordinator of the EU 5th Framework research project on ‘Formal and Informal Work in Europe’. Helene Schiffbänker is a Scientific Researcher of Joanneum Research Forschungsgesellschaft, Institute of Technology and Regional Policy (InTeReg). She studied sociology at the University of Vienna and at the University of California at Berkeley. Her main research focus is on gender (in)equality and the conditions of female employment (reconciliation, part-time). She is involved in the design and implementation of gender-measures in labour market and technology policy-programmes, focusing on women in science and technology. Jorma Sipilä is Professor of Social Policy and Social Work at the University of Tampere. Since the late 1980s, he has been working with several, often international, research teams on social care, social services and social protection. Recently he headed an EU 5th Framework research project,‘Soccare’, in which five European national teams were studying practical solutions which different families have arrived at in different European social care cultures.

xi

Care and social integration in European societies

Hildegard Theobald is Research Fellow at the Social Science Research Center Berlin (WZB). Her published work spans the fields of international comparative welfare state research, labour market and labour organisations and the development of new social care approaches. She is currently working on the EU Project, ‘Care for the Aged at Risk of Marginalisation’, funded by the European Commission within the 5th Framework. Clare Ungerson is Emeritus Professor of Social Policy at the University of Southampton and Honorary Professor in the School of Social Policy, Sociology and Social Research, University of Kent. She has written extensively on the topic of gender and social policy, particularly on gender and care, and on paid and unpaid care.

xii

Chapter title running head

Part One Care arrangements in European societies

1

Change in European care arrangements

ONE

Change in European care arrangements Birgit Geissler and Birgit Pfau-Effinger

Change in welfare state policies on social care has been often neglected in the cross-national research on welfare state restructuring in Europe in recent years. In current discourse and research on welfare-state policies in relation to gender, as well as on the question of social exclusion and social integration in relation to care, this issue plays a more important role. In general, however, analyses have mainly focused on the question of to what degree social care has been formalised and transformed into formal employment, and how this has contributed to an increase in the social integration of women (Kröger, 2001, p 3), while less emphasis has been put on the way informal care work itself has changed, and how such changes can be explained. In this chapter, we discuss on a conceptual/theoretical level what it means to analyse change in informal care work, as well as, in a comprehensive conceptual framework, processes of the formalisation of care work.

Concepts of ‘care’ As an initial approach, the concept of care should be understood empirically thus: Care is both the paid and unpaid provision of support involving work activities and emotional empathy. It is provided mainly … by women to both able-bodied and dependent adults and children in either the public or domestic spheres, and in a variety of institutional settings. (Thomas, 1993, p 665) With the concept of care in social sciences research, or the established English term ‘social care’ (Daly and Lewis, 1998), scientific concepts of welfare production were broadened with a critical intention: to

3

Care and social integration in European societies

emphasise the dichotomisation of societal life into public and private spheres, whereby care is included in the latter (secondary) private sphere, with the consequence of downgrading social care – also in its occupational or professional form – and with that, the work of women (Lewis, 1992; Daly and Lewis, 1998). Social science and economic gender research on ‘care work’ in the family and labour-market has been carried out (and received) by multiple disciplines from the beginning, and that applies equally to the welfare state debate. ‘Care’ is not just a comprehensive, descriptive approach to the analysis of the work of accompanying and educating people and attending to their personal needs. Beyond that,‘care’ signifies the principle element in welfare production and the welfare-state institutional network. Joan Tronto (1996, p 147) defines ‘social care’ as the sum of practices by which we attend to/care for ourselves, others, and the natural world. Moreover, the internationally discussed concept of social care (O’Connor, 1996; Tronto, 1996; Gender and Society, 2002) focuses on the importance of these activities for the social integration of those working in and receiving care. The concept evokes our dependence on the concern of others and the fragility of the societally more highly valued, masculine connotation of autonomy, and at the same time shows the social construction of autonomy and dependency (Leira, 1992; Finch and Mason, 1993; Fraser and Gordon, 1994; SenghaasKnobloch, 1999). Care includes the provision of daily social, psychological, emotional, and physical attention for people. (Knijn and Kremer, 1997, p 330) The term ‘attention’ shows that the necessary practical activities of housekeeping, child raising and personal care are bound to the symbolic production of everyday culture and the creation of personal bonds. With this concept, it becomes apparent that everyday attention to the needs of others and oneself is structured – that is, organised and communicated – in a special way; thus, these activities have a special quality. Therefore, instruments of efficiency measurement and improvement must be specifically applied to these particular communication structures and work methods. The ends–means rationality of society, most dominant in the service sector, should be – according to Waerness (2000) – complemented (above all in the caring professions) by a conscious ‘rationality of concern’, oriented towards comprehension and harmonisation of needs and perceptions, and requiring for its exercise sufficient room for structuring the work situation.

4

Change in European care arrangements

The early feminist thematic exploration of housework in the 1970s, in the context of the anti-capitalist critique of society, identified the unpaid private work of women as the invisible foundation of wage employment. This theory formulation treated care implicitly as the childcare and housework (care of the elderly went unmentioned at that time) necessary to “rebuilding the strength to work”; that is, ensuring and motivating the man’s continued ability to work. The demand made in this context for “wages for housework” (Dalla Costa and James, 1973) was not successful for the reason, among others, that the idea of housework as gender-specific task was rejected. Instead, a ‘de-mythologising’ of the mother’s role was proposed, and a democratisation of family life and greater access for women to education and the labour market. Simultaneously, family duties, child raising and personal care tasks were to be performed by state services and with that, also create new jobs for women. These demands have been meanwhile partly realised, whereby welfare-state policies have played an important role. The significance of ‘care’ – in processes of integration and exclusion of women, and for the analysis of welfare-state policies and comparison of welfare states – was elaborated within the framework of feminist social-policy research (for a discussion, see Chapter Ten of this book). In this the selectivity of such policies, for example, for criteria such as marital status, ethnicity and social milieu/class, was repeatedly pointed out (see also Thomas, 1993; Dale and Holdsworth, 1997; Duncan and Smith, 2002). The societal inclusion of women through their labour-market integration, and the transformation of unpaid household and family work into regular gainful employment are considered, in social-policy research into care, to be two sides of the same coin. However, two dilemmas exist: 1. The relatively lower societal recognition of and value attached to child raising and care tasks persists even when they are performed as publicly constituted services, above all in liberal and conservative welfare states (in the sense of Esping-Andersen, 1990, 1999). The construction of care as an only partly professional, poorly paid activity stands in close relation to the bipolar construction of the gender relation, which prescribes for women familial, as well as occupational, caring and attending tasks. Despite the expansion and professionalisation of the personal care service sector on the labour market, the identification of these activities as ‘feminine’, lower-paid, and with particular employment forms and career

5

Care and social integration in European societies

patterns, has become established especially in the types of welfare regimes mentioned (see Chapter Ten of this book). 2. For another thing, the character of this work itself sets limits to its formalisation and monetarisation. The idea that care work is not very compatible with the capitalist economy of time, and thus can only partially be made into formal employment, was put forth quite early (for example, Kramer, 1981; Geissler, 2002b). For, in the exercise of care, it is a matter of creating and strengthening relations based on emotional bonds with partners, children and relatives, regardless of whether these relations are freely entered into or socially prescribed. Therefore in childraising, housework and elderly care, normatively grounded and interactively recognised needs play a role.With that, the intentions and the attention of the carer, as well as the rights and needs of those receiving care, come into the spotlight. In terms of the care process itself, Tronto (1996, p 147) differentiates four phases: • caring about is attention to the need for care; • caring for is assuming responsibility; • care-giving is the practical attention to, and satisfaction of, need(s); • care-receiving is the response of those obtaining the attention and care. In the view of Tronto, these four phases must be contained in a complete description of care in order to address the immanent fragmentation and potential for conflict in care. The concept of social care makes conscious the human physical and emotional dependency on the personal attention of others (SenghaasKnobloch, 1999). For the carer, this often means dependency on a (male) provider or the state (Lewis, 1992; Fraser and Gordon, 1994). Western welfare states have weakened this connection between care and personal dependency through state social benefits (Daly and Lewis, 2000; Ballarin et al, 2003), and it would be worth examining what structures of dependency this creates. In their influential study ‘Gender and the caring dimension of the welfare states: towards inclusive citizenship’, Knijn and Kremer (1997) propose an understanding care as an integral part of citizen rights.The analysis of the extent and quality of social civil rights for caregivers is therefore a central element of the analysis of approaches to social care in the context of welfare states (see also Geissler, 2002a; Gerhard, 2003; Pfau-Effinger, 2005b). Social civil rights on the one hand represent a legal status in the sense of entitlement to social benefits, and on the

6

Change in European care arrangements

other hand a precondition to a political stake in the sense of a social practice, as a constituent of civil society (Marshall, 1964).This extension of social rights to ‘care work’ takes up the feminist idea of recognising unpaid work in household and family as the equal of gainful employment, and correspondingly extending society’s conception of work.

Social care and social integration The European model of social inclusion is based mainly on labour market participation and the social rights related to it. Consequently, in the thinking of scholars in social sciences and social policy, fulltime participation in employment and access to the respective social rights, as well as the formalisation of care was seen as the main road to social inclusion for women. In recent decades, family structures have changed substantially in many European countries. Besides the housewife model of the family, new models based on the assumption that women are included in labour markets are widely accepted and relevant in the social practice of individuals.This development has been accompanied (often with a substantial delay) by processes of formalisation of care work. That means that care work is transferred from the family household to other, often public institutions, becoming thereby visible and recompensed (see Geissler, 2002b). It is increasingly organised as formal, mainly public employment, and often also professionalised (see Chapter Six of this book). As an employment sector, the social service sector is mainly female and one of the most prospering in many European countries (OECD, 2000). It is expected that the importance of employment in the social service sector will grow in the future. However, developments have been, in part, also contradictory, for in most countries men have not been integrated to an equal degree – as carers – into the family. Moreover, because of their responsibility for the tasks of family care, women are still in part marginalised in labour markets, and in several European countries precarious types of employment in the social service sector are prominent. The labour-force participation rates of women, and the public provision of care in the formal sector are currently often also used as central indicators of the strength of a welfare state and its ‘womanfriendliness’ (Siim, 2000). Informal and formal care work in this context are often conceptualised as opposites, such that formal care employment is seen as ‘modern’ and ‘woman-friendly’, for it relieves women from care work at home, while informal care work by contrast is often

7

Care and social integration in European societies

associated with the social exclusion of the caregivers (see also Cousins, 1998). According to this argument, informal care is linked to the traditional family model of the housewife marriage; its main characteristics are that it is unpaid work, hidden from view in the family household, performed by women and excluded from formal employment, the main provider of income, prestige and social security, and reconnection. It is also argued that, because of their responsibility for informal care work, women are also at risk of social marginalisation when they enter the labour market. Informal care is thus associated with the ‘backwardness’ of tradition, a remaining element from the times of the housewife marriage, which confined women to the household. However, we argue that the concept of the two opposites of formal and informal care is too crude and does not leave space for examining the more recent development of informal work itself, for informal care work has been modernised in specific ways. As a consequence of social change in recent decades, new forms of informal care work, and in this context, also new forms of social inclusion based on care work have developed. Table 1.1 gives an overview of the diversity of such forms of informal care work. Two new main types of informal care work can be distinguished: Semi-formal family-based care work and Informal care employment.

Semi-formal family-based care work New forms of family-based care work which have gained substantial importance are those we call ‘semi-formal’ forms of care (Pfau-Effinger, 2001, 2005b), based on a new linkage of the care relationship in the household to the welfare state, as for example in paid parental leave, during which parents care at home for their children.The establishment of these new semi-formal forms is the result of changes in policies of European welfare states, and the appearance of a specific type of social right, as Knijn and Kremer (1997) have pointed out: the right to give care; that is, the right of parents, relatives or friends, during temporary life phases, to provide care for their children, frail elderly relatives or friends in the household. As tasks of childcare or elderly care are assumed by families (or social networks), forms of payment, as well as elements of an independent social security, are being introduced for those carrying them out (Geissler and Pfau-Effinger, 1989; Daly and Lewis, 1998; Meyer, 1998; Bang et al, 2000). With respect to pay in such cases, a commodification of care work is taking place, as Chapter Three of this volume argues, but not necessarily connected with the

8

No

Informal family care (by relatives or friends)

No (maybe a type of compensation)

Voluntary work

Non-formal, solidarity based relationship

Yes, (eg childcare allowances)

Semi-formal family care (by relatives or friends) Welfare state constructed care relationship

Non-formal, solidarity-based relationship

Yes

Yes

Yes

Pay

The different forms of informal care work Informal care employment Standard or atypical employment, but unregistered

Atypical employment or particular schemes

Standard or atypical employment

Formal care work Formal care employment

Informal care work combined with formal employment, mainly part-time work of parents

Type of work-relation

Type of work

Solidarity-based informal economy (state, non-profit sector, civil society)

Solidarity-based informal household economy

Solidarity-based informal household economy

Marketised household economy

All spheres of the economy

All spheres of the economy

Sphere of economy

Table 1.1: Formal and informal care work according to type of work relation, pay and sphere of the economy

Change in European care arrangements

9

Care and social integration in European societies

formalisation of this work. Chapter Three of this volume reveals the origins and underlying assumptions of these burgeoning policies in order to understand them within a broader context of gender structures. Ungerson’s analysis of the new ‘cash-for-care’ welfare schemes points to their variety with respect to the nature of the pay, which often does not have the character of pay for working time. Also in recent decades, in many European countries the proportion of varieties of formal part-time employment based on a combination of formal employment and informal, or semi-formal, family-based care work, was extended (see Chapter Two of this volume). In the context of such changes, a new type of home-caring parent or more general home-caring relative has emerged, who treats home care as a transitional stage of the life course, receives financial transfers from the welfare state and is protected by social security systems.This general conceptual approach does not include general statements about the quality of the social inclusion of the semi-formal caregivers. On the basis of in-depth analyses, it will be shown in this volume how different schemes in different countries have resulted in substantial differences in the situations of caregivers.

Informal care employment Another type of informal care has grown which is based on the employment of paid workers (nearly exclusively women) as caregivers in households, in which case the household acts as employer, although very often the employment relationship in the private household is undeclared; that is, it takes place outside the legal framework of formal employment.That also means that in such informal work agreements, no employee labour law or social security rights apply. This is a particularly precarious form of employment which has in part increased with the number of migrants, and mainly in those European welfare states which restrict the formal employment of immigrants (Gather et al, 2002). Chapter Five of this volume, using the findings of an empirical study on female migrants in Italy, shows how they use the rather precarious forms of employment of childcare and housework to build a ‘transnational space’ of action between their society of origin and the one in which they currently work. Informal care employment has also expanded together with unemployment rates in those countries where unemployment benefits are relatively low and possibilities among the unemployed of gaining an additional income in formal employment very restricted (Pfau-Effinger, 2004c). Also, the growth of ‘cash-forcare’ systems in some welfare states may have contributed to the

10

Change in European care arrangements

development, in as far as they include the possibility of hiring foreigners for the care tasks, and the use of these schemes is not strictly controlled (Ungerson, 1997).

Change in care policies of welfare states From the debate and analyses of comparative welfare-state research in the last few decades, it can be seen that the formalisation of care work is mainly the result of changes in welfare state policies. In many European countries in recent decades, state provision of social care services has increased, despite retrenchment in other welfare-state activities. However, the public provision of social care services is often still a contested policy area (see Lewis, 2003; Pfau-Effinger, 2004b). Also, in many countries the amount of public childcare is still rather unsatisfactory, which causes substantial problems in the everyday lives of women carers. During the transformations in Central and Eastern Europe, such problems have also increasingly emerged in several countries, as Chapter Twelve of this volume shows for the case of Slovenia. The new semi-formal forms of care in private households, on the other hand, are the result of the establishment of another new type of social right related to care: the right to give care (Knijn and Kremer, 1997), meaning the social right of parents, relatives or friends during temporary life phases to provide care for their children, frail elderly relatives or friends in the household. Moreover, parental leave schemes have been introduced which in some cases allow caregivers to keep their work contract during leave, thus guaranteeing the right to labourmarket integration after leave. The changes in welfare-state care policies have resulted from an irreversible weakening of family-based concepts of social care beginning in the Scandinavian welfare states of the 1970s and extending to all European countries since the 1980s. As the contributions to this volume show, since then in the European welfare states various models of care production have come about which, in the most diverse formulas, combine formal and informal employment and informal and semi-formal work within the family.As much as these arrangements differ according to the welfare-state path chosen by each country, they have in common that their national policy strategies were conceptually influenced by the feminist debate over women’s work, and politically, by the women’s movement and its demands for equality. This influence had international scale: in all countries, women’s movements represented an anti-familial programme and criticised

11

Care and social integration in European societies

women’s dependency on male providers (or state social benefits; see, for example, Gerhard, 1995; Pfau-Effinger, 2004a).

New forms of care and social citizenship That social rights that contribute to the extension of semi-formal forms of care have been introduced in recent decades – after the degree of formalisation of care was traditionally high in the 20th century – is shown by the example of the French welfare state in an historical indepth analysis in Chapter Seven of this volume. Such a policy has contributed to an increase in gender equality in France. Welfare-state policies in Austria support to an even higher degree semi-formal forms of care in private households. According to Chapter Nine of this volume, this policy has not, however, sufficiently contributed to a dissolution of the traditional male breadwinner family model or to the promotion of gender equality. More recently, some welfare states have also started to empower fathers of young children in their role as caregivers. In its analysis of policies on parental leave in the Nordic welfare states, Chapter Eight of this volume shows how a new welfare-state framework for new forms of social integration for fathers has been established in the last decade. Since these changes were often thoroughly controversial among the leading political actors, the transformation was not linear but often contradictory, accompanied by time lags and at times even by reversals. It could be argued that this development of welfare-state policies is based on a new, more comprehensive understanding of citizenship, one no longer limited to recognising only formal employment, but taking into account that outside formal employment and other types of work exist and need to be supported and protected (Knijn and Kremer, 1997; Pfau-Effinger, 2004d). The new forms often represent temporary phases of leave in personal biographies otherwise centred round the formal employment system. As a consequence, informal care has lost in substantial part its character as hidden and unpaid and its strong connection with the housewife marriage. This development goes often still unnoticed in the debate on the development of welfare states and work in societies. In-depth research on the reasons for welfare states starting reform processes, leading to the expansion of social rights for carers, has been conducted in two countries, Britain and Germany (see Chapter Fourteen of this volume). In this chapter, Meyer asks why this issue was considered relevant enough to warrant state intervention despite

12

Change in European care arrangements

“permanent austerity” (Pierson, 2001, p 99), and what forces were responsible for the decision to extend carers’ rights. In her findings, change is not necessarily caused by the intention of political actors to promote gender equality.

Care arrangements and international differences In social policy research, many approaches have been developed to broaden the typologies of comparative welfare-state research to include the ‘care’ dimension1.A pioneering role was played here by the approach of Lewis (1992), and Lewis and Ostner (1994), in which the state regulation of paid and unpaid work according to gender was made the basis of the comparison of welfare states, and welfare states were classified by the different relative strengths of the ‘male breadwinner’ model. Chapter Six of this volume introduces a theoretical framework for the classification of concrete patterns of care organisation in different societies (defined as ‘care regimes’). This chapter sees processes like individualisation, universalisation and increasing public delivery of primarily family-based activities as central to the analysis of the development of social care. Even though there are some elements of convergence in the development of care arrangements (as the findings of Chapter Six of this volume indicate), for some specific elements the development is also path-dependent. Chapter Two of this volume argues that at least two specific development paths of care arrangement in Western Europe can be distinguished, in each of which informal family care plays a substantially different role than it does in the other. And Chapter Ten of this volume, by using the findings of a comparative study of Germany and Sweden, shows how the structures of care work in formal employment are in different ways influenced by the informal, familybased care work of the past. However, the comparative analysis of care work patterns suffers from methodological and statistical problems. Chapter Thirteen shows that statistics on labour-market exclusion/integration of caring mothers are in part misleading, and that adequate methods for distinguishing between informal or semi-formal, family-based forms of care work and formal employment are broadly lacking. How can the differences between the specific care regimes of various countries be explained? Often, welfare-state policies are seen as the main factor determining the development of social care. According to Mósesdóttir (2000), differences among the main constellations of

13

Care and social integration in European societies

political actors also contribute to the explanation. We introduce here a more comprehensive multi-dimensional approach to the ‘carearrangement’, based on the assumption that various dimensions of the societal context, and the ways they interact, can explain the development of social care and cross-national differences in relation to the structures and development of social care. According to the definition as outlined by Pfau-Effinger (in Chapter Two of this volume), the ‘care arrangement’ comprises the underlying cultural, institutional and socio-structural framework of a society, on which the concrete structuring of social care and the welfare provision mix is based in each case, and which may change2. Care arrangements can be coherent or contradictory. They can be classified by the cultural values and models on which they are based. Conflicts, changes in power relations and negotiation processes at the level of social actors can contribute to change in a care arrangement. Particularly, variations in welfarestate policies as well as differences in cultural values and models contribute substantially to the explanation of cross-national differences (Chapter Two of this volume; Pfau-Effinger 2005b). Chapter Eleven of this volume analyses how, in a comparative perspective, public policies in France and Sweden shape mothers’ access to and position in the labour market. The chapter argues that this position is related to the way work and citizenship are linked differently in each of the two countries and for women and men. Chapter Four of this volume shows how differences in care arrangements for older people in private households in Germany and Austria can be explained in the context of differing elderly-care schemes in both welfare states. Care arrangements are also based on cultural ideas of the role of, and main sphere for the provision of social services and of the welfare provision mix; that is, the way, and how much the family, public sector, market, and non-profit organisations should contribute to the production of social services. They are also based on cultural ideas about the gender division of labour in the family and society, and refer to cultural notions, as for example a ‘good’ childhood, and a ‘good’ old age. These ideas also form the basis for the organisation of such main institutions in society as the family, labour market and welfare state.The relationship between the cultural and institutional level can, however, be contradictory and subject to change.The role of individual and collective actors is particularly important for, respectively, the reproduction or change in the care arrangement (see Chapter Two of this volume). If cultural factors are included in analyses, it also turns out that international differences in the degree to which the family is involved in childcare are not simply a reflection of differing welfare

14

Change in European care arrangements

state policies. Instead, deep-rooted differences in cultural ideas about ‘parenthood’, ‘childhood’ and the family contribute substantially to the explanation, as Pfau-Effinger (2004a; also Chapter Two of this volume) argues. Such cultural differences also contribute to the explanation for why family policies vary cross-nationally with respect to the degree to which they promote the formalisation of care on one hand, and the restructuring of informal care on the other (Pfau-Effinger, 2004b; 2005b). To conclude, the way social care is organised is of basic importance for the production of welfare in European societies.The discussion of the theoretical concepts surrounding care work and the presentation of recent empirical results in this volume should contribute to a better understanding of the change in European welfare states and work societies from a general, as well as gender perspective. Notes 1 For an elaborated discussion of such approaches see Kröger (2001). 2

For the general use of the theoretical approach of ‘arrangements’ for crossnational comparison, see Pfau-Effinger (1998, 1999, 2004a).

References

Ballarin, P., Euler, C., Le Feuvre, N. and Raevaara, E. (2003) Women in the European Union (www.helsinki.fi/science/xantippa/wee/ wee20.html). Bang, H., Jensen, P. and Pfau-Effinger, B. (2000) ‘Gender and European welfare states: context, structure, agency’, in S. Duncan and B. PfauEffinger (eds) Gender, work and culture in the European Union, London/ New York: Routledge, pp 115-42. Cousins, C. (1998) ‘Social exclusion in Europe: paradigms of social disadvantage in Germany, Spain, Sweden and the United Kingdom’, Policy & Politics, vol 26, no 2, pp 127-46. Dale, A. and Holdsworth, C. (1997) ‘Why don’t minority ethnic women in Britain work part-time’, in C. Fagan and J. O’Reilly (eds) Parttime perspectives, London: Routledge, pp 77-95. Dalla Costa, M. and James, S. (1973) Die Macht der Frauen und der Umsturz der Gesellschaft, Berlin: Merve. Daly, M. and Lewis, J. (1998) ‘Introduction: conceptualising social care in the context of welfare state restructuring’, in J. Lewis (ed) Gender, social care and welfare state restructuring in Europe, Aldershot: Ashgate, pp 86-103.

15

Care and social integration in European societies

Daly, M. and Lewis, J. (2000) ‘The concept of social care and the analysis of contemporary welfare states’, British Journal of Sociology, vol 51, no 2, pp 281-98. Duncan, S. and Smith, D. (2002) ‘Family geographies and gender cultures’, Social Policy and Society, vol 1, no 1, pp 21-34. Esping-Andersen, G. (1990) The three worlds of welfare capitalism, Cambridge: Polity Press. Esping-Andersen, G. (1999) Social foundations of postindustrial economies, Oxford: Oxford University Press. Finch, J. and Mason, J. (1993) ‘Obligations of kinship in contemporary Britain, is there normative agreement?’, British Journal of Sociology, vol 42, no 3, pp 345-67. Fraser, N. and Gordon, L. (1994) ‘“Dependency” demystified: inscriptions of power in a keyword of the welfare state’, Social Politics, vol 1, no 1, pp 4-31. Gather, C., Geissler, B. and Rerrich, M.S. (eds) (2002) Weltmarkt Privathaushalt. Bezahlte Haushaltsarbeit im globalen Wandel, Münster: Westfälisches Dampfboot. Geissler, B. (2002a) ‘Die (Un-)Abhängigkeit in der Ehe und das Bürgerrecht auf care. Überlegungen zur gender-Gerechtigkeit im Wohlfahrtsstaat’, in K. Gottschall and B. Pfau-Effinger (eds) Zukunft der Arbeit und Geschlecht, Opladen: Leske und Budrich, pp 183-206. Geissler, B. (2002b) ‘Die Dienstleistungslücke im Haushalt. Der neue Bedarf nach Dienstleistungen und die Handlungslogik der privaten Arbeit’, in C. Gather, B. Geissler and M.S. Rerrich (eds) Weltmarkt Privathaushalt. Bezahlte Haushaltsarbeit im globalen Wandel, Münster: Westfälisches Dampfboot, pp 30-49. Geissler, B. and Pfau-Effinger, B. (1989) ‘Neuere Lebensentwürfe von Frauen und das Recht auf geschützte Teilzeitarbeit’, in S. HabenichtErenler (ed) Frauenzeit am Arbeitsmarkt. Perspektiven einer Arbeitszeitpolitik für Frauen, Loccum: Akademie Verlag, pp 89-119. Gender and Society (2002) Special issue: Global perspectives on gender and carework, vol 17, no 2. Gerhard, U. (1995) ‘Frauenbewegung und Ehekritik – Der Beitrag der Frauenbewegung zu sozialem Wandel’, in B. Nauck and C. Onnen-Isemann (eds) Familie im Brennpunkt von Wissenschaft und Forschung, Neuwied: Luchterhand, pp 59-72. Gerhard, U. (2003) ‘“Ein Raum der Freiheit?” – Ansätze und Perspektiven des Konzepts europäischer Bürgerrechte’, Feministische Studien, vol 21, no 1, pp 71-82.

16

Change in European care arrangements

Hochschild, A.R. (1995) ‘The culture of politics: traditional, postmodern, cold-modern and warm-modern ideals of care’, Social Politics, vol 2, no 3, pp 331-46. Hochschild, A.R. (1996) ‘The emotional geography of work and family life’, in L. Morris and S. Lyon (eds) Gender relations in public and private, London: Macmillan, pp 13-32. Hochschild, A.R. (2000) ‘Global care chains and emotional surplus value’, in W. Hutton and A. Giddens (eds) On the edge: Living with global capitalism, London: Cape, pp 130-46. Knijn,T. and Kremer, M. (1997) ‘Gender and the caring dimension of the welfare states: towards inclusive citizenship’, Social Politics, vol 4, no 3, pp 328-61. Kramer, H. (1981) ‘Hausarbeit und taylorisierte Arbeit’, in Institut für Sozialforschung (ed) Gesellschaftliche Arbeit und Rationalisierung, Leviathan-Sonderheft, no 4, Opladen: Westdeutscher V., pp 136-51. Kröger, T. (2001) Comparative research on social care: The state of the art, SOCCARE Project Report 1, Brussels: European Commission. Leira,A. (1992) Models of motherhood:Welfare state policy and Scandinavian experiences of everyday practices, Cambridge: Cambridge University Press. Lewis, J. (1992) ‘Gender and the development of welfare regimes’, Journal of European Social Policy, vol 2, no 3, pp 159-73. Lewis, J. and Ostner, I. (1994) Gender and the evolution of European social policies (Arbeitspapier 4/94), Bremen: Zentrum für Sozialpolitik. Marshall,T.H. (1964) Class, citizenship and social development, Chicago/ London: University of Chicago Press. Meyer,T. (1998) ‘Retrenchment, reproduction, modernization: pension politics and the decline of the German breadwinner model’, European Journal of Social Policy, vol 8, pp 212-27. Mósesdóttir, L. (2000) The interplay between gender, markets and the state in Sweden, Germany and the United States, Aldershot: Ashgate. O’Connor, J. (1996) ‘From women in the welfare state to gendering welfare state regimes’, Current Sociology, vol 44, no 2, pp 102-18. OECD (Organisation for Economic Cooperation and Development) (2000) Employment outlook, Paris: OECD. Pfau-Effinger, B. (1998) ‘Gender cultures and the gender arrangement – a theoretical framework for cross-national comparisons on gender’, in S. Duncan (ed) The spatiality of gender. Special issue of Innovation, European Journal of Social Sciences, vol 11, no 2, pp 147-66. Pfau-Effinger, B. (1999) ‘Change of family policies in the socio-cultural context of European Societies’, Comparative Social Research, vol 18, pp 135-60.

17

Care and social integration in European societies

Pfau-Effinger, B. (2001) ‘Wandel wohlfahrtsstaatlicher Geschlechterpolitiken im soziokulturellen Kontext’, Kölner Zeitschrift für Soziologie und Sozialpsychologie, vol 41, no 3, pp 488-511. Pfau-Effinger, B. (2004a) Culture, welfare state and women’s work in Europe, Aldershot: Ashgate. Pfau-Effinger, B. (2004b) ‘Historical paths of the male breadwinner family model – explanation for cross-national differences’, British Journal for Sociology, vol 55, no 3, pp 177-99. Pfau-Effinger, B. (2004c) Informal employment in a comparative perspective in six EU member states – Denmark, Finland, Germany, Great Britain, Poland and Spain, Paper presented at the Fourth Workshop of the 5th EU Framework Programme Research Project,‘Formal and Informal Work in Europe (FIWE): A comparative analysis of their changing relationship and their impact on social integration’, 14-15 May 2004, Krakow. Pfau-Effinger, B. (2004d) ‘The concept of informal work’, in B. PfauEffinger (ed) Review of Literature on Formal and Informal Work in Europe, Discussion Paper no 2, 5th EU Framework Research Project,‘Formal and Informal Work in Europe (FIWE)’, Centre for Globalisation and Governance, University of Hamburg, Hamburg, pp 4-18. Pfau-Effinger, B. (2005a) ‘Culture and welfare state policies: reflections on a complex interrelation’, Journal of Social Policy, vol 34, no 1, pp 118. Pfau-Effinger, B. (2005b) ‘Welfare state policies and development of care arrangements’, European Societies, vol 7, no 3, pp 321-41. Pfau-Effinger, B. and Geissler, B. (2002) ‘Cultural change and family policies in East and West Germany’, in A. Carling, S. Duncan and R. Edwards (eds) Analysing families: Morality and rationality in policy and practice, London/New York: Routledge. Pierson, P. (2001) ‘Post-industrial pressures on the mature welfare states’, in P. Pierson (ed) The new politics of the welfare state, Oxford: Oxford University Press, pp 80-106. Senghaas-Knobloch, E. (1999) Das Problem der “Angewiesenheit” in der postindustriellen Gesellschaft, Artec paper 75, Universität Bremen. Siim, B. (2000) Gender and citizenship: Politics and agency in France, Britain and Denmark, Cambridge: Cambridge University Press. Thomas, C. (1993) ‘De-constructing concepts of care’, Sociology, vol 27, no 4, pp 649-69. Tronto, J. (1996) ‘Politics of care: Fürsorge und Wohlfahrt’, Transit – Europäische Revue, vol 7, no 12, pp 142-53.

18

Change in European care arrangements

Ungerson, C. (1997) ‘Social politics and the commodification of care’, Social Politics, vol 4, no 3, pp 362-81. Waerness, K. (2000) ‘Fürsorgerationalität’, in C. Eckart and E. SenghaasKnobloch (ed) Fürsorge, Anerkennung, Arbeit, Feministische Studien, vol 18, pp 54-66.

19

Development paths of care arrangements

TWO

Development paths of care arrangements in the framework of family values and welfare values Birgit Pfau-Effinger

The transformation of service structures has been an important topic in international comparative social policy research for several years. Due to neoliberal-oriented policy discourses, government budget crises, demographic shifts, as well as new discourses on and demand for civil participation in society and the restructuring of the relationship of state and private responsibility, considerable reorganisation processes are taking place. Indeed, there has now been a move beyond the typology of welfare state regimes developed by Esping-Andersen. Since the 1990s, in the framework of theoretical approaches relating to the transformation of services, concepts for the classification of welfare states in terms of the way in which it shapes the provision of care provided formally as services and the informal care delivered within the family have also been developed (Langan and Ostner, 1991; Lewis, 1992; Orloff, 1993; Lewis and Ostner, 1994; Anttonen and Sipilä, 1996; Hanssen, 1997; Knijn and Kremer, 1997; Land and Lewis, 1998; Mósesdóttir, 2000; Siim, 2000; Pfau-Effinger, 2001; Rostgaard, 2002). In this context, it has been argued that the way in which care work is organised is based on gender-specific roles and tasks, and that it influences life opportunities in a gender-specific way. Concepts such as ‘care policies’, ‘gender policies’ or ‘care regimes’ express the distribution of care tasks among private and public actors, and the access to social services, financial aid, or other social welfare rights of those in need of care, or family members providing care, is varied. Moreover, it is stressed that such factors affect the life opportunities of women (Daly and Lewis, 1998; Ungerson, 2000). A main aim of cross-national analyses of the restructuring of social care services was to identify changes of the ‘welfare mix’, the degree to which the family, the state, the market, and the non-profit sector contribute to the provision of social care (Evers and Olk, 1996). By

21

Care and social integration in European societies

comparing welfare-state policies in relation to care, it has been possible to identify national care profiles, corresponding to the different dominating actors in the delivery of social services in each case (see Anttonen and Sipilä, 1996), or European care regimes, corresponding to the amount of freedom of choice between paid work and care (Rostgaard, 2002). In addition, familial-versus-individualistic strategies have been discerned (Daatland, 1992, 2001; Daatland and Herlofson, 2003). It has been shown that welfare policy also increasingly provides access to care services or material help for informal care given by women within the family, with such care becoming a part of ‘citizenship’ (Knijn and Kremer, 1997). However, there are still deficits regarding the development of an explanatory framework for cross-national differences in relation to the societal organisation of care and the welfare mix. Indeed, the way in which care is organised in society is not determined by welfare policies alone, and the explanation of cross-national differences cannot be restricted to differing welfare state policies. Instead, the structures of care and the welfare mix are the result of the complex interplay of different factors in the societal context. In addition to welfare state policies, cultural values and models (‘Leitbilder’) in particular also contribute substantially to explaining differences.The role of differences in the cultural values to which social actors in the population and political actors orient their behaviour was often neglected in comparative analyses (however, see Duncan, 1998; Pfau-Effinger, 1998, 2004a; Bang et al, 2000; Daatland and Herlofson, 2003). The aim of this chapter is to elaborate on the theoretical approach of the ‘care arrangement’ for comparative analyses. The theoretical framework will be used for the explanation of cross-national differences in relation to the degree to which the family contributes to the provision of childcare in eight European countries.

The approach of the ‘care arrangement’ The approach of the ‘care arrangement’ adopts the strategy, gleaned from comparative social policy analysis, of analysing the development of ‘care’ in the context of configurations of explanatory factors (see Figure 2.1). It is based on the idea that, besides institutional, social and socioeconomic factors, values and cultural models (‘Leitbilder’) regarding the role of different spheres of society for the provision of care also contribute to explaining the way in which care policies and their transformation into social practices develop (Dallinger, 2001; Pfau-Effinger, 2004a, 2005b; also Chapter One of this volume). The

22

Development paths of care arrangements Figure 2.1: Care provision within the care arrangement Supranational influences, ie globalisation, EU-integration

Ideas Social acteurs (collective and individual) • Power relations • Negotiation processes • Social practices

Cultural system Values and notions in relation to: • Family, childhood, old age • Welfare state Structures of care provision Reproduction or change Basis: Ideas and interests

Interests

• • • • •

Social system Social Central structures institutions • Structures of social Welfare state inequality (by class, Family gender, ethnicity, Labour market region …) Market • Power relations Non-profit sector

concept of ‘care’ is used here in the sense of ‘social care’. This was developed in order to expand critically on academic concepts of welfare production (Daly and Lewis, 1998).The emphasis is that societal life is split into a public and a private sphere, and that care is ascribed to the private sphere. According to the ‘care arrangement’ approach (see Figure 2.1), the structures of the welfare mix in relation to care and the relationship of formal and informal care are embedded, in specific ways, into the institutional setting of the welfare state, the labour market structures, family, the market, and non-profit organisations. Furthermore, they are also entrenched into social structures such as social inequality (through class, gender, ethnicity, and so on) and power relations. Moreover, they are influenced by the dominant cultural values and models (‘Leitbilder’) concerning the family and welfare in society; the main actors refer with their ideas and interests on the one hand to cultural values and models and on the other to the institutional and socio-structural framework. It should be considered that the cultural system and the social system are themselves interrelated (see PfauEffinger, 2004a).With such an approach, an actor-centred perspective should therefore broaden the comparative analysis of care arrangements, and a systematic analysis of the influence of cultural factors should be brought into play. ‘Culture’ is defined here as the “system of collective constructions of meaning by which human beings define reality”

23

Care and social integration in European societies

(Neidhard et al, 1986, p 11). It includes stocks of knowledge, values and ideals: in sum, ideas. Cultural values can be seen as ‘switches’ on the pathways along which interests influence actions to be taken, as has also been argued by Lepsius (1990, p 31; 1995).

Cultural values on which care arrangements are based Care arrangements are mainly based on two types of values: family values on the one hand, and welfare values on the other. Family values include cultural values and notions regarding the structure of the family and the gender division of labour. Cultural values in relation to differing dimensions of the family together form ‘family models’ (Pfau-Effinger, 1998, 1999, 2004a).Within such family models, values about what is a ‘good’ or ‘adequate’ childhood are combined with values relating to the adequate division of labour within the family and between family and the employment system. They thus imply suppositions about how, with its caring tasks, the family should function with other societal institutions. The models can be characterised in terms of their central cultural ideas about the role of the family via other societal institutions for the provision of care. To what degree is the family seen as mainly responsible for providing care, and which members of the family carry this responsibility? Moreover, how does this relate to values concerning the gender division of labour and gender hierarchy or gender equality? It is possible that one specific family model is dominant in a society, or that different family models coexist or compete1. It is my argument that care arrangements can be comparatively analysed and classified on the basis of the given cultural values in relation to the family and care upon which they rest. It should be noted that the ways in which welfare state policies are interrelated with such cultural ideas can differ in the time–space context, and that the relationship can be orderly or can display discrepancies and delays.The way in which new cultural models, having developed at a given time in the population, are dealt with, is strongly influenced by the conflict and negotiation processes taking place in the arena of the social actors. Previously, I have developed a classification of different cultural models of the family and the way in which it is related to gender and care (Pfau-Effinger, 1998, 2004a). Accordingly, at least five family models can be distinguished based on the development in Western Europe, which have been significant for the development of care policy since the middle of the 20th century:

24

Development paths of care arrangements

• • • • •

the family economy model; the housewife model of the male breadwinner family; the male breadwinner/female part-time carer model; the dual breadwinner/external care model; the dual breadwinner/dual carer model.

Welfare values, on the other hand, include values relating to the institution(s) that should be responsible should care be provided outside the family, whether social rights relating to care should be familybased or individual, and the re-distributive role of the welfare state. According to Esping-Andersen’s welfare regime approach (1990, 1999), such values (which he does not directly define as cultural values but rather as ‘principles’ of welfare-state policies) vary systematically with the welfare regime. According to his argument, in the liberal welfare regime, the market is seen as mainly responsible for providing care outside the family, social rights are individual-based and of low quality. In the conservative welfare regime, in contrast, non-profit organisations are given a relatively strong role for the provision of childcare, social rights are in part family-based, and the state provision and the quality of social rights is at a medium level. The role that is given to the state is strongest in the welfare values underlying the social democratic welfare regime, where the state is the main responsible institution for the organisation and provision of childcare, and social rights are individual and of a high quality.

Path dependence of care arrangements A care arrangement can be firmly established and coherent in the long term if its cultural foundations are anchored as norms on the level of societal institutions – and form the basis of the social actors’ behaviour. As a result of general processes of social and cultural change, it can obviously occur that the degree of cultural and social integration of the care arrangement declines, and then the possibilities for social or cultural change in the care arrangement increase. A transformation can mainly be expected if contradictions in the arrangement are seized upon by certain political actors who endeavour to bring about change in welfare-state policies. In this case, the welfare arrangement can become the object of conflict and negotiation processes by social actors concerning innovative cultural models or new institutional arrangements.

25

Care and social integration in European societies

As Nullmeier and Rüb (1993) have argued, these conflicts can also take the form of discursively conducted ‘struggles for interpretations’ that precede policy change and relate to the reasons for action, the goals of action, and the manners of action. If a change in policies is to be established successfully, a strong link with the cultural orientations of voters is necessary – the groups who wish to implement the change have to canvass in public debates in order to gain support for the political interpretations they offer (Bleses and Rose, 2002).The success of such discourses is, as Vivian Schmidt (2001) has also argued, dependent on the extent to which they can pick up on trends or contradictions in the attitudes of the general population in favour of the changed values. Actual policies in the German welfare state in relation to elderly care support the argument that the real effects of innovative welfare state policies may deviate substantially from their intention if the cultural values to which they refer deviate from the predominant attitudes in the population. In West German opinion, as well as in official political semantics, there remains a family-oriented culture concerning responsibilities for children and elderly family members in need of care (Ostner, 1998; Dallinger, 2001). This is important in explaining why elderly people in Germany are often cared for by their relatives, mainly women, who reduce their working time or stay at home in order to provide such care. The German nursing care insurance scheme, which was implemented in 1995/96, extended the choice for elderly people between care provided by relatives and care provided by professional caregivers (Chapter Four of this volume). Both types of care can be paid for. Experts at the ministry responsible expected the proportion of elderly people who hired a professional carer to increase dramatically (Pabst, 1999). However, the effect on the increase of jobs in that field was marginal. Today, long-term care provided by relatives is still much more common than that provided by professional caregivers.This can, to a considerable extent, be explained by the high value placed on care by relatives in West Germany (Dallinger, 2001; Pfau-Effinger, 2005a). Within a particular development path, change in welfare-state policies does not necessarily follow cultural change but can develop at a different rate. Policies and their effects in such processes can be characterised by discrepancies and contradictions.The development of cultural ideals about the family on the one hand and family policies on the other in the Netherlands in the 1970s and 1980s is a good example. In the 1950s and 1960s, the housewife model of the family was absolutely dominant as the cultural basis of family structures and welfare-state

26

Development paths of care arrangements

policies (Plantenga, 1996; Knijn, 1998). Accordingly, only 4% of married women were employed in the 1950s. At the end of the 1960s, however, a dramatic change in the cultural foundations of the family took place in the framework of a general ‘cultural revolution’. Waged work of married women and mothers was increasingly seen as acceptable. As a consequence, labour-force participation rates of women have increased dramatically since then. These changes took place, however, almost without changes in welfare state policies, which continued to promote the housewife model of the family and did not even extend public childcare provision substantially. Change here started much later, in the middle of the 1980s (Plantenga, 1996; Bussemaker, 1998;Voet, 1998).This caused serious dilemmas for employed mothers, as Knijn (1994) found in her empirical research. Inasmuch as transformation occurs in the institutional or cultural foundations of the care arrangement, it can be expected that the transformation process will usually be ‘path dependent’, since basic elements of the institutional and cultural context are partially maintained. This is because the social actors in the process are still behaving under the influence of the structures and models they have challenged.The direction of the transformation is not predetermined but, since elements of continuity are generally at work, it is not free either. In the more recent discussion on path dependency of welfare states, it is mainly the longue durée of the institutional foundations of welfare-state policies that is analysed (Pierson, 1996, 2001). According to Esping-Andersen (1996, p 6), welfare regimes evolve in a pathdependent manner, for which he attributes responsibility to “institutional legacies, inherited system characteristics, and the vested interests that these cultivate”. One should consider the fact, however, that path dependence is often also based on a longue durée at the cultural level (Goodin 1996, p 19; Cox, 2004).

Renegotiation of the care arrangement In the current public discourses on crises of welfare states and the consequences of globalisation for welfare-state policies, processes of renegotiation of the welfare values are taking place in many European societies.The renegotiation processes include the cultural ideas on the market–state relationship and on the redistributive effects of welfarestate policies. New public discussions partially question the legitimacy of welfare expenditures and stress the role of the market for the provision of welfare, often based on neoliberal ideas. Other discourses are related more to the welfare mix and stress the importance of the role of civil

27

Care and social integration in European societies

society vis-à-vis the welfare state and for the provision of welfare, often based on communitarian ideas. Such discourse can also be relevant for the development of care arrangements. Even if these new discourses take place in many European countries, the ideas in the social context of the different societies are often adapted in specific ways, filtered in each case by the institutional and cultural particularities of the respective country (or group of countries). In the current German discourses, for example, the necessity of improving pre-school education and extending public childcare provision in order to prepare the society for competition in the globalised ‘knowledge society’ is a much-debated issue. At the same time, however, proposals by social scientists (Beck, 2000) to establish a low-wage sector, particularly also in the field of care services, and communitarian ideas according to which unpaid care work within the family and by volunteers in civil society could contribute to solving the problems of high unemployment rates, are rather popular among politicians of all parties (Mutz, 1999; Sing, 2002), even though these ideas contradict the aim of improving childcare. This can be explained by specific German cultural traditions in which actors and associations in civil society, the family and the non-profit sector were accorded a high cultural value and, in part, priority over state institutions in the provision of welfare by using the ‘subsidiarity’ principle (Effinger, 1994; Evers and Olk, 1996; Gottschall, 2001). The example of Germany indicates that change in welfare values and welfare-state policies, which is currently taking place in Western Europe, can be seen as a complex relationship of convergence and path dependence. In the future, the relationship between the cultural and institutional dimensions of path dependence should gain increasing attention in comparative research relating to care.

Different development paths of care arrangements In the following section the theoretical framework will be used to explain cross-national differences in terms of the degree to which the family contributes to the provision of childcare in eight European countries. The following countries will be considered on the basis of comparative case studies: Sweden, Finland, Norway, France, the Netherlands, Great Britain and Western Germany2. The time period analysed is the beginning of the 1970s until the end of the 1990s. Such a comparative historical study is particularly useful as it allows temporary, contingent differences between care arrangements to be distinguished from long-lasting differences along differing development

28

Development paths of care arrangements

paths. As the change in cultural orientation of women and men with regard to employment was demonstrated only insufficiently on the basis of previous, internationally comparative attitude questionnaires, I shall present the cultural context essentially using country-specific case studies, consisting of country-specific data and questionnaire results, as well as a secondary analysis of empirical studies. The findings of the study show that two distinctly different development paths of care arrangement can be distinguished on the basis of cross-national empirical research (Pfau-Effinger, 2004a, 2005b): • a development path that is based on a relatively high contribution of the family to the welfare mix in relation to childcare, even though the proportion of informal care has decreased during the development; • a development path that is based more on a relatively moderate contribution of the family to the provision of childcare. In the following, I show that cultural values – family values and welfare values – and the interplay of these with welfare-state policies contribute substantially to the explanation of such differences.

The role of family values for differences Development path 1: countries with a relatively high contribution of the family to the welfare mix in relation to childcare The first path appears in Great Britain, Norway, the Netherlands and Western Germany, where long into the postwar period the housewife model of the male breadwinner family maintained strong cultural predominance (Great Britain: Fox Harding, 1996; Dasko, 2000. Norway: Leira, 1992; Ellingsaeter, 1999. Netherlands: Pott-Buter, 1993; Knijn, 1994; Plantenga, 1996. Western Germany: Sommerkorn, 1988; PfauEffinger and Geissler, 1992; Geissler, 1997; Pfau-Effinger, 2004a). The countries in this group are among those in which the percentage of women, who, at the end of the 1990s, were working part-time for family reasons, was highest in an EU comparison (the Netherlands at 37%, Great Britain and Germany each at 24%). It is characteristic of part-time work in these countries that in general it has the extent of half-day employment, or slightly less, in terms of working hours. Correspondingly, in these countries the amount of care taking place at home was near the top in a European comparison in the late 1990s (European Commission, 1998, p 12).

29

Care and social integration in European societies

This latter model is based on the premise of a fundamental separation of the ‘public’ and ‘private’ spheres, and a corollary location for both genders: the husband’s proper work is in the ‘public’ sphere, while the housewife is responsible for the private household and childcare; her financial security exists on the basis of the husband’s income. This model is also linked with the cultural construction of ‘childhood’, according to which children need special care, and comprehensive individual tutelage of the mother in the private household. In the countries listed earlier, a process continuing from the 1980s to the end of the 1990s considerably weakened the central position of the traditional family model as the cultural basis for the care arrangement. This transformation, which generally had already begun in the 1960s, was initiated principally when a fundamental contradiction at the cultural level came to a head: essentially, the contradiction between the cultural construct of autonomous and equal citizens of modern industrial societies on the one hand, and the cultural construct of the inequality and dependence of the housewife model on the other. In addition to this, there were also alternative family models available on the cultural level; these had filtered down from the new, international feminist discourse into the public discussion that was taking place at the respective national level. Particularly significant was that these contradictions were seized upon by newly forming feminist movements (Geissler, 2002; Pfau-Effinger, 2004a). The old housewife model as a dominant cultural image was increasingly replaced by the ‘male breadwinner/female part-time carer model’ of the family (West Germany: Pfau-Effinger and Geissler, 1992; Geissler and Oechsle, 1996; PfauEffinger, 2004a. Great Britain: Fox Harding, 1996; Crompton, 1998; Daune-Richard, 1998; Dasko, 2000)3. This model rests essentially on the vision of full integration of women and men into paid economic activity.Within it, however, it is expected that women, as mothers, may interrupt their gainful activity for a few years, after which they combine employment and responsibility for childcare through part-time work until their children are no longer considered to require particular care. As shown, for example, by findings of a representative attitude survey conducted by the Institut für Arbeitsmarkt- und Berufsforschung [Institute for Employment Research] in 2001, at the beginning of the 21st century the most popular cultural model of the family in West Germany is based on the marriage of a male breadwinner and a female part-time carer (Engelbrech and Jungkunst, 2001). In some countries following this path, a great proportion of the population actually shares the attitude that fathers should also contribute equally to the provision of childcare in the family. In these countries,

30

Development paths of care arrangements

such as Norway and the Netherlands, the dominant cultural model has been further developed towards a ‘dual breadwinner/dual carer’ model, even though the cultural notion of equal contribution of fathers to informal family care is still only in some part reflected in everyday practices of care within the family (Leira, 2002; Chapter Eight of this volume).Today, elements of home-based childcare continue to receive substantial cultural support among the populations of these countries. According to the values of the new family model, both parents should be employed part-time and share a part of the childcare between themselves, while entrusting the other part to an institution outside the family (Netherlands: Morée, 1992; Knijn, 1994, 1998; Plantenga, 1996; Voet, 1998; van Oorschot, 2001. Norway: Leira, 1992, 2002; Waerness, 1998; Ellingsaeter, 1999). The findings of a representative survey, conducted in 1999 and, 2002 by the Social een Cultureel Planbuereau (SCP, 2002), for example, are very illuminating with regard to the current development of the cultural basis of the care arrangement in the Netherlands. Adults with partners, and mothers with children aged 9-12 were asked which forms of labour-force participation they prefer for themselves and their partners. In general, it is clear that the majority of both women (63%) and men (68%) preferred an egalitarian model. The most popular model was the ‘half-and-half breadwinner’ one, in which both partners work part-time. The new cultural models for family and gender relations are characterised in all four countries by the expectation that the mother should be employed, but also by the idea that the ‘private’ childhood should still play an important role in family life. As an effect of these transformations in the care arrangements in these countries, the structures of the gender division of labour have also changed considerably. The employment activity of mothers has broadened greatly, usually taking place as a sequence of employment interruptions and part-time work (Fagan et al, 1999). The cultural change in the care arrangement has been interrelated with general processes of cultural change; this has led to a positive reassessment of the value of individual autonomy (Beck, 1986). Thus, the new care arrangement model based on a ‘modernised breadwinner model’ has some distinctly contradictory aspects, for example, the financial dependence taken on by a family that cares for its own children conflicts with the high cultural esteem enjoyed by autonomous financial security. This is a possible point of departure for further cultural change. However, some clear differences among countries can be discerned with regard to the extent of the change. In the conservative welfare regime of West Germany, the unpaid care by mothers is still an

31

Care and social integration in European societies

important basis for the production of welfare, and, as before, requires a great deal of financial dependence in the marriage (Geissler, 2002). In the ‘mixed’ welfare regime of the Dutch welfare state, in contrast, there have been some far-sighted attempts to encourage symmetry in the share of employment and informal family childcare by parents. However, a departure from marriage as the fundamental unit of existential security has been promoted here to a much lesser extent than in Norway, where social rights stem from the individual, and individual social security is a central aim of welfare-state policy (Leira, 2002). The development of welfare-state policies towards care is interrelated with the development of the cultural basis of the care arrangement. Traditionally, welfare states whose policies rested on the housewife model of the male breadwinner family incorporated men as individual citizens and employees who could pay into their social insurance system. Married women, by contrast, were included only as family members; that is, as wives and mothers. The welfare states of societies in which development can be characterised as ‘modernisation of the male breadwinner family model’ were confronted with specific new demands by cultural and structural changes in the family and gender division of labour of the last two decades of the 20th century. A number of socio-political measures enacted by these welfare states in the last 15 years can be seen as attempts to adjust to the new challenges, although some are thoroughly contradictory to that end. In all cases, the housewife model, with its edifice of dependencies, as the focal point for policy, was gradually replaced through greater promotion of equality in gender relations and the enhancement of individual autonomy for women.

Development path 2: societies with a more moderate contribution of the family to the welfare mix in relation to childcare In societies where the care arrangement in recent years has changed along the second path of development – that is, in France, Denmark, Sweden and Finland – the ‘dual breadwinner/external childcare model’ is currently dominant and was already predominant by the beginning of the period studied4.The model posits that, as a principle, all women as well as men can be employed full time, and that childcare is essentially the responsibility of service organisations outside of the family. In these countries, the state is seen as primarily responsible for organising access to these services (France: Hantrais, 1996; Veil, 1997; DauneRichard, 1998; Martin et al, 1998; Jensen and Sineau, 1998. Denmark:

32

Development paths of care arrangements

Borchorst, 1994; Jensen, 1996; Siim, 2000. Sweden: Hirdman, 1994; Anttonen, 1997; Veil, 1997; Daune-Richard, 1998; Szebehely, 1999. Finland: Anttonen, 1997; Gordon and Kauppinen, 1997; Julkunen, 1999; Julkunen and Nätti, 1999).This group of countries traditionally already had above-average full-time employment levels for women (OECD, 2000), and the number of women who work part-time for family reasons is generally low – Denmark 6%, France 7% at the end of the 1990s (European Commission, 1998, p 12).Although the number of part-time working mothers in Sweden was clearly greater, the parttime jobs here usually involve fairly long working hours and tend to resemble full-time positions with somewhat fewer hours (DauneRichard, 1998; Chapter Eleven of this volume). In countries following the second path, the family economic model of the agrarian society was succeeded by a dual breadwinner model, with public childcare in the transformation to modern industrial or postindustrial society. As far as the housewife model of the family played a role in the historical development towards modern society, its role was either relatively weak (as in Denmark; see Jensen, 1996), mainly only important for a relatively short interim period as in Sweden (Hirdman, 1994), or played virtually no role at all (as in Finland; see Pfau-Effinger, 1999, 2004b). For a long time, characteristic in these countries was more a cultural orientation towards the complete and full-time integration of women in the labour force and the main responsibility of the state for childcare. Today, the dual-breadwinner/ state-carer model of the family is the framework for the social practice of women and men and the structure of the gender division of labour in these countries. The change in the cultural foundations of the care arrangement in these countries was clearly less apparent than in those that followed the first path of development. Differences exist among these countries with respect to the extent of the egalitarian character of the new family model. In France, the dominant model assigns the responsibility for informal care work unilaterally to the woman (Chapters Seven and Eleven of this volume). Part-time work, in the sense of a definite reduction in the working week, has barely any significance in this model. In France in the 1990s, women’s part-time work was indeed on the rise, but this occurred mainly upon the initiative of employers, and part-time work was often not freely chosen by women themselves (see Daune-Richard, 1998). The Finnish, Swedish and Danish family models, by contrast, result from an egalitarian cultural image of the family, according to which couples should divide family responsibilities equally – even though, in part, structures relating to the gender division of labour in families

33

Care and social integration in European societies

are still far from this ideal (Anttonen, 1997; Gordon and Kauppinen, 1997; Daune-Richard, 1998; Land and Lewis, 1998; Siim, 2000; Chapter Eight of this volume). In a representative attitude survey by the Statistical Office of Finland in 1998, for example, 91% of Finnish women and 88% of men agreed with the statement that ‘married women have the full right to work whatever their family situation’. The male breadwinner role of men, still rather common for instance in West Germany, in contrast, is not very popular: the great majority of women (74%) do not support this role model, whereas the proportion of men who object to it is not nearly as high (60%) (Melkas, 2002, p 11). In the development of welfare-state policy in the countries whose care arrangements have changed according to the second path, there was an increasing tendency – even though welfare states were generally in crisis – for demands for women’s equality to be recognised and supported by the promotion of the expansion of public childcare provision.

The role of welfare regimes and underlying values for the explanation of differences Welfare values, as mentioned above, include values (a) in relation to the institution(s) that should be responsible if care is provided outside the family; (b) based on whether social rights in relation to care should be family-based or individual; and (c) relating to the re-distributive role of the welfare state together with the quality of social rights. The findings of the comparative study show that each of the two paths can coincide with different welfare regimes. Within each path, the field in which childcare is provided outside the family, and the quality and nature of social rights, differ in part with the differing welfare regimes. The empirical evidence of my cross-national comparison does not completely support the argument put forward by Esping-Andersen (1990, 1999), but it does concur with it to a considerable degree. Different to family values, which do not systematically vary with the welfare regimes, cross-national differences in relation to the dominant welfare values that are relevant in the context of welfare regimes vary to a greater or lesser extent with the welfare regime types.

Development path 1: countries with a relatively high contribution of the family to the welfare mix in relation to childcare In the countries whose development began with a strong position of the housewife model of the family, the turn away from the cultural

34

Development paths of care arrangements

values (‘Leitbilder’) inherent in this model necessitated a considerable restructuring of the care arrangement. Generally, the public provision of childcare was extended. In other respects, though, the welfare states reacted differently according to the welfare regime.The liberal welfare regime of Great Britain is still among EU members with a particularly low level of state support for childcare, even though the Labour government has put substantial efforts into extending childcare provision (Lewis, 2002; Daune-Richard, Chapter Eleven in this volume). Job-leave possibilities for parents who take over childcare are limited to the relatively short period of maternal leave, only partly paid, and not accessible to all women (Daune-Richard, 1998). Therefore, essentially only the financial dependence of the male breadwinner can enable mothers to practise the ‘male breadwinner/ female part-time carer model’ (Dingeldey, 2000; Geissler, 2002; Lewis, 2002). In the ‘conservative’ West German welfare state, by comparison, halting attempts at a transformation of care policies are visible: an individual right for children between three and six years was introduced, and the public provision of childcare at least for children between three and six was also substantially expended (Esch and Stöber-Blossey, 2002). A parental leave scheme was introduced, which has increased the possibilities for parents to keep their work contract during leave, and since 2001 this can be combined with part-time work. In addition, childcare allowances have been brought in, and there has been an integration of informal carers into the social security system (Veil, 2002; Meyer and Pfau-Effinger, 2004). However, the low amounts of childcare allowances and the fact that they are means-tested assured that the principle of financial dependence of mother-carers on their ‘male breadwinners’ was not fundamentally changed (Geissler, 1997; Ostner, 1998; Dingeldey, 2000). A greater level of progress in restructuring family policy in the direction of individualised, egalitarian dual breadwinner models with partner-shared childcare is demonstrated by the welfare states of the Netherlands and Norway (Plantenga, 1996;Waerness, 1998; Ellingsaeter, 1999; Leira, 2002). It seems adequate to classify the Dutch welfare state as a ‘mixed’ welfare regime with social-democratic, liberal and conservative features (for example, Bussemaker and Kersbergen, 1994; van Oorschot, 2001), whereas Norway represents a social democratic welfare regime (for example, Leira, 2002). In these countries, the number of public childcare facilities remained particularly low until the mid-1980s (Leira, 1992; Bussemaker, 1998; Voet, 1998). However, both states began extensive development of

35

Care and social integration in European societies

social care services in the second half of the 1980s in spite of financial crises (caused by the labour market above all), and at the end of 20th century were among the European countries with the most developed childcare infrastructure (European Commission, 1998).This policy can be assessed as the response to cultural change and to the great general increase in employment, and it contributed to a further increase in women’s employment. Furthermore, the possibilities for parents’ part-time work were promoted extensively; in both countries this was related to change in the patterns of working hours of both parents and was an explicit part of a policy of equality (Plantenga, 1996; Ellingsaeter, 1999). As the social security systems of these countries include a universal minimum retirement pension, the interruption of employment and part-time employment there has much less serious consequences for the individual’s social security than in Germany, where the typical female life course always carries the risk of old-age poverty (Veil, 1997). Particularly also in Norway, rather generous social rights in relation to informal care and part-time care were introduced: during parental leave, which can be combined with part-time work, nearly full replacement income is paid.Thus, the principle of financial autonomy of the parent who provides informal care is realised in the Norwegian welfare state. Besides this, a special leave for fathers – non-transferable to mothers – was also introduced. Of course, the fact that labour market structures in the areas of the private economy, which is dominated by men, continue to be geared to normal employment relationships, has caused the realisation of the gender equality model to remain – in social practice – in its infancy (Ellingsaeter, 1999; Leira, 2002).

Development path 2: societies with a more moderate contribution of the family to the welfare mix in relation to childcare Even though the welfare states of the countries within the second development path are also characterised as representing different welfare regimes, the differences with respect to the welfare values and welfare state policies are relatively marginal. In France, which Esping-Andersen (1990, 1999) classifies as a conservative welfare regime, the family is seen as the main unit to which social rights primarily refer (Veil, 1997, 2002; Daune-Richard, 1998; Siim, 2000), while in the three social-democratic regimes of Sweden, Finland and Denmark, social rights are established as individual rights (Siim, 2000). At the same time, however, since 1977, French family policy has provided parents with generous, universal childcare

36

Development paths of care arrangements

payments that are not means-tested, and thus exhibits social-democratic features.The payments, paid at the birth of a second and every following child, make it possible for mothers to stay at home or work part-time until a child reaches the age of three, as a basic income is assured. However, only a few women, even those who have two children, take advantage of this opportunity, although only about one-half of children under three are in public childcare. Indeed, continuation of employment has become a self-evident cultural pattern, even after the birth of a second child and longer (Maruani, 2000; Chapters Seven and Eleven of this volume). France also had a tradition of extensive state childcare, which since the 1970s has been in further expansion. The evolution of state care policies during the 1980s, especially after the election of Mitterrand, was marked by a shift towards promoting gender equality (Martin et al, 1998). Since then, however, the emphasis of French state family policy is still on promoting natality and motherhood rather than on the real achievement of equality in the family. It seems, though, that the idea of the egalitarian division of labour in the family was not supported by a majority of the population until recently (see Chapter Eleven of this volume). Welfare states with a social-democratic orientation introduced an extensive system of public childcare facilities, mainly in the 1960s. This can be seen as a reaction to the cultural transformation and the demands of women for integration into the employment system in transition to industrial society, in as far as they were articulated in a political setting (Siim, 2000). In Sweden, by the 1970s, an exemplary parental leave scheme model had also been established, which offered parents generous and flexible leave options and a replacement income for the greater part of their leave period (Geissler and Pfau-Effinger, 1989; Pfau-Effinger and Geissler, 1992; Nordic Council of Ministers, 1996; Daune-Richard and Mahon, 1998; Koistinen, 1999). Even in the crisis period of the welfare state, social rights with regard to childcare and access to public childcare facilities were, in part, still being extended (Szebehely, 1998; Siim, 2000).

Conclusions Differences in the underlying family values contribute substantially to the explanation of the existence of two different types of care arrangements in Western Europe.The care arrangements have, by and large, changed along two different cultural paths, and these differ fundamentally according to the cultural situation found in the different countries following the Second World War. Important cultural

37

Care and social integration in European societies

differences continue to exist today surrounding the value of informal family childcare by the mother or both parents and the question of whether mothers should work part- or full-time. Within each development path, there are also variations concerning the institution outside the family in which care is provided, the generosity of welfarestate policies and whether they are family or individual-based, depending on the welfare regime and the underlying welfare values. Notes 1 Also, the ideas about childcare and elderly care may differ in important respects. See the contributions to Lewis (1998). 2

For a comparison of the differing development paths of the care arrangements in East and West Germany, see Pfau-Effinger and Geissler (2002).

3

Even if this model in these countries today has the greatest significance, this does not preclude that other family models still exist and influence behaviour.

4

For a socio-historical explanatory model, see Pfau-Effinger (2004b).

References

Anttonen, A. (1997) ‘The welfare state and social citizenship’, in K. Kauppinen and T. Gordon (eds) Unresolved dilemmas: Women, work and the family in the United States, Europe and the former Soviet Union, Aldershot: Ashgate, pp 59-72. Anttonen, A. and Sipilä, J. (1996) ‘European social care services: is it possible to identify models?’, Journal of European Social Policy, vol 6, no 2, pp 87-100. Bang, H., Jensen, P. and Pfau-Effinger, B. (2000) ‘Gender and European welfare states: context, structure and agency’, in S. Duncan and B. Pfau-Effinger (eds) Gender, economy and culture in the European Union, London/New York: Routledge, pp 115-42. Beck, U. (1986) Risikogesellschaft. Auf dem Weg in eine andere Moderne, Frankfurt: Suhrkamp. Beck, U. (2000) ‘Die Seele der Demokratie: bezahlte Bürgerarbeit’, in U. Beck (ed) Die Zukunft von Arbeit und Demokratie, Frankfurt: Suhrkamp.

38

Development paths of care arrangements

Bleses, P. and Rose, E. (2002) ‘Der Umbau hat längst begonnen: Deutungswandel in der Arbeitsmarkt- und Familienpolitik’, Zeitschrift für Sozialreform, vol 44, no 8, pp 570-92. Borchorst, A. (1994) ‘Welfare state regimes, womens’s interests and the EC’, in D. Sainsbury (ed) Gendering welfare states, London: Sage, pp 2644. Bussemaker, J. (1998) ‘Gender and the separation of spheres in twentieth century Dutch society: pillarisation, welfare state formation and individualisation’, in J. Bussemaker and R.Voet (ed) Gender, participation and citizenship in the Netherlands, Aldershot: Ashgate. Bussemaker, J. and van Kersbergen, K. (1994) ‘Gender and welfare states: some theoretical reflections’, in D. Sainsbury (ed) Gendering welfare states, London: Sage, pp 8-25. Cox, R. (2004) ‘The path-dependency of an idea: why Scandinavian welfare states remain distinct’, Social Policy and Administration, vol 38, no 2, pp 204-19. Crompton, R. (1998) ‘The equality agenda, employment, and welfare’, in B. Geissler, F. Maier and B. Pfau-Effinger (eds) FrauenArbeitsMarkt. Der Beitrag der Frauenforschung zur sozioökonomischen Theorieentwicklung, Berlin: Sigma, pp 154-76. Daatland, S.O. (1992) ‘Ideals lost? Current trends in Scandinavian welfare policies on ageing’, Journal of European Social Policy, vol 2, no 1, pp 33-47. Daatland, S.O. (2001) Ageing, intergenerational relations, care systems and quality of life:An introduction to the OASIS project, Oslo: Norsk institutt for forskning om oppvekst, velferd og aldring. Daatland, S.O. and Herlofson, K. (2003) ‘ “Lost Solidarity” or “Changed Solidarity”: a comparative European view of normative family solidarity’, Ageing and Society, vol 23, no 5, pp 537-60. Dallinger, U. (2001) ‘Organisierte Solidarität und Wohlfahrtskultur. Das Beispiel des “Generationenvertrages” ’, Sociologica Internationalis, vol 39, pp 67-89. Daly, M. and Lewis, J. (1998) ‘Introduction: conceptualising social care in the context of welfare state restructuring’, in J. Lewis (ed) Gender, social care and welfare state restructuring in Europe, Aldershot: Ashgate, pp 1-24. Dasko, F. (2000) ‘Zum Zusammenhang von Frauenerwerbstätigkeit und Kinderbetreuung in England’, in M. Steinrücke (ed) “Von den NachbarInnen lernen”. Vereinbarkeit von Familie und Beruf in Europa, Bremen: Angestelltenkammer Bremen, pp 38-61.

39

Care and social integration in European societies

Daune-Richard, A.M. (1998) ‘How does the “societal effect” shape the use of part-time work in France, the UK and Sweden?’, in C. Fagan and J. O’Reilly (eds) Part-time prospects, London: Routledge, pp 214-31. Daune-Richard, A.M. and Mahon, E. (1998) ‘Suède: le modèle egalitaire en danger’, in J. Jenson and M. Sineau (eds) Qui doit garder le jeune enfant?, Paris: L.G.D.J. Daycare Trust (1999) Childcare changes lives, London: Daycare Trust. Dingeldey, I. (2000) ‘Einkommensteuersysteme und familiale Erwerbsmuster im europäischenVergleich’, in I. Dingeldey (ed) Erwerbstätigkeit und Familie in Steuer- und Sozialversicherungssystemen. Begünstigungen und Belastungen verschiedener familialer Erwerbsmuster im Ländervergleich, Opladen: Leske, pp 26-42. Duncan, S.S. (1998) ‘Theorising gender systems in Europe’, in B. Geissler, F. Maier and B. Pfau-Effinger (eds) FrauenArbeitsMarkt. Der Beitrag der Frauenforschung zur sozio-ökonomischen Theorieentwicklung, Berlin: Sigma, pp 195-228. Eisenstadt, S.N. (2000) Die Vielfalt der Moderne, Weilerswist: Velbrück Wissenschaft. Effinger, H. (1994) ‘Soziale Dienste zwischen Gemeinschaft, Markt und Staat’, in H. Effinger and D. Luthe (eds) Sozialmärkte und Manager, Bremen: Universität Bremen, pp 13-40. Ellingsaeter, A. (1999) ‘Dual breadwinners between state and market’, in R. Crompton (ed) Restructuring gender relations and employment. The decline of the male breadwinner, Oxford: Oxford University Press, pp 143-64. Engelbrech, G. and M. Jungkunst (2001) Erwerbsbeteiligung von Frauen: Wie bringt man Beruf und Kinder unter einen Hut?, Nuremberg: Institut für Arbeitsmarkt- und Berufsforschung, IAB-Kurzbericht, no 7. Esch, K. and Stöber-Blossey, S. (2002) Kinderbetreuung: Ganztags für alle? – Differenzierte Arbeitszeiten erfordern flexible Angebote. IAT-Report 2002-09, Gelsenkirchen: Institut für Arbeit und Technik. Esping-Andersen, G. (1990) The three worlds of welfare capitalism, Cambridge: Polity Press. Esping-Andersen, G. (1996) ‘After the golden age? Welfare state dilemmas in a global economy’, in G. Esping-Andersen (ed) Welfare states in transition, London/Thousand Oaks/New Delhi: Sage, pp 131. Esping-Andersen, G. (1999) Social foundations of postindustrial economies, Oxford: Oxford University Press.

40

Development paths of care arrangements

European Commission (1998) Care in Europe: Joint report of the ‘Gender and Employment’ and the ‘Gender and Law’ groups of experts, Brussels: European Commission. Evers,A. and Olk,T. (eds) (1996) Wohlfahrtspluralismus.Vom Wohlfahrtsstaat zur Wohlfahrtsgesellschaft, Opladen: Leske. Fagan, C., Rubery, J. and Smith, M. (1999) Women’s employment in Europe: Trends and prospects, London/New York: Routledge. Fox Harding, L. (1996) Family, state and social policy, London: Macmillan. Geissler, B. (1997) ‘Netz oder Sieb? Generationenkonflikt und Geschlechterkonflikt in der aktuellen Krise des Sozialstaats’, Kritische Justiz, no 1, vol 30, pp 1-14. Geissler, B. (2002) ‘Die (Un-)Abhängigkeit in der Ehe und das Bürgerrecht auf Care. Überlegungen zur Gendergerechtigkeit im Wohlfahrtsstaat’, in K. Gottschall and B. Pfau-Effinger (eds) Zukunft der Arbeit und Geschlecht, Opladen, Leske, pp 183-206. Geissler, B. and Oechsle, M. (1996) Lebensplanung junger Frauen. Die widersprüchliche Modernisierung weiblicher Lebensläufe, Weinheim: Deutscher Studien-Verlag. Geissler, B. and Pfau-Effinger, B. (1989) ‘Neuere Lebensentwürfe von Frauen und das Recht auf geschützte Teilzeitarbeit’, in S. HabenichtErenler (ed) Frauenzeit am Arbeitsmarkt. Perspektiven einer Arbeitszeitpolitik für Frauen, Loccum: Akademie Verlag, pp 89-119. Goodin, R. (1996) The theory of institutional design, Cambridge: Cambridge University Press. Gordon, T. and Kauppinen, K. (1997) ‘Introduction: “Dual Roles and beyond”’, in T. Gordon and K. Kauppinen (eds) Unresolved dilemmas: Women, work and the family in the United States, Europe and the former Soviet Union, Aldershot: Ashgate, pp 169-85. Gottschall, K. (2001) ‘Zwischen tertiärer Krise und tertiärer Zivilisation’, Berliner Journal für Soziologie, vol 11, no 2, pp 217-35. Hanssen, J. (1997) ‘The Scandinavian model as seen from a local perspective’, in J. Sipilä (ed) Social care services:The key to the Scandinavian welfare model, Aldershot: Ashgate, pp 195-214. Hirdman, Y. (1994) Women: From possibility to problem?, Research Report 3, Stockholm: Arbetslivcentrum. Jensen, J. and Sineau, M. (1998) Qui doit garder le jeune enfant? Modes d’accuiel et travail des mères dans l’Europe en crise, Paris: Librairie Générale de Droit et de Jurisprudence. Jensen, P.H. (1996) Komparative Velfaerdssystemer. Kvinders reproduktionsstrategier mellem familien, velfaerdsstaten og arbejdsmarkedet, Copenhagen: Nyt fra Samfundsvidenskaberne.

41

Care and social integration in European societies

Julkunen, R. (1999) ‘Sukupuoli, työ, hyvinvointivaltion, Teoksessa’, in P. Lipponen and P. Setäla (eds) Suomalainen nainen, Otava: Keuruu, pp 79-100. Julkunen, R. and Nätti, J. (1999) The modernisation of working times: Flexibility and work sharing in Finland, Jyväskylä: SoPhi, University of Jyväskylä. Knijn, T. (1994) ‘Social dilemmas in images of motherhood in the Netherlands’, European Journal of Women’s Studies, vol 1, pp 183-206. Knijn,T. (1998) ‘Social care in the Netherlands’, in J. Lewis (ed) Gender, social care and welfare state restructuring in Europe, Aldershot: Ashgate, pp 85-110. Knijn,T. and Kremer, M. (1997) ‘Gender and the caring dimension of welfare states: toward inclusive citisenship’, Social Politics, vol 5, pp 32861. Koistinen, P. (1999) ‘The lessons from the labour market policies of Finland and Sweden’, in J. Christiansen,A. Kovalainen and P. Koistinen (eds) Working Europe – reshaping European employment systems,Aldershot: Ashgate, pp 213-32. Land, H. and Lewis, J. (1998) ‘Gender, care and the changing role of the state in the UK’, in J. Lewis (ed) Gender, social care and welfare state restructuring in Europe, Aldershot: Ashgate, pp 51-84. Langan, M. and Ostner, I. (1991) ‘Geschlechterpolitik im Wohlfahrtsstaat’, Kritische Justiz, vol 24, no 3, pp 302-17. Leira,A. (1992) Models of motherhood:Welfare state policy and Scandinavian experiences of everyday practices, Cambridge: Cambridge University Press. Leira, A. (2002) Working parents and the welfare state: Family change and policy reform in Scandinavia, Cambridge: Cambridge University Press. Lepsius, R.M. (1990) ‘Interessen und Ideen. Die Zurechnungsproblematik bei Max Weber’, in R.M. Lepsius (ed) Interessen, Ideen und Institutionen, Opladen: Westdeutscher Verlag, pp 31-43. Lepsius, R.M. (1995) ‘Institutionenanalyse und Institutionenpolitik’, in B. Nedelmann (ed) Politische Institutionen im Wandel. Sonderheft 35 der KZfSS, Opladen: Westdeutscher Verlag, pp 392-403. Lewis, J. (1992) ‘Gender and the development of welfare regimes’, Journal of European Social Policy, vol 2, pp 159-73. Lewis, J. (ed) (1998) Gender, social care and welfare state restructuring in Europe, Aldershot: Ashgate. Lewis, J. (2002) ‘Gender and welfare state change’, European Societies, vol 4, no 4, pp 331-58.

42

Development paths of care arrangements

Lewis, J. and Ostner, I. (1994) Gender and the evolution of European social policy, (Working Paper 4), Bremen: Centre for Social Policy Research, University of Bremen. Martin, C., Math, A. and Renaudat, E. (1998) ‘Caring for very young children and dependent elderly people in France: towards a commodification of social care?’, in J. Lewis (ed) Gender, social care and welfare state restructuring in Europe, Aldershot: Ashgate, pp 139-74. Maruani, M. (2000) Travail et emploi des femmes, Paris: La Decouverte. Melkas,T. (2002) The gender barometer 2001, Helsinki:The Council for Equality and Statistics Finland. Meyer, B. and Pfau-Effinger, B. (2004) Gender in the discourse on old age – old age in the discourse on gender, Paper presented at the ISA Research Committee RC11 ‘Sociology of Ageing’ on ‘Ageing Societies and Ageing Sociology: Diversity and Change in a Globalised World’, University of Surrey, Roehampton, 7-9 September. Morée, M. (1992) Mijn Kinderen Hebben Er Niets Van Gemerkt. Buitenshuis werkende moeders tussen 1950 en nu, Utrecht: Ivan Arkel. Mósesdóttir, L. (2000) The interplay between gender, markets and the state in Sweden, Germany and the United States, Aldershot: Ashgate. Mutz, G. (1999) ‘Strukturen einer Neuen Arbeitsgesellschaft. Der Zwang zur Gestaltung der Zeit’, Aus Politik und Zeitgeschichte, vol 9, pp 3-11. Neidhard, F., Lepsius, R.M. and Weiss, J. (eds) (1986) Kultur und Gesellschaft. Sonderheft 27 der Kölner Zeitschrift für Soziologie und Sozialpsychologie, Opladen: Westdeutscher Verlag. Nordic Council of Ministers (1996) Women and men in the Nordic countries: Facts and figures 1994, Copenhagen: Nordic Council. Nullmeier, F. and Rüb, F. (1993) Die Transformation der Sozialpolitik. Vom Sozialstaat zum Sicherungsstaat, Frankfurt/New York: Campus. OECD (Organisation for Economic Cooperation and Development) (2000) Employment outlook, Paris: OECD. Orloff, A.S. (1993) ‘Gender and social rights of citizenship’, American Journal of Sociology, vol 58, no 3, pp 303-28. Ostner, I. (1998) ‘The politics of care policies in Germany’, in J. Lewis (ed) Gender, social care and welfare state restructuring in Europe, Aldershot: Ashgate, pp 111-38. Pabst, S. (1999) ‘Mehr Arbeitsplätze für Geringqualifizierte nach Einführung der Pflegeversicherung? Beschäftigungswirkungen des SGB XI im ambulanten Bereich’, WSI-Mitteilungen, no 2, pp 23440.

43

Care and social integration in European societies

Pfau-Effinger, B. (1998) ‘Gender cultures and the gender arrangement – a theoretical framework for cross-national comparisons on gender’, in S. Duncan (ed) The spatiality of gender: Special issue of innovation. European Journal of Social Sciences, vol 11, no 2. Pfau-Effinger, B. (1999) ‘Change of family policies in the socio-cultural context of European societies’, Comparative Social Research, vol 18, pp 135-69. Pfau-Effinger, B. (2001) ‘Wandel wohlfahrtsstaatlicher Geschlechterpolitiken im soziokulturellen Kontext’, Kölner Zeitschrift für Soziologie und Sozialpsychologie, vol 41, pp 488-511. Pfau-Effinger, B. (2004a) Development of culture, welfare states and women’s employment in Europe, Aldershot: Ashgate. Pfau-Effinger, B. (2004b) ‘Historical paths of the male breadwinner family model – explanation for cross-national differences’, British Journal for Sociology, vol 55, no 3, pp 177-99. Pfau-Effinger, B. (2005a) ‘Culture and welfare state policies: reflections on a complex interrelation’, Journal of Social Policy, vol 34, no 1, pp 118. Pfau-Effinger, B. (2005b) ‘Welfare state policies, cultural differences and care arrangements’, European Societies, pp 321-41. Pfau-Effinger, B. and Geissler, B. (1992) ‘Institutionelle und soziokulturelle Kontextbedingungen der Entscheidung verheirateter Frauen für Teilzeitarbeit. Ein Beitrag zu einer Soziologie des Erwerbsverhalten’, Mitteilungen aus der Arbeitsmarkt- und Berufsforschung, vol 25, pp 358-70. Pfau-Effinger, B. and Geissler, B. (2002) ‘Cultural change and family policies in East and West Germany’, in A. Carling, S.S. Duncan and R. Edwards (eds) Analysing families: Morality and rationality in policy and practice, London/New York: Routledge, pp 77-83. Pierson, P. (1994) Dismantling the welfare state, Cambridge: Cambridge University Press. Pierson, P. (1996) ‘The new politics of the welfare state’, World Politics, vol 48, pp 143-79. Pierson, P. (2001) ‘Post-industrial pressures on the mature welfare states’, in P. Pierson (ed) The new politics of the welfare state, Oxford: Oxford University Press, pp 80-105. Plantenga, J. (1996) ‘For women only? The rise of part-time work in the Netherlands’, Social Politics, no 3, pp 57-71. Pott-Buter, H. (1993) Facts and fairy tales about female labor. Family and fertility.A seven-country comparison 1850-1950, Amsterdam:Amsterdam University Press.

44

Development paths of care arrangements

Rostgaard, T. (2002) ‘Caring for children and older people in Europe – a comparison of European policies and practices’, Policy Studies, vol 23, no 1, pp 51-68. Schmidt,V. (2001) ‘Values and discourse in the politics of adjustment’, in F.W. Scharpf and V.A. Schmidt (eds) Welfare and work in the welfare economy, Oxford: Oxford University Press, pp 229-310. SCP (Social een Cultureel Planbureau, Central Bureau voor de Statistiek) (2002) Emancipatiemonitor 2002, Hague. Siim, B. (2000) Gender and citizenship: Politics and agency in France, Britain and Denmark, Cambridge: Cambridge University Press. Sing, D. (2002) ‘Die Bedeutung des (sozialen) Ehrenamtes für die Arbeitsmarktintegration von Frauen - Chance oder Risiko?’, in K. Gottschall and B. Pfau-Effinger (eds) Zukunft der Arbeit und Geschlecht, Opladen: Leske, pp 207-30. Sommerkorn, I. (1988) ‘Die erwerbstätige Mutter in der Bundesrepublik, Einstellungs- und Problemveränderungen’, in R. NaveHerz (ed) Wandel und Kontinuität der Familie in der Bundesrepublik Deutschland, Stuttgart: Enke, pp 115-44. Szebehely, M. (1998) ‘Changing divisions of carework: caring for children and frail elderly people in Sweden’, in J. Lewis (ed) Gender, social care and welfare state restructuring in Europe, Aldershot: Ashgate, pp 257-83. Ungerson, C. (2000) ‘Thinking about the production and consumption of long-term care in Britain: does gender still matter?’, Journal of Social Policy, vol 29, no 4, pp 623-43. van Oorschot, W. (2001) Flexicurity for Dutch workers: Trends, policies and outcomes, Paper presented at the EU COST Action 13 Meeting, Ljubljana University, 8-10 June. Veil, M. (1997) ‘Zwischen Wunsch und Wirklichkeit: Frauen im Sozialstaat. Ein Ländervergleich zwischen Frankreich, Schweden und Deutschland’, Aus Politik und Zeitgeschichte, B 52/97, pp 29-38. Veil, M. (2002) Alterssicherung von Frauen in Deutschland und Frankreich. Reformperspektiven und Reformblockaden, Berlin: Sigma. Voet, R. (1998) ‘Citizenship and female participation’, in J. Bussemaker and R.Voet (eds) Gender, participation and citizenship in the Netherlands, Aldershot: Ashgate, pp 11-24. Waerness, K. (1998) ‘The changing “welfare mix” in childcare and care for the frail elderly in Norway’, in J. Lewis (ed) Gender, social care and welfare state restructuring in Europe, Aldershot: Ashgate, pp 207-28.

45

Chapter title running head

Part Two New forms of informal, semi-formal and formal care work

In this part, the focus is on the various new forms of informal care work and their relation to formal care work. In particular, the new semi-formal forms of care (see Chapter One) and the new forms of social integration and citizenship that are constituted by them are also analysed. Through this, it is shown that the relationships between caregiver and care receiver in the private household have also changed, whether they are based on family relations or not. In addition, it will be pointed out that from the European welfare states also new types of social rights with regard to ‘care’ were established. The various contributions analyse the development from an international comparative perspective and highlight common features and differences. It becomes clear that in the framework of differing types of care arrangements, the new forms of informal care work hold different meanings and are used in different ways.With the differences between welfare state regimes also comes a distinction in terms of the quality of social rights that are linked to these forms. It is worked out in what way these new forms of social integration are also related to new forms of migration. On the basis of migration and care work, new forms of social inequality have evolved.

47

Gender, labour markets and care work in five European funding regimes

THREE

Gender, labour markets and care work in five European funding regimes1 Clare Ungerson

Faced with ageing populations and the growing participation of women in the conventional labour market, welfare states in recent years have developed innovations that are designed to resolve the problem of the ‘care deficit’. In so doing, they have tried to find ways to bolster informal care through the payment of informal carers, and, sometimes, the introduction of a formalised contractual relationship between the care receiver and the caregiver such that the informal carer is obligated to care through a stronger system of obligation than that arising out of affect alone. The methods of bolstering the conditional incomes of informal carers are variable and have been classified by this author in previous work and named as the ‘commodification of care’ (Ungerson, 1997). This chapter explores the particular form of commodification previously identified as ‘routed wages’. This is the method whereby people in need of care are given cash rather than (or in addition to) formal care services, and then encouraged to employ their own caring labour directly with these cash payments. Many (but not all) of these systems are specifically designed to deal with issues of elderly care, and it is the shifting and increasing permeability of the boundary between formal and informal care in relation to elder care that this chapter examines.

Origins The fact that ‘routed wages’ have developed so commonly, and, for most of the European countries, within a rather similar time period (the late 1990s), indicates that similar trends may be driving them.We know quite a lot about the way these policies work (Evers et al, 1994; Weekers and Pijl, 1998), but the history of their various origins remains unwritten. Nevertheless, one can speculate as to the general impulses

49

Care and social integration in European societies

that underlie these developments. Interestingly, some of these impulses seem contradictory, at least at first sight. For example, one can argue that these policies emerge out of a critique of the welfare state that developed in the 1980s and 1990s: that the welfare state is an unwieldy and clumsy responder to ‘need’ and that ‘need’ is all too often defined by professionals intent on self-aggrandisement and hegemony. This critique, which argues for the ‘empowerment’ of care users, such that their needs are more directly heard and responded to, is clearly part of a more general trend towards consumerism and individualism identified by many commentators on late modernity (Beck, 1992; Giddens, 1992). At the same time, however, another impulse – the move to the expansion of the concept of ‘citizenship’ such that it moves away from a male breadwinner-dominated model (Pateman, 1988), and towards a model that takes into account the contribution of citizens, particularly female citizens, to ‘care’ (Fraser, 1994; Lister, 1997) – has also driven a much less consumerist discourse, but rather a discourse that emphasises and broadens out some of the older ideas of collectivism and social responsibility. It can be argued that this expansion of concepts of citizenship to take on board ‘care’ has also had its own impact on policies to give cash to care users. If care users are funded to employ their own care directly, this demonstrates a form of trust by the state that its citizens know best as to how to resolve their own needs. At the same time, if care users are given carte blanche to employ whoever they want – and, as we shall see, many welfare states do precisely this – then, should care users choose to pay their relatives who care for them, such payments to care constitute a recognition of the care that informal carers deliver and provides them, very directly, with a sense of the presence of the state in the care relationship.Thus, the notion of a partnership between welfare state and its caring citizens and its citizen care users is, at least notionally, developed. Two further impulses towards such policies can be identified. They can also be understood within another trend of the 1980s and 1990s; namely, the trend towards the marketisation, in the sense of introducing quasi-markets, of the welfare state, and its wholesale privatisation. Both these trends took place on the grounds of increasing efficiency of allocation of resources, and also to allow for the development of consumer choice.The development of purchaser/provider splits within the quasi-market model always begged the question as to why the ‘purchaser’ need necessarily be an arm of the welfare state. Indeed, both the discourses of consumerism and of citizenship referred to above, rather indicated that the purchaser could indeed be the individual citizen, trusted to choose the form of care that he or she authentically

50

Gender, labour markets and care work in five European funding regimes

needed. Moreover, once the presence of care delivery organisations was guaranteed through the process of welfare state privatisation then, in theory at any rate, a market supplying caring labour was available for participation by the individual citizen purchaser. So, it is arguable that once the quasi-market systems were in place, it was only a matter of time before the logic of market ideologies drove towards the direct purchase of services by their users2. At the same time, other responses to marketisation and individualisation paradoxically drive a more communitarian and conservative impulse, which in its own turn also feeds into the development of ‘routed wages’. In response to the process of individualisation and fragmentation that takes the form of the breakdown of the traditional family based on marriage and a gendered division of labour, some governments come to emphasise policies that attempt to pull the traditional family back into shape.The payment of cash to care users, where care users are able to use the monies to pay whoever they want, including their relatives, is seen to be a means of reinforcing intergenerational and intra-generational familial obligations. As part of a response to ageing populations, a further impulse behind many of these policies is cost containment.The distribution of monies to care users to spend on their own care, particularly where they are allowed to spend those monies on payments to relatives, means that care can be generated through systems of residual and non-pecuniary obligations and feelings of affect, as well as through the payment of a wage. Hence it is assumed that where care work is generated through this combination of cash, affect and obligation, particularly when it is located in the care user’s home, then the costs of care are expected to be lower than the cost of organised, formal care. One of the aspects of these policies that is often ignored is the impact they have on the organisation and status of care work and care workers. Three shifts are taking place. First, the construction of what constitutes ‘work’ and ‘care’ is changing. The payment of kin to care has the potential to commodify a set of tasks that until very recently have been regarded as classic ‘unpaid work’ (Himmelweit, 1995). The introduction of the cash nexus into previously uncommodified territory could create new forms of family and household relations whereby particular individuals move into employment relations with each other.That said, however, it is important to maintain a distinction between ‘family’ on the one hand, and ‘household’ on the other. It is possible to imagine the emergence of commodified kin relations where the kin are not co-resident with care users. However, co-residence may mean that the additional monies paid to the care user enters the household and are treated simply as one other resource to be allocated

51

Care and social integration in European societies

and managed along well-established guidelines, such that the caregiver remains, to all intents and purposes, a giver of care rather than a care worker.Thus, while the boundaries of paid and unpaid work may well be shifting as a result of these policies, it is also the case that there remain older cultures of the handling of household resources which place a brake on wholesale commodification of care within the household. Second, the introduction of cash for care policies, particularly where there is no regulation of their ultimate destination, can encourage the further development of care work that is carried out by untrained, unskilled, unprotected and even undocumented labour. While care work has traditionally been regarded as the particular territory of working-class women socialised and willing to nurture, embedded in these policies there are incentives to encourage this even further. By leaving the recruitment, management and payment of these workers to individual care consumers, the likelihood is that such consumers will seek out labour that is cheap, and yet authentically ‘caring’. The cheapest labour will be ‘grey’: invisible and hence untaxed, and yet visible enough to be relatively easily accessed by elderly care users with good local networks built up over long biographies. Thus, such caring labour will be unprotected by social rights and employment regulation, and, in the long run, is at considerable risk of poverty, especially in their own old age (Ungerson, 2000). Third, a development may take place (and indeed there are signs of it doing so) whereby, particularly in the systems where cash for care is on a very large scale or in regulated systems, a much more formal labour market for care work develops. In these systems, private and non-governmental organisation (NGO) agencies develop which provide care workers for those who wish to employ them. The care users may pay a fee to the agency, or they may pay their care workers directly. In such cases, the care work is visible, and located within the formal economy. Inherent in such organised care delivery is a hierarchy of line managers, and a need to be seen to conform to any statutory framework of regulation. In terms of recruitment of care workers, such organisations have to be able to convince, and, if necessary, produce the evidence, that their carers are trustworthy and reliable. Increasingly, as a result of domiciliary care policies, care users have complex and health-related needs; thus, these agencies will be expected to provide additional evidence that their care workers are trained to execute healthrelated tasks. Hence, embedded in this type of care work development is a logic of growing credentialism, and the acquisition of occupational hierarchies and status.

52

Gender, labour markets and care work in five European funding regimes

Thus, the labour market impacts of these policies are complicated, potentially contradictory, and dependent, at least to some extent, on the funding regime adopted by the particular welfare state.We currently know very little about how these impacts are working out in practice, and it is for this reason that I have undertaken, with my colleague Sue Yeandle (Sheffield Hallam University) and four research teams working in four other EU nations3, a qualitative study of the employer–employee relationship that emerges out of a selection of these various systems. The five countries under scrutiny are Austria, France, Italy, the Netherlands, and the UK. Each of these countries appeared, at the start of the study, to offer rather different types of regime, with a speculated differential impact on the labour market for care. The data collected in this project was largely qualitative and exploratory. We were concerned to investigate the employer–employee relationship in depth, and to develop an understanding of how and whether the presence of the cash nexus alters the care relationship, such that it emerges as a hybrid of work and care (Ungerson, 1999). In each country, interviews were conducted with 10 elderly care users in receipt of ‘routed wages’. They were then asked to name and grant access to their caregivers, and these caregivers were also interviewed in depth. In each country, about 30 interviews were conducted

The ‘cross’ of ‘routed wages’ and funding regimes In this diagram (Figure 3.1) of commodified care schemes, the vertical axis describes the policy context, and the way in which schemes are or are not regulated in their implementation. The horizontal axis describes the type of care relationship involved in commodified care. In those schemes which allow relatives to be paid, the relationship, and the work of care, may most resemble that of informal care – a relationship based on kinship and affect rather than contract, and providing holistic care. In those schemes which most strongly promote the activity of care as paid work, the activities of care may most resemble conventionally paid work – subject to contract, and with the right (and legitimacy) of the employer to hire and fire, and the right (and legitimacy) of the employee to exit employment. The model can be further used to identify different types of arrangements for commodified domiciliary care and different types of caregiver/worker. Figure 3.2 identifies different types of carer, along the two axes of regulation/non-regulation, and care/work. In the lefthand lower quadrant are the ‘classic’ informal carers – wholly unregulated, and recruited through affective relations. In contrast, in

53

Care and social integration in European societies Figure 3.1: The ‘cross’ of ‘routed wages’ REGULATION Of care delivery • Standards • Qualifications • Credentials • Authorisation

Of care work • Taxed • Employmentderived social rights • Wage regulation • Hours of work • NI benefits

KINSHIP

LABOUR MARKET

CARE

PAID WORK MODE OF RECRUITMENT

AFFECTIVE RELATIONS

BASIS OF CARE RELATIONSHIP

NON-REGULATION

54

CONTRACTUAL RELATIONS

Gender, labour markets and care work in five European funding regimes

the upper right-hand quadrant are the care workers and professionals recruited through the labour market, and subject to contractual relations. Some carers straddle quadrants; for example, a group named as ‘remunerated’ carers, who are paid a wage to care for their relatives, are subject to a mix of affective and contractual relations. They could also be further up the ‘regulation’ axis and move into the upper quadrants depending on how far their income is subject to taxation, their hours contracted, and their social rights guaranteed. Similarly, ‘agency’ workers could consist of workers who are heavily regulated through, for example, the 2000 British Care Standards Act, which imposes minimum training and quality assurance procedures on domiciliary care agencies; but they could also be workers who are self-employed and possibly beyond the frameworks of employment law. Hence, this group could be both relatively heavily regulated, and be situated in the lower right-hand quadrant to indicate relative lack of regulation. As should be clear, Figure 3.2 is somewhat schematic. The policy and labour market contexts will impact on the precise position of particular groups of carers, and since both policy shifts and labour markets change, there are moments when groups of carers will move around this ‘map’. Figure 3.3 uses the same axes to identify different ways of organising ‘commodified’ care; that is, specifically the type named as ‘routed wages’ (Ungerson, 1997). In this model, different types of routed wage systems are located along the axes. The degree of regulation can vary, from a fairly minimalist insistence on the presentation of invoices for expenditure on the employment of care workers before payment of the cash subsidy, rising to an insistence of demonstration that care workers are fully covered for social rights (such as social security and employment rights).An even stronger type of regulation would consist of insistence on all these employment conditions for the workers, plus a condition that the workers employed have a care work qualification. The term ‘regulation’ can also mean rather more than the relatively uncomplicated monitoring to ensure that cash is expended on care, and that the workers are covered for employment rights and/or credentialised. A regulatory body can itself be the body that recruits workers and pays them. Non-regulation is rather less graduated: it means precisely that, in the sense that receipt of the cash payment is contingent on demonstration of need on the part of the care user, rather than demonstration of any aspect of the ensuing commodified care relationship. Its impact on the type of person who comes forward to care may vary from members of the care user’s household to informally employed workers operating in a ‘grey’ labour market, and

55

Care and social integration in European societies Figure 3.2: Carers REGULATION Of care delivery • Standards • Qualifications • Credentials • Authorisation

Of care work • Taxed • Employmentderived social rights • Wage regulation • Hours of work • NI benefits

CAREWORKERS/ PROFESSIONALS

• Employment rights • Wages at agreed rates • Contracts • Qualifications • Quality audit

Unpaid carers organised by voluntary organisations ORGANISED CARERS

May do other types of agency work, or be self-employed LABOUR MARKET

KINSHIP AGENCY WORKERS

PAID WORK

CARE MODE OF RECRUITMENT AFFECTIVE RELATIONS

BASIS OF CARE RELATIONSHIP

Carers who receive incomereplacement benefits from the state

REMUNERATED CARERS

RECOGNISED CARERS Caregivers who are paid a wage to care for a relative or a friend Caregivers who are completely unpaid

INFORMAL CARERS

56

NON-REGULATION

CONTRACTUAL RELATIONS

Gender, labour markets and care work in five European funding regimes Figure 3.3: Schemes for organising ‘routed wages’: types of payment and time availability REGULATION

B. Regulation plus credentialism:

Usually delivered as short bursts of care. 24/7 very unlikely

A. Fully commodified informal care:

All relatives, friends, neighbours, can be paid. Payment may be by an outside agency. Care can often be 24/7.

France

The Netherlands United Kingdom C. Direct payments:

CARE

Relatives cannot be paid – a mix of ‘local networks’, agencies. May be 24/7 or ‘short bursts’ of care.

PAID WORK

CONTRACTUAL RELATIONS

AFFECTIVE RELATIONS

Austria, Italy Austria, Italy D. Additional income flows into the household:

Co-resident carer does not receive additional monies. Non-resident carer may receive small ‘tips’. Normally 24/7 care, possibly with purchased surrogate care over short periods.

E. Use of undocumented ‘grey’ labour:

NON-REGULATION

Often depends on local networks for recruitment, even for foreign labour. Can be 24/7 or short bursts of care.

57

Care and social integration in European societies

in these types of system one also might expect both types of ‘employment’ to occur concurrently. The following analysis demonstrates that these different types of arrangement do already exist (see Figures 3.2 and 3.3). For example, the Dutch system, which is highly regulated by quasi-government agencies (in this case, the Social Insurance Bank) falls into the upper left quadrant – it is both highly regulated, and its overall impact, by allowing for kin, friends and neighbours to be paid, is to commodify ‘classic’ informal care. The French system, insofar as our qualitative data collected in Rennes and its hinterland indicates, is a regulated system, dependent on paper trails for monitoring and audit of expenditure, forbids the employment of spouses but not of other relatives, and encourages, through scale and culture, the employment of care workers recruited and managed through agencies. Many of them are qualified with a basic care work diploma. It therefore falls within the upper right-hand quadrant. The UK system, known as ‘direct payments’, is also a regulated system, forbids the employment of close relatives or co-residents (unless they are employed specifically as personal assistants), and insists on a paper trail of expenditure and the payment of national insurance contributions for the care workers. However, recruitment of care workers is difficult and, from the evidence of our data, consists of a mix of using very local networks (which may well mean the actual employment of people long known to the care users) and more conventional care agencies and job centres. This mixture means that it is located nearer the centre of the regulation half of the diagram. The Austrian and Italian systems fall into the lower half of the regulation/non-regulation axis.These systems simply provide monies for the care users, and do not regulate at all. One result can be that the monies simply enter the household economy of the care user, effectively raising the household income, but not the individual caregiver’s income, who may be a spouse or other coresident. Another possibility is that the money is used to pay for care work that is located within an informal ‘grey’ labour market. It is only within such an unregulated form of disbursement that such an opportunity arises, and it is not surprising that, particularly in countries where such labour is easily available, these monies are used to recruit it. Commonly, in these systems both (D) and (E) occur concurrently.

A. Fully commodified ‘informal’ care In this study, there were two examples of fully commodified ‘informal’ care: the Dutch system which is organised by the Social Insurance

58

Gender, labour markets and care work in five European funding regimes

Bank and framed by welfare state legislation, and an arrangement organised by a major Catholic charity, Caritas, in Austria, which pays informal carers to care. The Dutch system pays cash according to the amount of care work time that is judged to be necessary, in conjunction with an assessment as to how much ‘domestic’,‘personal’ and ‘nursing’ care is required within the total amount of care hours allotted to the care user. Thus, the amounts of cash provided to the respondents in our survey varied considerably. In the Dutch sample in this study, a paraplegic man was assessed as needing 19 hours of nursing care per week, and three hours’ domestic help. For this care his wife received, through the Social Insurance Bank, which administers the ‘personal budget scheme’, the considerable sum of £21,828 per annum. Rather more common were smaller sums, in the region of £300 per month, with which to pay for a combination of personal and domestic care. In Austria, on payment of a fee from the care user, Caritas acts as the employer of their caregiver, who may well be a relative. In such a case, the caregiver receives pay over and above the amount of cash subsidy the care user receives, and is also fully covered for social security rights, holiday pay, and has a contract of employment which limits the hours worked.The satisfaction with these schemes, on both sides of the care relationship, was general. For example, an elderly Dutch couple, both of whom have had strokes, are now cared for by their daughter five mornings a week, for which she receives £4,591 per year, plus her social rights. As the elderly mother said: Things are excellent the way they are now. And I am happy if she receives some money. … He doesn’t want a nurse, which is why our daughter does it. … Bad weather or fine weather, in the winter in frost and snow, she is always here. These comments are typical of the Dutch ‘employers’ of their informal carers, and the caregivers/workers also report satisfaction with the scheme. Interestingly, many of them, while aware of their social rights and the fact that the scheme covered them, were also reluctant to exercise them, particularly where to do so meant that they would have to spend time away from caring: In principle I could take a summer holiday …. I can have three weeks holiday like anyone else, but I do not do that. The Austrian Caritas scheme also evoked positive comments from both sides of the care relationship. All the paid kin working within the Caritas scheme were satisfied with it and the care ‘workers’ were too:

59

Care and social integration in European societies

It’s marvellous. To be at home, do the housework and get paid for it. One carer, who had previously cared for her father-in-law outside the Caritas scheme, described how she felt when she discovered she could be paid for caring: You can only say that I simply felt as if I had been promoted. Society also saw it totally differently then. Suddenly, it was, “Aha! You’re doing a job!” Although I didn’t do anything differently from before, it was suddenly seen as self-evident. Thus, there were individuals within these fully commodified informal care schemes who had begun to regard themselves, and be regarded, as ‘workers’ rather than ‘carers’. In general, the level of satisfaction on both sides of the care relationship indicates that elderly care users had been made comfortable, through payment of their informal carers, and were receiving care from the people (their familiar kin) whom they much preferred. Caregivers/workers also felt valued and recognised, and their incomes had, on the whole, increased (some were receiving more money from this work than they had been receiving previously in the conventional labour market). Their social rights were intact, although their ability to exercise those that took them away from the immediate caring tasks at hand were attenuated. This positive picture has, though, to be somewhat moderated by two factors. First, it is unlikely that this occupation of commodified informal carer will be recognised as valid ‘experience’ if and when these caregivers re-enter the more conventional labour market. In that sense, while remunerated and recognised in the present, their human capital may be in the process of being downgraded, and their future employability somewhat jeopardised. Second, this is the type of ‘job’ where it is particularly difficult to exit – should these caregivers or care users decide that they would prefer an alternative form of care (residential care for example, or a different caregiver) then these relationships, as a result of payment, are now even more difficult to leave, since to do so would incur direct economic costs as well as emotional costs.

B. Regulation plus credentialism One of the advantages of fully commodified ‘informal’ care is that, like informal care, the caregiver/worker commonly gives ‘24/7’ care, where needed. In another form of regulated care, which is combined

60

Gender, labour markets and care work in five European funding regimes

with credentialism and quality control, the opportunity to offer ‘24/7’ care is practically non-existent due to the very high cost of paying fully qualified care workers to deliver domiciliary care on a full-time basis.The result is that regulation plus credentialism is likely to lead to a proliferation of care delivered over very short bursts of time at crucial periods of the day or night – getting up and dressing in the morning, bed time at night, and meal times during the day. In the five-country study on which this chapter draws, the nearest system is that prevailing in France. In France, the means-tested Prestation Spécifique Dépendance (PSD) was, at the time of the study, in the region of £350 a month, which is certainly not enough to employ someone full time, or even for many hours. As a result, many care workers are employed through agencies and engaged in multiple care relationships. In our study, we found French care workers working for up to 13 clients whom they visited at least once a day. Second, most of these workers had a basic care qualification known as the CAFAD (‘Certificat d’aptitude fonction d’aide à domicile’, or, in English, the ‘Certificate of Suitability for Domiciliary Care Tasks’), which had provided them with training. The fact that these care workers were employed by numerous ‘employers’ meant that they were engaged in a constant battle with time. Many of them complained about the problem of dealing with so many employers at once, and how difficult they found it to combine holistic care with the exigencies of having to deliver care work at speed. These workers were engaged in a wide variety of tasks, including cooking and shopping and were constantly moving from client to client, delivering services to them in short bursts.Their bureaucratically determined time frequently ran contrary to the body times and the preferences of their elderly ‘employers’. At the same time, this is a group of workers who have a care work qualification, and who are highly reflexive on the contradictions of, and boundaries between, the tasks they undertake: The profession is not recognised.You are really a cleaner, a housekeeper. Of course we do all that! But when you allow yourself to wash somebody, do the shopping, fill in papers … you deviate a little from the profession of a cleaner. Nobody understands. This sense of not being properly understood was something of a continuous refrain in these interviews. Another care worker said: It is true that the work of the carer is not understood very clearly. Frankly, we are not recognised.

61

Care and social integration in European societies

It was also clear that, as a group, they are engaged in a boundary dispute with the neighbouring (and better paid) occupational category of ‘care assistant’: We are not permitted to do dressings, or anything like that. We do not have a care assistant diploma. If we give any assistance, it is at the request of the doctor and we can refuse to do it. Thus these care workers are in an interesting relation to the issues of empowerment and independence. In terms of independence, they are operating within the conventional labour market and their social and employment rights are fully intact. But within the job itself they encounter frustrations: working within a strict division of labour, they are not allowed to act autonomously and provide the service they judge best. Moreover, the need to move from client to client according to bureaucratic rather than their elderly clients’ body times means that they experience a dissonance between their desire to provide holistic care untrammelled by the need to ration time, and the imperative to provide task oriented care. This dissonance appears to be made worse as a result of training that has stressed holism rather than fragmentation in the delivery of care. Hence, it is not surprising that, in important respects, they feel themselves disempowered in their job. One major advantage of their position remains: they are located within an occupational hierarchy which means that, for those with the ambition and the skill, career progression is available to them. The care users in this system were generally satisfied. However, interestingly, the language they used to describe their relations were full of somewhat distanced language to describe their caregivers.Words like ‘kind’ and ‘competent’ rather than ‘loving’ and ‘sensitive’ recurred in the interviews. I myself, and my wife as well, have a certain consideration, esteem. I cannot say affection.You get used to these people and in particular she is very kind, very competent. She enjoys her work. Where they felt the quality of care was not adequate they felt able to complain, or exit the relationship altogether: You can always say that you are not happy.You pay a lot of money and want to receive a good service. Thus the care users within this type of system are supported in their desire to maintain their independence and feel empowered to voice

62

Gender, labour markets and care work in five European funding regimes

complaints and exit relationships if they wish. Using an employment and service-related discourse, they are empowered to act as consumers of task oriented care.These are distanced relationships based on contract. The roles are clear, and the emotional content concomitantly reduced.

C. Direct payments We have suggested in Figure 3.3 that the direct payments type of ‘routed wage’ system falls nearer the centre of the ‘care/work’ spectrum and lower down the regulation/non-regulation axis. The reason for this is that, from our research, particularly on the UK direct payments scheme, we found that some care users searched for labour by using close local networks, such that the people they finally recruited were sometimes people whom they had known for long periods (although, given the British rules about not employing close relatives or members of the household, they could not be kin). Moreover, we also found among this group a number of care users who only had one carer who worked for many hours for them, and a number of care workers who only worked for one employer. Hence, these are rather different types of care relationship from those that occur within a regulated credentialised system described earlier, where, we have suggested, credentialism means that costs of this qualified labour are so high that it is beyond the pocket of most households to afford ‘24/7’ care. In the direct payments type of situation, care users and care worker alike operate within a labour market characterised by low wages, lack of skill and qualifications, and where organisation of care work through, for example, agencies may be rudimentary or non-existent. The situation that emerges is a very complicated one. Among our sample, we found care users who had recruited their care workers through word of mouth, and others who had used adverts in newspapers and at the Jobcentre. Some of the care users had only one care worker who provided care over long periods during the day, while others employed, through huge supplementation from their own resources, what seemed like battalions of care workers who, working in shifts, effectively provided ‘24/7’ care.Within this regulated care system, care users and care workers are left to their own devices as to how they recruit and organise their own care. This is indeed part of the policy, couched as it is in the discourse of consumerism and empowerment. The result is a wide variety of care ‘solutions’ and relationships that may, or indeed may not, increase the independence and empowerment of both care users and care workers. Direct payments in the UK have evolved from a policy designed

63

Care and social integration in European societies

initially for disabled people of working age, and have only recently been introduced (since 2000) for elderly care users. The use of the ‘direct payments option’ by older care users has yet to become widespread, and although all our sample of care users were of pensionable age most of them had come to direct payments through disability rather than age. Many of them had therefore absorbed the empowerment discourse which the disability lobbies had used to support the development of direct payments in the first place. Thus care users were well aware of the reason why they had taken the option of direct payments: I mean, we have to have these carers and it’s better than having social services that come in at a certain time and treat you like you’re robots …. Whereas your own carers, to a certain extent, you have got control of what time you want to get up, what time you go to bed, things like that. Another respondent had taken advantage of the direct payments scheme to employ two carers who were from the Caribbean, as she herself was. The picture from the care workers’ perspective was somewhat more mixed. Some of them were very positive. They reported that they preferred to work in the domiciliary setting on a one to one basis because it allowed them to work to the standards they preferred: When I had the chance to go and work with one lady – I can then make sure that lady gets all the attention that she needs.Whereas when I was in the nursing home I couldn’t do anything about it. Some days it was just like a conveyor belt. Moreover, the discourse of the relationship was often couched within ‘family’ terms. A typical comment was:“Here, it is sometimes like I am part of the family”.Thus, these care workers had managed to construct for themselves an occupation that they found more congenial.Whether this constitutes an enhancement of their independence or empowers them is more difficult to judge, since the downside of being treated as ‘one of the family’ is that expectations grow, on the side of the care users, that the care users’ needs will always have priority. This was particularly clear in the frequent mention of disputes about time that occur in these interviews. The difficulty was that, given that so many of these care workers lived close to the people they helped, they were frequently called to assist them beyond their contracted hours. For these workers, it was often a matter of luck whether they got a ‘good’ employer or not. The fact that they were frequently working alone

64

Gender, labour markets and care work in five European funding regimes

with no colleagues, and operating in a segment of the labour market which credentialism has barely touched, meant that they were vulnerable to exploitation based on emotional blackmail. Their independence was hardly enhanced, and their power (as demonstrated by one particular employer in this sample who appeared to sack numbers of his employees on a whim) was minimal.

D. Additional income flows into the household As has already been suggested, in the systems which are entirely unregulated, the payment of these cash supplements, which in theory are intended for use on the purchase of caring labour, can, in actuality, be spent on anything – or not spent at all and saved, or even given away. In our five-country study, the systems in Austria and Italy were entirely unregulated, and we encountered a number of households in these countries, particularly those where spouses were carers, where our questions as to how the money flowed towards the caregiver were regarded as entirely absurd. Once the allocation of funds is devolved, by default, to the household itself, it understandably is impossible, within the prevailing culture of the allocation of resources within marriage, to unpack these monies such that the carer directly benefits, especially where that carer is a co-resident and a close relative such as a spouse. Not only were there strong cultural reasons embedded in these decisions not to use the monies to ‘pay’ carers. In most cases these households reported that, as a result of receipt of these cash benefits, they were now able to make financial ends meet. A typical Italian respondent said: I put it together with my pension, and with this money I try to arrive in some way at the end of the month …. I use it also to pay the rent, the electricity, the gas, the telephone, medicines, household shopping – everything in fact …. I could not live without the money. Thus there were also strong material reasons as to why these subsidies were being used as supplements to the household income. Nevertheless, there were a number of examples, particularly among the Italian sample, of using these monies also to oil the wheels of social relationships such that they changed and became a mix of social and caring relationships. For example, in the case of the respondent quoted earlier, she also used the money to pay a neighbour, whom she had known for 40 years, to do some regular cleaning.The use of the word ‘favour’

65

Care and social integration in European societies

or ‘tips’ was common among the Italian elderly to describe the symbolic payments they gave to people with whom they shared long biographies – such as friends, neighbours and adult children – in return for relatively discrete caring tasks provided over short time periods. Hence, the payment of these monies within an entirely unregulated context had, through supplementing household incomes of disabled elderly people, allowed them to continue to live independently with reduced financial anxiety. At the same time, it had enabled them to shift existing social relationships into small-scale caring relationships and reciprocate in a small way for these limited services. In both these senses, their independence had been maintained and even enhanced. Similarly, they had gained control over some aspects of their lives, had reduced their sense of indebtedness to kindly neighbours and loving kin, and hence had been moderately empowered. However, the position of the informal carers who cared for many of these individuals had hardly altered at all – their position remained that of the ‘classic’ unpaid informal carer.The only substantial difference was that, as a few of our caregiver respondents noted, it was now possible to use the additional income to purchase very small amounts of surrogate care, again largely recruited through the social networks used by the elderly care users themselves. Those who gave the small-scale services and were recompensed through small-scale payments were satisfied, but their lives had hardly altered, since the time they spent caring was limited.

E. Use of undocumented ‘grey’ labour Within the non-regulated forms of routed wages it is also possible to pay labour that is itself unregulated, and operating within the ‘grey’ labour market. This kind of labour is relatively cheap since there are no ‘on costs’ arising out of taxation and social security contributions. This, in turn, makes it attractive to those who need intensive and continuous care, but are unable to pay the kinds of wages demanded by care workers operating within the visible and documented labour market. Not surprisingly, in the five-country study, the two countries where ‘routed wages’ are unregulated, namely Austria and Italy, revealed extensive (and, in Austria, organised) use of undocumented care workers, almost all of whom were foreign migrants. Among the Italian sample, the needs-tested cash subvention that elderly care users received was commonly in the region of €700 to €1,000 per month (about £500). It became clear, in the course of the interviews, that a full-time, non-resident carer employed within the ‘grey’ market could command an income of about €750. Live-in paid

66

Gender, labour markets and care work in five European funding regimes

carers in Milan appeared to be paid somewhat less. Hence the amount that is available to elderly care users through this cash payment is enough, should they so wish it, to employ ‘24/7’ help. Thus, it is not surprising that among those who had decided to use a paid carer from outside the immediate kin network, only ‘grey’ labour was employed.Three of these workers were immediate neighbours who provided small amounts of care – one hour in the afternoon for example while a carer husband did the daily shopping – and were paid in cash and small presents for their care tasks.All of the five paid carers who lived in the same dwelling as the care user and provided 24-hour care, in some instances for seven days a week, were non-EU nationals. It is clear from the interview material that only one of these non-EU nationals had residence rights in Italy. In Milan there is clearly a culture of ‘taking a foreigner’, as one respondent put it, to provide care. The general understanding of and acceptance of this culture is so widespread that this respondent had been advised by the consultant neurologist in charge of her 90-yearold mother that she should “absolutely not take a non-European, because it does not go down well with people like this”. It was also clear that local networks worked very well in the recruitment of these workers: workers were passed from neighbour to neighbour, from sister to sister, and some were found by the concierges of apartment blocks. For the elderly recipients of this cheap ‘24/7’ care, there were no difficulties reported. All were satisfied with the quality of the care provided (despite the strictures of the consultant neurologist). Their independence had been maintained, and they were absolutely in control of their care workers, especially if they were co-resident. For the workers, however, it was, for almost all of them, a different story. Many of them were unwilling care workers. A typical comment came from a Peruvian woman working in Milan: Even if I don’t like it, what can I do? It is a stressful job, not easy work. Here the only work that one can do is to care for old people. One of the main difficulties these care workers experienced was the organisation of their own personal time. An Italian respondent who had worked for her employer for 26 years reported that her relationship with her employer, of whom she was clearly deeply fond, had recently broken down as a result of her trying to establish a right to her own personal time. In this particular case, the care worker was Spanish but had acquired Italian citizenship and was not co-resident. The arrangement was that she would be paid for two hours a day, but would be continuously available:

67

Care and social integration in European societies

Certainly it was a job with no fixed time table – let’s say that for a fixed payment I was obliged to stay with her for two hours a day, but that this could be more or less according to the situation …. In practice she called for me only when she needed me; and called me also from one moment to another, sometimes in the morning, sometimes in the afternoon, and I had to keep myself free to go to her immediately …. Sometimes I went every day, six hours or more a day; or I might go for a week or even a month without seeing her, because she went away, to her holiday home, and did not need me. In certain respects, the Austrian sample was similarly engaged with the use of undocumented, foreign labour. However, there were some crucial differences. First, it became clear that the routes into the recruitment of foreign labour were entirely different, in the sense that the Viennese labour market for care was being specifically orchestrated by agencies that were recruiting caring labour in the bordering transition economies of Hungary and Slovakia. Hence, this was unlike the Milanese labour market for undocumented labour in two senses. First, it was not a global market drawing in permanent migrants from the South, but rather was a labour market located across a permeable border, allowing for transition from one economy to another over temporary and brief periods. Second, the Austrian recruitment of foreign labour was specifically directed towards finding care workers for elderly care users; in Italy, in contrast, it appears to be the case that care work is one of a very limited range of alternatives available to illegal immigrants, and in some respects may be the most palatable of those alternatives, especially to women with housing needs.The range of cash supplement payable to Austrian care users depended on the level of their disability. A typical level of payment was either £400 or £543 per month. The typical wage paid to a foreign worker was between £281 and £300 for a period of a fortnight in every month. For this cash payment (and it always was cash) workers from Hungary and Slovakia provided 24-hour care while they lived in the same accommodation as their elderly employer.At the end of ‘their’ fortnight, they returned to their home country, while another worker, usually from the same country, replaced them for their fortnight ‘off ’. Thus the amount of cash that the elderly employers were receiving from the state was almost enough to cover the entire cost of paying for fulltime ‘24/7’ care, so long as that care was provided by illegal,

68

Gender, labour markets and care work in five European funding regimes

undocumented care workers. Typically the care workers so employed were very young – all those who lived with their employers for their fortnight ‘on’ were in their late teens to mid 20s. In contrast to the Italian migrant care workers quoted earlier, the Austrian care workers thus engaged were highly satisfied with their work. It constituted a means of working part-time and leading a transitional life between two economies and two homes, in a way that generated a reasonable income. As one of them put it: Well, it’s good pay for me and he gains as well – it isn’t too much for him either. He would have to pay more for an Austrian woman. It’s quite a good deal. Thus, the picture that emerges from our somewhat superficial dip into the world of undocumented caring labour is that the position of the care users is, in general, enhanced. So long as they are able to access this labour market, they can afford to employ care workers who provide them with good enough and continuous care. But for the care workers themselves, the position is not so positive. Wages, particularly given the time they have to devote to their occupation, are very low; their social and employment rights are non-existent; their housing, especially if they are co-resident, is likely to be poor; their future, despite aspirations to improve their lot, is unpromising, since their race and perceived ‘foreignness’ is likely to trap them in the work they currently occupy. However, this is the case where migrants have made the complete transition from fourth or third world to the first.Where care workers, as in the Austrian case, can take advantage of permeable frontiers and their location in the transition economies of the second world, then care work can provide a way of acquiring human capital (a first-world language) and of acquiring the additional income to fund a reasonable way of life in their countries of origin.

Conclusions These different funding regimes for ‘routed wages’ demonstrate that, as a result of regulation and whether or not relatives can be paid, they can have very various impacts on the lives of the women (and men) caregivers/workers involved. Similarly, the quality of the care received by care users, many of whom are elderly women, its timing and the amount of care time care users can purchase, is profoundly affected by the funding regime in which these care users find themselves. The Dutch system and the system promoted by the Austrian charity, Caritas, come closest to payment of what amounts to ‘wages for caring’; it is

69

Care and social integration in European societies

interesting to note, in the light of the inconclusive ‘wages for housework’ debate in the feminist 1970s, that both care users and caregivers/workers report high levels of satisfaction with these systems. However, it is also clear that the geographic, social and economic contexts in which these systems occur also help to determine their ultimate impact on the labour market for care. Similarly, once considered in the light of the criteria of independence and empowerment of all those involved in the care relationship it is clear that there are costs and benefits to all these systems, whether regulated or not. Indeed, perhaps the most important conclusion to draw is that the assumptions of increased independence and empowerment have to be tempered by the form in which the system is delivered. These are not policies or systems that have a straightforward utility, and it is important to understand, and eventually to measure, their differential impacts on both care users and caregivers/workers, before leaping to the conclusion that ‘routed wages’ are the obvious solution to the management of social care. Notes 1 This is a modified and shortened version of Ungerson (2003).The research on which this chapter is based was funded by the Economic and Social Research Council within the Future of Work Programme, grant number L212252080. I am very grateful to my colleagues, Sue Yeandle, Cristiano Gori and Marja Pijl, who commented on an earlier version of this chapter, and to the research teams (see note 3) who, through their commitment to this project, generated the rich data, some of which is analysed here. 2

This is probably a particularly British version of the logic and sequence of development. In some countries, the quasi-market stage is not an essential prerequisite for ‘routed wages’ since they are driven by more powerful other impulses.

3

Research teams: Austria: August Oesterle and Elisabeth Hammer (Vienna University of Economics and Business Administration). France: Claude Martin and Blanche Le Bihan (ENSP, Rennes). Italy: Cristiano Gori, Barbara da Roit and Michela Barbot (Istituto per la recerca sociale, Milan). Netherlands: Marja Pijl and Clarie Ramakers and Fransje Baarveld (University of Nijmegen). UK: Sue Yeandle and Bernadette Stiell (Sheffield Hallam University).

70

Gender, labour markets and care work in five European funding regimes References

Beck, U. (1992) Risk society: Towards a new modernity, London: Sage Publications. Evers, A., Pijl, M. and Ungerson, C. (1994) (eds) Payments for care: A comparative overview, Aldershot: Avebury. Fraser, N. (1994) ‘After the family wage: gender equity and the welfare state’, Political Theory, vol 22, no 4, pp 591-618. Giddens, A. (1992) The transformation of intimacy: Sexuality, love and eroticism in modern societies, Cambridge: Polity Press. Gori, C. (1999) Contrasted situations at the local level: The Italian case, Paper presented at the international seminar, ‘Policies Towards the Frail Elderly in Europe’, ENSP: Rennes. Himmelweit, S. (1995) ‘The discovery of “unpaid work”: the social consequences of the expansion of work’, Feminist Economics, vol 1, no 2, pp 1-19. Lister, R. (1997) Citizenship: Feminist perspectives, Basingstoke: Macmillan. Morris, J. (1993) Independent lives: Community care and disabled people, Basingstoke: Macmillan. Pateman, C. (1988) The sexual contract, Cambridge: Polity Press. Ungerson, C. (1997) ‘Social politics and the commodification of care’, Social Politics, vol 4, no 3, pp 362-81. Ungerson, C. (1999) ‘Personal assistants and disabled people: an examination of a hybrid form of work and care’, Work, Employment & Society, vol 13, no 4, pp 583-600. Ungerson, C. (2000) ‘Thinking about the production and consumption of long-term care in Britain: does gender still matter?’, Journal of Social Policy, vol 29, no 4, pp 623-43. Ungerson, C. (2003) ‘Commodified care work in European labour markets’, European Societies, vol 5, no 4, pp 377-96. Weekers, S. and Pijl, M. (1998) Home care and care allowances in the European Union, Utrecht: Netherlands Institute of Care and Welfare (NIZW).

71

Changing long-term care regimes

FOUR

Changing long-term care regimes: a six-country comparison of directions and effects1 Ute Behning

In the 1970s, long-term care regimes in industrialised countries differed according to the welfare state regime employed in the nation states. However, all of the institutionalised care regimes rested on the assumption that women care for elderly people in their families without any payment. Due to the rise in female labour-force participation, this assumption has not held true since the 1980s. Thus, an explosion of costs for the growing group of elderly people in need of care forced major shifts in long-term care policies in most of the countries during the last three decades. New forms of formal, semi-formal, and informal care arrangements have been institutionalised and culturally adopted. The study reported here examines changes in care policies in selected industrialised countries. It will specifically focus on whether or not a divergence or a convergence of institutional changes in the provision of long-term care regimes in industrialised countries can be observed during the period 1973-97. The report of the study is organised as follows. First, the theoretical approach and the selection of countries are presented.Then the policy changes in the provision of care are examined. Finally, the findings are evaluated.

Welfare mix approach and welfare state typologies To identify institutional changes in the provision of care, Evers (1990) developed an analytical tool kit to examine changes in the so-called ‘welfare mix’ (see also Gershuny, 1983; Rose, 1985). He defined the provision of welfare as a triangle consisting of the market economy, the state, and households: the welfare mix. While the economy and the state provide formalised care in the public sphere, households are classified as informal care providers and are located in the private

73

Care and social integration in European societies

sphere. Evers’s contribution to comparative analyses of the provision of welfare and care was to pull the dimension of households into the economic discourse.Thereby, he opened up the possibility of examining institutional changes, or, as he put it, policy transformations in the provision of care (see also Evers, 1994). Evers and several other researchers have conducted large-scale scientific projects which identified changes in specific national welfare mixes (see, for example, Glendinning and McLaughlin, 1993; Evers et al, 1994b). However, until today, the interplay of societal changes and transitions in welfare policies has not been examined on an empirical base. The aim of this study is to provide a broad understanding of transitions in policies on care and their relationships to changes in gendered participation rates on labour markets in different types of welfare regimes.The selection of countries for assessment follows the classification of welfare regimes developed by Esping-Andersen (1990). He recognised three types of welfare states: • the liberal regime (for example, the US, Canada and the UK); • the conservative regime (for example, Austria, France, Germany and Italy); • the social democratic regime type (to which the North European countries belong). These different regime types are well described in the following summary of Anette Borchorst (1994, p 27): The liberal regime is dominated by means-tested benefits; modest universal cash transfers predominate, and some social insurance schemes exist. The sovereignty of the market is strongly emphasised.… The conservative regime is characterised by status differentiation, and social rights are connected to status and class. Compulsory labour market insurance is common, and church and family play a crucial role.… The social democratic regime provides many universal benefits as social rights based on citisenship and [is] financed by taxes. Benefits are relatively high, and the welfare state itself is extensive. Esping-Andersen’s analysis of welfare states is based on three dimensions, namely state–market relations, stratification and decommodification; together these produce the typology of welfare state regimes. This approach is useful for understanding the development of social rights attached to wage labour and, therefore, social security

74

Changing long-term care regimes

schemes; but it is less useful in the analysis of claims and rights based on needs, for example social assistance; and it is ambiguous about claims and rights on the basis of gender (Orloff, 1993; Bussemaker and van Kersbergen, 1994).The roots of these problems become clear if we take a closer look at the typology. A nation’s welfare state regime is not so much identified by a specific configuration of market, state and family as by the dominance of either the market or the state. As a result of the focus on these two institutions rather than on the specific configuration of all three institutions, the status of the family remains unclear. Therefore, it seems useful to combine the regime concept with the welfare mix approach. As noted earlier in this chapter, the selection of countries for this study follows the regime type approach of Esping-Andersen, because the clustering of types of welfare states seemed useful and the only reported typology of social care services uses a similar classification of countries (Anttonen and Sipilä, 1996). Two countries were selected from each regime type. The countries were chosen on the basis of available research on the topic.The liberal regime type is represented by the UK and Canada; the conservative regime type by Austria and Germany; and the social democratic regime type by Denmark and Sweden. This chapter examines whether the selected countries have shifted their welfare mixes in the provision of care. Therefore, it is necessary to answer the following questions: • Did policy changes occur in the provision of care on a national level? • In which direction – formal or informal care: market, state or family – are the policy changes pointing?

Policy changes in the provision of long-term care The liberal welfare state regimes Before describing the country profiles, it seems useful to provide the reader with an idea of the typical organisation of long-term care in the liberal welfare state regime type in the early 1970s. Generally, the state left the organisation of care up to private households (families) and, to a far lesser extent, to public institutions. These public care institutions included hospitals and nursing or residential care homes. People in need of care were eligible for means-tested benefits as well as special arrangements within social insurance schemes. Nevertheless, the dominant pattern of care provision in the early 1970s involved

75

Care and social integration in European societies

family members taking care of persons in need of care. For the most part these caregivers were female. The gendered role model of this type of country can be viewed as the ‘male breadwinner–female homemaker-model’.To sum up, the typical welfare mix arrangements in the provision of care in liberal type countries put the major stress within the welfare triangle on private households and, to a lesser extent, on public institutions.

UK Prior to 1980, in the UK – as indicated earlier in this chapter – only a very small private sector of nursing and residential care homes existed. This can be explained by the fact that the majority of people needing care lacked the resources to pay the costs. This situation changed in 1980 when a change in policy took place. Both of the major policy regulating institutions of the UK, the National Health Service (NHS; national authority) and the Social Services Departments (SSDs; local authorities), changed their means-tested supplementary benefit system (SBS) for frail elderly people to help them meet the costs of both private nursing homes and private residential homes (OECD, 1996). As a result, during the period 1980-90, a major shift in the provision of institutional care occurred in the UK.As can be seen from Table 4.1, the proportion of long-term and geriatric hospital beds decreased, while the number of nursing home beds occupied by frail elderly people grew by over 400% and the number of beds in residential care homes increased by 48%.Virtually all of the new nursing and residential home beds were in private institutions and were funded in whole or in part through the SBS, supported by the NHS or the SSDs. Taking all the institutional care sectors together …, the contribution of the private sector (both non-profit and profit) grew over the decade from fewer than 1 in 6 beds to well over half of all beds. The United Kingdom had Table 4.1: Number of older people receiving care in long-term institutions in the UK (1980-90)

Long-stay hospitals Nursing homes Residential care homes Total

1980

1990

% change 1980-90

112,200 19,600 182,600 315,400

89,600 100,800 270,300 460,700

–20.1 +414.3 +48.0 +46.1

Source: Department of Health, cited from OECD (1996, p 183)

76

Changing long-term care regimes

very rapidly acquired a mixed economy of institutional long-term care, in which most beds were provided outside the traditional public sectors. (OECD, 1996, p 184) Nevertheless, it should be emphasised that even during the 1980s the great bulk of community care was provided by friends, family and neighbours. Evandrou et al (1990) estimated that the input from the six million informal caregivers of elderly people in 1986 (about 15% of the adult population) could have cost an equivalent £2.4 billion in services, or roughly five times the expenditure in that year on longterm institutional care. Thus costs as well as a growing awareness of the right of self-determination by frail elderly people (that is, the need to give people the choice of who would care for them) furthered the debate on the reorganisation of long-term care in the late 1980s. This debate has led to the two major reforms in policy on longterm care since 1949 (OECD, 1996):The NHS and Community Care Act of 1990 was implemented in two stages in 1992 and 1993 (Lead and Ungerson, 1994).The reforms were largely designed to introduce restricted means-tested policies in both health and social care.The Act introduced new financial structures and management in health care, and shifted the organisation and financial arrangements towards local authorities.The chief objective of these reforms was to install a ‘mixed economy of care’, essentially prolonging community care in the private sector (OECD, 1996). Through this process, long-term care, housing and social care were increasingly privatised and strictly means-tested (Bond and Buck, 1999). The new community care regime generated an expansion of private home-based care-attendant services as local authorities contracted out care to for-profit agencies and voluntary organisations working at the local level (Lead and Ungerson, 1994; Bond and Buck, 1999).Thus in the UK, new forms of payments for care were designed to pay carers at symbolic and semi-paid rates. Lead and Ungerson (1994) classify this form of caring work as more informal care, mostly provided by untrained providers. The most important of the payments for care is the Invalid Care Allowance (ICA). In order to get this ... the carer must be looking after someone for at least 35 hours a week, and must be of working age …. This is because the ICA is constructed as compensation for giving up paid work in order to care for someone with special needs. … While it is one of the lowest

77

Care and social integration in European societies

benefits in the British portfolio, it is also one of the fastest growing, and received an enormous boost when … the European Court of Social Justice ruled that it had to be payable to married women who had originally been excluded from it. (Lead and Ungerson, 1994, p 263) In summary, during the period, 1973-97, two important policy changes took place. These changes occurred during the early 1980s and the early 1990s. Both policy changes put the emphasis on informal care in the private sphere and in the private sector.The difference between the situation in the early 1970s and the late 1990s is that caring work for dependent people in private households is now reimbursed on a semi-formal basis, and institutional care is now provided mainly by private organisations, furthering home-based care. These changes in the provision of long-term care have been driven by the dual policies of cost containment in public expenditures and privatisation (Bond and Buck, 1999).

Canada Until the late 1990s, a fundamental value of the Canadian welfare state was universal access to health care based on need rather than ability to pay. During the period under examination (1973-97), this made it possible for dependent frail elderly people to obtain care. No major policy changes occurred during the period. However, what we see in Canada (CAN) is a major debate on the privatisation of health care, especially long-term care.The debate became increasingly visible in the late 1990s (NACA, 1997). As in the UK, the Canadian debate has its roots in the rapid growth of costs for institutional care. As in the UK, responsibility for the organisation and financing of long-term care was partly shifted from the national level to the provinces in the early 1980s (Stryckman and Nahmiash, 1994; OECD, 1996). The consequence of this was a reorganisation of institutional care in the provinces. As in the UK, a move from the public provision of institutional care towards private non-profit and for-profit provision of institutional care took place. At the beginning of the 1990s, 40% of the institutions for long-term care were in the public sector, 20% in the private non-profit sector and 40% in the private for-profit sector (Stryckman and Nahmiash, 1994). However, it should be emphasised that the main care providing institution in Canada was and is the family: 85% of all caring work is done by family members and friends (Stryckman and Nahmiash, 1994). To support these kinship

78

Changing long-term care regimes

arrangements, some of the Canadian provinces, for example Quebec, Nova Scotia, and New Brunswick, have introduced partial payments for informal care to family members. Thus, in Canada national policy changes on long-term care did not occur during the period 1973-97.What did occur were reorganisations of care-providing institutions and, in some Canadian provinces, experiments in the area of payments for informal care. The emphasis was on informal care in the private sphere and in the private sector.The major differences between the situation in the early 1970s and the situation in the late 1990s are that caring work for dependent people in private households is now sometimes paid for, and institutional care is now mainly provided by private organisations. As in the UK, these changes in the provision of care in Canada have been driven by the impacts of cost containment in public expenditures and a tendency toward privatisation. As suggested in the reports of the National Advisory Council on Aging (NACA, 1997), this tendency will probably lead to national policy changes in the near future, strengthening the indicated shift in the welfare mix.

Conclusion In the early 1970s, the typical welfare mix arrangement in the provision of long-term care in both liberal type countries, the UK and Canada, put the major stress in the welfare triangle on private households and, to a lesser extent, on public institutions. In the late 1990s, the major emphasis in the provision of care was on private households, and the care providing person received cash benefits from the state (UK) or the provincial government (CAN).At the same time, private institutions had become the major institutions for long-term care.This shift in the welfare mix can be summarised as a move toward a ‘mixed economy of care’.That is, the state shifted responsibility for the provision of care more and more toward private institutions and the local level, and private households became semi-institutions in which informal care was paid for. Thus a move toward formalisation and marketisation in the provision of care can be recognised in the liberal type countries.

The conservative welfare state regimes In the early 1970s, the arrangements for the provision of long-term care in conservative welfare state regimes are similar to those in the liberal type countries and thus the conditions for policy reforms in

79

Care and social integration in European societies

the conservative type countries were similar to those described in the previous section of this chapter.

Austria In Austria (A) a major shift in the provision of care took place at the national level in 1993 with the passage of the Long-term Care Allowance Act. This Act went into effect in 1994; care is financed through taxes and uniformity is guaranteed throughout Austria. Cash benefits are granted to people in permanent need of personal care and they are not means-tested.The cash allowance is intended to enhance the independence of people in need. It may be spent in any way the beneficiary believes will best meet his or her health and/or personal needs. Usually the money is used to pay an informal caregiver, or to purchase formal personal care assistance or housekeeping and escort services. (Brodsky et al, 2000, p 57; for further details, see Pfeil, 1998; Behning, 1999) It must be emphasised, however, that the benefits provided through the Austrian Long-term Care Allowance Act were established on a low pay basis. In other words, people in need of care and eligible for the payments have to employ personnel recruited from the family or the neighbourhood, and most are untrained. This is especially problematic given the fact that the provision of institutional and homebased care in Austria is fairly underdeveloped (Evers et al, 1994a; Behning, 1999). Evaluations of the Austrian Long-term Care Allowance Act have expressed the same concern noted by experts prior to the enactment and implementation of the law: There are good reasons to assume that the market for care, which will take shape spontaneously, will be predominantly a semi-legal or even illegal labour market. (Evers et al, 1994a, p 202; see also Badelt et al, 1997) The Austrian approach can be interpreted as an attempt to reorganise the provision of long-term care by strengthening informal care in private households via semi-paid and semi-legal work arrangements. The difference between the situation in the early 1970s and that in the late 1990s is that informal care in private households is now paid for on a low-fee basis. In addition, semi-legal work arrangements in private

80

Changing long-term care regimes

households are becoming the standard method of provision of longterm care in Austria.

Germany As in Austria, in Germany (D) long-term care was traditionally provided informally within families, while institutional care played a minor role as late as the 1970s. This situation changed during the 1980s as more and more elderly people used institutional care. However, in the German system people in need of care who chose cost-intensive institutional care but could not afford to pay for it, could rely on social welfare assistance (Sozialhilfe). In contrast, home-based care was financially covered to a far lesser degree.The result was that more and more people chose institutional care.Therefore, social assistance schemes were more and more used to finance the provision of long-term care. Policy interventions were essential to help reduce costs. During the period under examination, the first policy change went into effect in 1988.This health insurance reform law introduced partial coverage of the cost of home-based care. It offered either 25 visits of domiciliary care or a small cash benefit, if private caregivers were available. Residential care was not covered (Albers, 1996). Evaluations showed that this kind of policy intervention had some effects, but it did not reduce the cost of social assistance schemes (Infratest, 1992). Further policy changes were necessary. In 1994, the Social Dependency Insurance Act was passed, and it was implemented in two stages in 1995 (home-based care allowances) and 1996 (institutional care allowances). This care insurance programme offers an incentive to choose less costly community care instead of expensive institutional or residential care. The costs of board and lodging are not reimbursed by the care funds, and clients are required to share at least 25% of total cost. This is meant to be an incentive to choose community care, which is perceived as being preferable to institutionalisation. (Brodsky et al, 2000, p 69) Benefits for home-based care are provided as in-kind home-based services, cash allowances or a combination of the two. Coverage of institutional care involves the provision of in-kind services only. Two trends can be observed as a result of the Social Dependency Insurance Act. First, the number of private agencies providing longterm care has nearly tripled (Brodsky et al, 2000). Second, the use of cash benefits, along with the possibility for informal caregivers to

81

Care and social integration in European societies

receive credits in the German pension scheme, has increased the number of informal caregivers who can be paid (Evers, 1997). In summary, during the period 1973-97, two important policy shifts occurred in Germany. Both placed emphasis on informal care in the private sphere and led to the expansion of private home-based care agencies. In addition, under the new policies, informal care giving has become semi-paid and is in part covered by social security. These changes in the provision of long-term care were driven by the need for cost containment and a desire to stabilise the traditional provision of longterm care in private households. Both objectives were reached by the installation of an extra insurance scheme that employees and employers fund through extra payments; they are thus financing formal and informal care in private households.

Conclusion The conservative type countries Austria and Germany passed major reform laws in the early 1990s, which reorganised the provision of long-term care. Both countries are trying to retain the traditional provision of care through family members by allowing care receivers to employ caregivers on a semi-paid basis in private households. Austria leaves it up to the care receivers to organise the fulfilment of their needs and thereby fosters the growth of semi-legal work arrangements in private households; Germany is fostering the growth of formal but private home-based care agencies to meet the needs of caregivers and care receivers.The shift in the welfare mix in the conservative type countries can be summarised as a move towards the market by encouraging selfregulation (A) or by developing private home-based care agencies (D), along with a shift towards the formalisation of caring work provided in private households by family members, neighbours, or friends.

The social democratic welfare state regimes In the 1970s, in the social democratic welfare state regimes long-term care was provided primarily in institutions. These countries provided citizens with a range of universal benefits and services, which were financed largely by a progressive taxation system based on full employment of both men and women. Therefore, the traditional gendered role model of this type of country can be described as the ‘dual breadwinner model’. The typical welfare mix arrangement in the provision of long-term care in the social democratic countries put

82

Changing long-term care regimes

the major stress within the welfare triangle on public provision of institutional care in hospitals, nursing homes and residential care homes.

Sweden In the 1970s, Swedish experts began to question the public institution bias of policies in the area of long-term care, on both economic and humanitarian grounds. A new professional ethos emerged which stressed the inhumanity of moving people away from their well known and loved homes unless absolutely unavoidable. (OECD, 1996, p 167) As a result, home help services were expanded throughout the 1970s, although this expansion of services slowed in the early 1980s. The right of individuals to receive municipal services at all stages of their life was affirmed by the Social Service Act in 1982 (OECD, 1996). Then, to help reduce costs, privatising public care was proposed during the 1990s (OECD, 1996). Even after citizens’ rights to receive home-based services were reconfirmed, the costs of meeting the care needs of elderly people who continued to stay in hospitals or residential homes continued to increase. The ‘Ädel’ reform of 1992 was a major Swedish reform focusing on the reorganisation of institutional care. The central reform was to delegate responsibility for the care of the elderly to the municipalities, [who] now took over all responsibility for long-term care. … In the first year after this reform, the number of elderly people remaining in hospital inappropriately had been halved. (OECD, 1996, p 172) Thus, since the beginning of the 1990s the dominant pattern of longterm care provision in Sweden (S) has changed, moving from institutional care in hospitals and residential homes towards homebased services. Although formal care provision in Sweden was primarily institutional throughout much of the 20th century, payments for family care giving have existed since the 1940s. Further, until the 1950s it was possible for private caregivers to be employed by the municipality, receiving a salary equivalent to that received by home-helpers. The payment was treated as a normal salary for tax and social insurance purposes. However, with the increase in home-based services, the number of

83

Care and social integration in European societies

paid caregivers declined: from 18,517 in 1970 to 6,861 in 1990 ( Johansson and Sundström, 1994). Research and policy debates concerning long-term care in Sweden have thus far focused mainly on the formal care system. It was not until recently that research on informal care by families was done.The results showed that informal support was more than twice the size of formal support. Further, the results indicated that informal care provision is increasing. Nevertheless, until the end of the 1990s, the central policy goal in the provision of long-term care was to offer services before cash. In summary, during the period 1973-97, two important policy changes took place in Sweden. These changes occurred during the early 1980s and the early 1990s. Both policy changes emphasised a move from formal care in institutions like hospitals and residential homes towards formal care provided by home-based services. In addition, the policy revision in the 1990s introduced a radical shift of responsibility for the provision of long-term care, from the national to the local level, and public care institutions were replaced by private home-based care services.

Denmark In 1974, Denmark (DK) changed the provision of long-term care with the passage of the Social Assistance Act (SAA), which was implemented in 1976.This Act may be considered the basis of Danish social and health policy even today. The main object of this reform was to increase interest in home-based care and move towards deinstitutionalisation of care (Swane, 1994; OECD, 1996). Further, the act introduced a shift in the responsibility for solving social problems from the national level towards the municipalities. Until 1976, the Danish central government reimbursed up to 70% of the cost of care in residential old age homes. After the implementation of the SAA, the situation changed. Central government subsidies for old age homes were reduced to 50%. Then, in 1987, subsidies for institutional care were discontinued (OECD, 1996). Since the early 1990s, Danish care policies have been explicitly oriented toward home-based care. Home-based provision of long-term care, however, is increasingly organised in cooperation with the public sector and tries to incorporate self-help groups through payments for voluntary care (Swane, 1994). These payments can be viewed as a kind of symbolic compensation for the expenses of care giving. However, in 1978 some municipalities

84

Changing long-term care regimes

introduced a special offer to family caregivers called attendance allowances. The unwritten requirement, which is used by local authorities, is that the person concerned should be ‘active’, with out-turned interests. Normally, it is not possible to receive allowances according to this provision for persons who get a social pension. … The attendances correspond to the wages of a home-helper. … Individual needs … determine the exact amount of the allowance. (Swane, 1994, p 114) While in the late 1970s the attendance allowances were accessible only in some local areas, by the late 1990s almost all municipalities were providing family caregivers with payments for care. Swane (1994, p 121) interprets this development as follows: The increasing amount of care relations based on public allowances also shows that relatives have an interest in dealing with tasks that were professionalised and institutionalised during the 1960s and 1970s – with support from professionals. To sum up, in 1976 Denmark introduced a major policy change in the provision of long-term care with a strong emphasis on deinstitutionalisation, and this was followed by a total cut of public subsidies for institutional care in 1987. During the 1980s and the 1990s, Denmark moved the provision of care from public institutions towards the private home-based care supplied by professionals as well as family caregivers. This move from publicly provided care toward privately provided care provision was accompanied by localisation of the organisation of the provision of care and progressive implementation of payments for care to family caregivers.

Conclusion In the early 1970s, the typical arrangements for long-term care in the social democratic welfare state regimes Sweden and Denmark can be characterised as public institutional care. By the late 1990s, the deinstitutionalisation, privatisation and localisation of long-term care had occurred in both Sweden and Denmark.This shift occurred as a result of policy reforms in both countries, which put emphasis on homebased services (S 1982; DK 1976) and cut back public subsidies for institutional care (S 1992; DK 1976, 1987). While Sweden has not

85

Care and social integration in European societies

explicitly encouraged care provision by relatives, payments for family care giving do exist. Denmark is promoting family care giving and offers payments for care. In both social democratic countries there has been a move towards the market with a shift towards a public–private partnership in the organisation of care, and an informalisation of caring work. These developments have gone hand in hand with a transfer of responsibilities for the organisation of care from the national to the local level.

Summary of developments in the different types of welfare state regimes Surprisingly, the developments in the six countries under examination, which belong to three different types of welfare state regimes, show certain similarities in their re-organisation of the provision of longterm care even though they started at different points of departure. Nevertheless, some differences in the form of the development can be identified. The similarities and differences in the developments in the three welfare state regimes are briefly summarised here.

From national to local organisation of care In the early 1970s, policies related to the provision of long-term care placed responsibility for the organisation and financing of care at the national level. During the 1980s and especially the 1990s, national governments introduced policy changes in the provision of care that placed the responsibility for the organisation of care at the local level. This shift in responsibility for institutional and home-based provision of formal or professional care was significant in all of the six countries under review. However, there were differences in the reconfiguration of financial support systems. The UK, Canada, Sweden and Denmark introduced policies that moved financial support systems for longterm care towards the local level. However, in the conservative type countries, Austria and Germany, in the early 1990s new systems for the financing of care were introduced at the national level.

From public to private provision of formal care A second similarity in developments in the provision of long-term care in all six countries can be seen in the move from the public provision of institutional or home-based care towards the privatisation of formal or professional provision of care. In the 1990s, more and

86

Changing long-term care regimes

more private sector and for-profit care providers were to be found in all of the countries. In the terminology of the welfare triangle, this means a move from the state towards the market provision of care.

Towards home-based provision of care While in the 1970s all of the six countries under examination were to a certain extent providing care in institutions like nursing homes, all of the countries moved towards home-based provision of care during the period 1973-97. However, in looking at home-based care, we have to differentiate between (a) formal or professional care in private households and (b) informal and non-paid, semi-paid or paid care in private households. In this context, the developments in the reorganisation of care differed in the three welfare state regimes. In the 1970s, the liberal welfare state regimes, UK and Canada, started with the assumption that home-based care was to be provided by female relatives of people in need of care on the basis of love. Care was not paid for and its organisation was left to kinship networks. During the 1980s and 1990s, this assumption underwent a major shift. More and more formal home-based care agencies were established, and payments for informal care to relatives and payments to neighbours looking for people in need of care in their own homes were introduced. In the 1970s, the conservative type countries, Austria and Germany, also started with the assumption that home-based care was to be provided by female relatives of people in need of care on the basis of love. Care was not paid for, and its organisation was left to kinship networks. During the 1980s and 1990s, the conservative type countries underwent almost the same shift as the liberal type countries, although it should be noted that Austria introduced only payments for informal care and did not establish a lot more home-based care agencies. In Germany, however, home-based care became more and more institutionalised even though payments for informal care were introduced. This difference can be explained by looking at the newly established care allowances in Austria and Germany. While Austria pays an amount of money to people in need of care, depending on their needs, the amount of the payments in Germany depends on the choice of provider. Formal care is paid at almost twice the rate of informal care. The last group, the social democratic countries, Sweden and Denmark, were already paying for informal care provision on a wagebasis in the 1970s, although this kind of care provision was not the main focus of care policies at the time. In the early 1970s, institutional

87

Care and social integration in European societies

care, for example, in nursing homes, was the main focus.This care was financed by taxes and every citizen was eligible to receive it. Since the mid-1970s, the social democratic welfare state regimes have changed their views of the provision of care and moved towards deinstitutionalisation. Now, formal provision of home-based care is the main method of providing long-term care in these countries. In addition, wage payments for informal care in private households exist and people in Sweden and Denmark use them more and more.

Conclusions Although the different welfare state regimes began from different points of departure, by the late 1990s formal and informal home-based care was the dominant pattern of care provision in the industrialised countries. All the industrialised countries under examination pay informal caregivers in private households. However, while the social democratic regimes pay wages to informal caregivers, the liberal and conservative regimes reimburse informal caregivers only on a semipaid basis. Using the terminology of the welfare triangle, all of the forms of home-based provision of care can be more or less located in the centre of the welfare triangle; they represent a ‘mixed economy of welfare’, or, in other words, specific ‘public–private partnership arrangements’ in private households. All of the developments identified earlier – localisation, deinstitutionalisation, and payments for informal care – are rooted in problems that the welfare states under examination have been facing during the last decades. In this context, the explosion of costs for the growing group of elderly people in need of care have to be highlighted. One reason for this may be the rise in female labour-force participation in all of the six countries under examination.The assumption that women care for elderly people in their families without payment did not hold during the 1980s and institutional care became more and more the norm. That institutional care, for example, in nursing homes, became far too expensive, and it came discursively to be more and more viewed as inhumane. Therefore, the cheaper home-based care, organised by local authorities on the basis of citizens’ needs, became the primary form of care. Home-based care is supplied not only by private providers, but also by informal caregivers in private households. This is in part because formal caregivers from home-based care agencies are generally not available on a 24-hour basis. Semi-paid informal caregivers have to provide care in addition to formal home-based care to people within

88

Changing long-term care regimes

their homes. Thus, the six selected countries introduced formal and informal (semi) wage-paid home-based care allowances, which have led to an increase in informal care giving. In this sense, a convergence of care regimes in industrialised countries can be identified. Note 1 This chapter represents parts of the results of the research project,‘Changing Care Regimes: A Comparative Analysis’, commissioned by the World Health Organisation (WHO) in 1999. I would like to thank especially Miriam Hirschfeld for her helpful comments on the chapter. References

Albers, J. (1996) ‘The debate about long-term care reform in Germany’, in OECD (ed) Caring for frail elderly people: Policies in evolution, Social Policy Studies, no 19, Paris: OECD, pp 261-78. Anttonen, A. and Sipilä, J. (1996) ‘European social care services: is it possible to identify models?’, Journal of European Social Policy, vol 6, no 2, pp 87-100. Badelt, C., Holzmann-Jenkins, A., Matul, C. and Österle, A. (1997) Analyse der Auswirkungen des Pflegevorsorgegesetzes, Wien: Bundesministerium für Arbeit, Gesundheit und Soziales. Behning, U. (1999) Zum Wandel der Geschlechterrepräsentationen in der Sozialpolitik. Ein policy-analytischer Vergleich der Politikprozesse zum österr. Bundespflegegeldgesetz und zum bundesdeutschen Pflege-Versicherungsgesetz, Opladen: Leske. Bond, J. and Buck, D. (1999) Comparative study of social protection for dependency in old age in the United Kingdom, Newcastle: University of Newcastle Press. Borchorst, A. (1994) ‘Welfare state regimes, women’s interest and the EC’, in D. Sainsbury (ed) Gendering welfare states, London: Sage Publications, pp 26-44. Brodsky, J., Habib, J. and Mizrahi, I. (2000) A review of long-term care laws in five developed countries, Jerusalem: Brookdale Institute of Gerontology and Human Development. Bussemaker, J. and van Kersbergen, K. (1994) ‘Gender and welfare states: some theoretical reflections’, in D. Sainsbury (ed) Gendering welfare states, London: Sage Publications, pp 8-25. Esping-Andersen, G. (1990) The three worlds of welfare capitalism, Cambridge: Polity Press.

89

Care and social integration in European societies

Evandrou, M., Falkingham, J. and Gennerster, H. (1990) ‘The personal services: everyone’s poor relation but nobody’s baby’, in J. Hills (ed) The state of welfare: The welfare state in Britain since 1974, Oxford: Oxford University Press, pp 54-78. Evers,A. (1990) ‘Shifts in the welfare mix – introducing a new approach for the study of transformations in welfare and social policy’, in A. Evers and H.Wintersberger (eds) Shifts in the welfare mix:Their impact on work, social services and welfare policies, Frankfurt/Boulder (CO): Campus Verlag/Westview Press, pp 7-30. Evers, A. (1994) ‘Payments for care: a small but significant part of a wider debate’, in A. Evers, M. Pijl and C. Ungerson (eds) Payments for care: A comparative overview, Aldershot: Avebury, pp 19-41. Evers, A. (1997) Geld oder Dienste? Zur Wahl der Verwendung von Geldleistungen im Rahmen der Pflegeversicherung, Unpublished paper. Evers, A., Leichsenring, K. and Pruckner, B. (1994a) ‘Payments for care: the case of Austria’, in A. Evers, M. Pijl and C. Ungerson (eds) Payments for care: A comparative overview, Aldershot: Avebury, pp 191214. Evers, A., Pijl, M. and Ungerson, C. (eds) (1994b) Payments for care: A comparative overview, Aldershot: Avebury. Glendinning, C. and McLaughlin, E. (1993) Paying for care: Lessons from Europe, Social Security Advisory Committee, Research Paper 5, London: HMSO. Gershuny, J. (1983) Social innovation and the division of labour, Oxford: Oxford University Press. Infratest (1992) Hilfe- und Pflegebedürftigkeit in Deutschland 1991, Bonn: Bundesministerium für Familie und Senioren. Johasson, L. and Sundström, G. (1994) ‘Payments for care: the case of Sweden’, in A. Evers, M. Pijl and C. Ungerson (eds) Payments for care: A comparative overview, Aldershot: Avebury, pp 87-100. Lead, D. and Ungerson, C. (1994) ‘Payments for care: the case of Britain’, in A. Evers, M. Pijl and C. Ungerson (eds) Payments for care: A comparative overview, Aldershot: Avebury, pp 261-74. NACA (National Advisory Council on Aging) (1997) The NACA position on privatization of health care, Ottawa: Minister of Public Works and Government Services, Canada. OECD (Organisation for Economic Cooperation and Development) (1996) Caring for frail elderly people: Policies in evolution, Social Policy Studies, no 19, Paris: OECD. Orloff, A.S. (1993) ‘Gender and the social rights of citizenship: state policies and gender relations in comparative perspective’, American Sociological Review, vol 58, no 3, pp 303-28.

90

Changing long-term care regimes

Pfeil, W.J. (1998) ‘Die Pflegevorsorge in Österreich’, in K. Sieveking (ed) Soziale Sicherheit bei Pflegebedürftigkeit in der Europäischen Union, Baden-Baden: Nomos Verlagsgesellschaft, pp 51-66. Rose, R. (1985) The state’s contribution to the welfare mix, Studies in Public Policy Working Paper 140, Glasgow: University of Strathclyde. Styckman, J. and Nahmiash, D. (1994) ‘Payments for care: the case of Canada’, in A. Evers, M. Pijl and C. Ungerson (eds) Payments for care: A comparative overview, Aldershot: Avebury, pp 307-19. Swane, C.E. (1994) ‘Payments for care: the case of Denmark’, in A. Evers, M. Pijl and C. Ungerson (eds) Payments for care: A comparative overview, Aldershot: Avebury, pp 101-24.

91

Migrants’ care work in private households

FIVE

Migrants’ care work in private households, or the strength of bilocal and transnational ties as a last(ing) resource in global migration Felicitas Hillmann

All over the globe, women and men with middle and high incomes hire migrant workers in the private sphere of care.Women from Mexico and Central America leave to work for double-income families in the US; Indonesian women leave for economically more prosperous regions in Asia and the Arab countries; women from Sri Lanka migrate to Greece and Southern Europe, where quota systems have been introduced, especially for care workers1.Women from Eastern Europe migrate to Germany, France, Italy, the US and Canada.The Philippines systematically developed the export of care and domestic workers. Here a substantial part of the country’s migration industry focuses on often well-educated women leaving for care and domestic work abroad. The country, some call it a migrant nursery, ‘supplies’ about 160 countries all over the world with domestic workers (see Aguilar Jr, 2002). In Asia, Indonesia and Sri Lanka are also considered to be ‘supply’ countries. High and middle-income states in Asia, including Hong Kong, Singapore, Taiwan, China and Malaysia, as well as the Gulf states, employ thousands of women migrants as domestic workers (Parrenas, 2003). In Europe, too, care work is increasingly migrant work. There are differences in government policies toward women going abroad to work as domestic workers, ranging from liberal or encouraging systems (Philippines) to systems banning the outmigration of female workers (Bangladesh and Pakistan).Within Europe a variety of regulations concerning migrant work exists among the various countries.This chapter asks why care work is rapidly becoming migrant work in Europe, too – irrespective of different national labour

93

Care and social integration in European societies

market regulations and care arrangements in the individual countries. It is argued that global migrations follow existing regional hierarchies. Migrations further depend on regulations at extremely different geographic scales.Two intertwined trends add to the increase of migrant workers in the field of care and domestic work. First is the growing feminisation of migration on the global scale. The first part of this chapter presents the salient features in this respect by giving a rough overview of numbers and by presenting in a nutshell the existing theoretical lines of thinking on the impact of gender in the migration debate. Second are bilocal and transnational strategies adopted by the migrants themselves, which function well in many regional and local settings, and which are often characterised by growing numbers of elderly people and unchanged gender arrangements concerning the national labour market. Two contrasting regional examples, Italy and Germany, were chosen to highlight the high capacity of migrant strategies to adapt to the needs of an informalised labour market and to cope with precarious situations in the countries of origin. The second part of this chapter presents the two regional case studies. The southern European, that is, Italian, model is highlighted by characterising the situation of migrant care workers in the 1990s and by pointing out their transnational strategies.The conclusion formulates answers to this question: why is care and domestic work increasingly migrants’ work? It also points out research perspectives.

The feminisation of migration in the 1990s: migrants as care workers The 1990s brought many changes in the pattern of international migration; that is, a feminisation of migration. From the outset the care work sector has been one of the most important fields for the economic integration of female migrants all over the world – and became even more so during the 1990s.

Figures and flows For many years it was taken for granted that male migrants constitute the majority of migrant workers, and it was widely believed that the impact of women in international labour migration was negligible. In 1990, the UN Secretariat (1990, p 3, Division for the Advancement of Women) remarks in its state-of-the-art report:

94

Migrants’ care work in private households

The extent of female international migration, just as several other aspects of the migration of women across international borders, has been a largely neglected subject. Lack of readily available information on the participation of women in the international migration is probably at the root of the conventional view that the typical migrant is a young economically motivated male. Only in 1998 did the UN’s Population Division present for the first time a set of data on the estimates of the share of females in the total number of international migrations (including foreign-born women and refugees). It became clear that in the 1960s women already accounted for nearly 47% of all migrants living outside their countries of birth. Since then the proportion of women has been rising steadily, reaching 48% in 1990 and 49% in 2000 (Zlotnik, 2003). In the years between 1960 and 2000, the overall number of migrants had doubled and the number of women rose continuously (see Table 5.1). This quantitative tendency is one fact of the ‘feminisation of migration’. There are big regional and national differences in the composition of the sexes in the migration process. The ‘feminisation of migration’ covers a whole range of qualitative changes. When considering the impact that female migrants had on the changes in worldwide migration patterns during the 1990s, various differences from male migrants become conspicuous. First, female migrants became much more prominent as senders of remittances, as agents within migration networks. Second, female migrants are among the most vulnerable groups of migrants and became even more vulnerable in the 1990s, as data indicate. Stricter immigration controls and more restrictive regulation of immigration to North America and to Europe led to an increase in all irregular forms of migration and had a high impact on migrant women. Estimates say that irregular migration accounts for one-third to one-half of new entrants into developed countries, which would be an increase of 20% over the

Table 5.1: Quantitative dimension of female and male migration (1960-2000) Time

Total migrants

Women

Men

75 million 175 million +100 million

35 million 85 million +50 million

40 million 90 million +50 million

1960 2000 Increase Source: Zlotnik (2003)

95

Care and social integration in European societies

past 10 years. Migrant smuggling became an industry on its own and certainly counts as a growth industry (US$10 billion a year) (IOM, 2003, p 60). Trafficking, which in many cases includes abuse and violence along with prostitution and criminality, became an important policy issue only in the late 1990s. It is estimated that about 700,000 persons, especially women and children, are trafficked each year across international borders. Female migrants have to fear possible violence and abuse by their co-migrants and helpers during each migratory trip – this makes them more vulnerable than male migrants are.Third, they also possess different skills and role models, which are often less well-adapted to the male-dominated ‘world of migration’. In most cases migrant women are also less visible in the context of arrival, and there is no infrastructure to give them shelter anyway.This invisibility can add to their often vulnerable status. Non-governmental organisations (NGOs) such as the International Labour Office (ILO, 2004, p 58) see the “migrant domestic worker … among the world’s most vulnerable workers”. Non-governmental organisations, like the RESPECT-network, concentrate on the protection of female migrants working as domestic and care workers in Europe (see Schwenken, 2003; Anderson, 2004). As this suggests, there has always been a substantial proportion of women taking part in processes of international migration and working as domestic workers and care workers abroad. However, only over the past few years have migration studies started to recognise the importance of this issue2.Two lines of thinking emerged in the 1990s. A considerable body of literature researches the transnational character of domestic and care work. Another line of thinking puts the focus of research more on the functionality of domestic and care work within changing forms of labour organisation on the global scale. In the reality of migration, on the local scale, both approaches add to our understanding of the process.

Transnationalism and the rise of global care chains The conceptual framework of transnationalism dominates the scientific discourse on migrants during the 1990s. The discovery that transnational communities had developed in many countries and that they had started to sustain international migration coincided with the restriction on migration movements in the western world. Migration is now also perceived as a social concept and the attention of researchers shifts to questions of the social construction of migration (Khoser and Lutz, 1998) and, more generally, on transnational social formations

96

Migrants’ care work in private households

(Vertovec, 2001). The role of gender within transnational households and transnational strategies is of great importance for the research on female domestic workers. While some authors state that transnationalism, understood as the potential of the migrants to commute and the ability to span social networks across countries, is a new characteristic of worldwide migration patterns, other authors remain rather cautious in their findings. Referring to the work of Hondagneu-Sotelo (1994) on Mexican families, Phizacklea (2003, p 85) states that: [h]ouseholds are not the cosy rational decision-making units that some accounts would lead us to believe. It is possible that the number of households, who sit down around the kitchen table and discuss in a rational way who it is that will make the most money if they migrate, is very small indeed. Here the household, often seen as a gender-neutral unit, decides on the basis of gendered norms; it is doing ‘gender work’ through gendered practices and discourses that reproduce hierarchies of privileges and power. Nyberg Sørensen (1999), starting from her research on the transnational strategies of the Dominicans in Santo Domingo, New York and Madrid, asks whether transnational migration did not even strengthen social and regional disparities instead of overcoming them. The author relates transnational moves to categories of social status and belonging in the country of origin and to the broader frame of migration possibilities (which countries accept which kind of immigrants?) and concludes that different qualifications and differentiated access to migrant networks produced gendered migration routes. Hillmann (1996, p 194) underlines that there are gendered regional targets of migration in Europe. Pessar and Mahler (2003) speak of ‘gendered geographies of power’ when analysing transnational migration. They claim (2003, p 815) that “gender operates simultaneously on multiple spatial and social scales (for example, the body, the family, and the state) across national territories” and there is criticism that the transnationalists “tend to overemphasise the ‘national’ dimension and gloss over the differences and belongings, in particular gender” (Morokvasic, 2003, p 102). Concentrating on care, Hochschild’s work (2000) claims that global care chains developed in the past years. New about this trend is that female migrants who work as domestic and care workers in the western world delegate the care work for their own children and kin to other paid helpers in their countries of origin. Hochschild calls this

97

Care and social integration in European societies

phenomenon ‘care drain’, alluding to the concept of brain drain and strengthening the idea of care as a universal good that follows regional hierarchies. In this view migrant domestic workers are part of a gendered economic restructuring worldwide. Even more clear-cut is research that takes into account transnational family relationships. Left-behind children may suffer from ‘care drain’ and whole countries are degraded to migrant nurseries; in addition, transnational families require a stable partner for remittance management. Up to now, the import of love and care from poorer to richer countries has been taken for granted – without formulating the losses that go along with such spatially fractured forms of employment in the country of origin. Largely ignored is also the question whether the feminisation of migration serves as an exit strategy for women from violent societies (see Nyberg Sørensen, 2004). The multiplicity of ‘imagined communities’ within transnational networks that are organised along different, often conflicting principles (Waldinger and Fitzgerald, 2004) seems to have an explicitly gendered nature and the supposed tendency to ‘stick together’, to generate solidarity (Portes, 1997), is questioned. Recently the focus on ‘transnational parenthood’ has broadened the concept of transnationalism again (Shinozaki, 2003). In the perspective of economic restructuring, Sassen (2003) interprets the feminisation of migration as part of the emergence of countergeographies of globalisation. Alternative circuits of migration, within which care workers typically act, only become possible in an institutional setting that facilitates cross-border flows and transnational forms of living. And those movements of domestic workers are, in many cases, close to illegal forms of migration, such as trafficking in women for prostitution or the organised export of women as brides and nurses. In her conceptual landscape the ‘feminisation of survival’ is one of the gendered dimensions of the globalisation process. Increasingly, households and whole communities depend on the remittances of female migrants, enterprises that make profits at the margins of the ‘licit’ economy depend on the earnings of the migrant women. There is also a certain degree of institutionalisation in those migrations that, at first sight, seems to stem from individual behaviour. In this view, the feminisation of migration described earlier is functional to the globalisation process of the 1990s and to be explained by economic changes. This argument is backed up by the geographical pattern of those migration flows. All over the globe, women from less developed countries migrate to more developed countries offering care work.The import–export trade of care work is not geographically

98

Migrants’ care work in private households

connected to a national basis, but to different places within nations that show fragmented regional patterns. In this perspective, the delegation of care work seems to be in the centre of processes of globalisation. Parallel to this regional hierarchical pattern of migrant care and domestic workers, changes in the value attributed to care work might be one reason for the increasing proportion of migrants in this sector. Hochschild (2000, p 144) concludes: The low value placed on caring work is not due to the absence of a need for it, or to the simplicity or the ease of the work, but to the cultural politics underlying this global exchange. The declining value of child-care anywhere in the world can be compared with the declining value of basic food crops, relative to manufactured goods on the international market. … Just as the market price of primary goods keeps the Third world low in the community of nations, so the low market value of care keeps the status of women who do it – and, by association, all women – low.

Two regional examples: migrant domestic workers in Italy and Germany Care and domestic work is becoming increasingly migrant work in Europe, too, and is in the centre of the work of NGOs such as RESPECT and KALAYAAN.The leading proposition of this chapter – that migration follows regional hierarchies and that it works precisely through the activation of transnational and bilocal ties – is underlined by comparing two regional examples. Two countries that belong to fairly different migration regimes were chosen: Italy and Germany. While Italy only started to be an immigrant country in the early 1980s, Germany actively recruited immigrants in the 1960s and early 1970s. Today the foreign population accounts for 2.2% of the total population in Italy and for 9% in Germany, and generates different forms of migrant care workers. Italy’s immigrant population is characterised by a high degree of informality and a high share of illegal migration (as is the case in other southern European countries like Spain; see Ribas and Oso, forthcoming). Germany’s immigrant population is much more established: most immigrants have lived in the country for more than 20 years, and their access to the labour market is highly regulated. Both countries rely on migrant care workers and have introduced specific regulations. In both countries, migrant care and domestic workers are mostly concentrated in the urban areas.

99

Care and social integration in European societies

Both Italy and Germany show very strong regional differences in the participation of women in the labour market (see Perrons, 1998).The regional examples look first at the cultural side of employing care and domestic workers; second, they sketch the importance of migration history for the current employment of migrants in the care and domestic sector; third, they accentuate the gender contract in the given national context; and fourth, they highlight the migration strategies of the migrant worker.

Italy Italy has always had a longstanding tradition in employing domestic workers, and so finding many migrant women in this sector is nothing new.The employment of domestic workers signalled status and prestige to the outer world and has been common since the late 19th century for the upper and upper middle classes. Up to the 1980s, these domestic workers usually came from less developed, often rural, areas in Italy itself and were mainly younger women with little educational background. The Istituto Nazionale Della Previdenza Sociale (INPS) registered in the years 1992-94 around 1.5 million domestic workers, 12.1% of whom were of foreign origin (Caritas, 1997, p 288) – considering by definition only the legal dimension of that part of the labour market. Recent studies give another picture: according to a study by Eurispes, in 2002 60% of all domestic workers in Italy came from abroad, 87% of whom were women. Compared to domestic workers with Italian passports, they were younger, better educated and worked more hours per week. Most of the registered persons working in Italian households are employed in Northern Italy, especially in Lombardy, and in Latium in the capital city Rome as well as in Naples. Only 1/60th is registered in Southern Italy, Sicily and Sardinia (Eurispes, 2002). The history of migrants as domestic workers starts in the mid-1970s, when church agencies began to recruit domestic workers from abroad, especially from the Philippines (Hillmann, 1996). Some diplomats also brought their personnel from the former colony of Somalia – once that country had become an independent state.These foreign domestic workers were the exception until the early 1980s when, slowly but continuously, migrant women took up such jobs.Young Italian women stopped working as domestic workers or professionalised their care work by specialising in nursing or postnatal care, and so on. During the 1980s and the 1990s, thousands of collaboratrici extracomunitari (the official Italian term for foreign domestic worker) came to work in

100

Migrants’ care work in private households

Italy and special legal regulations have been passed, including five legalisation waves3. The bulk of migrant women working in the care sector came without a legal permit and most of them found work only in the informal economy – making the care sector a migrantdominated sector.What are the reasons for that change? Why did the migrant women fit so perfectly in this field of the labour market and what migration strategies made them so competitive compared to the professionalised Italian workers4? Qualitative data suggest that there are good reasons for this reaction. Up to today there are two work models for migrants to work in Italian households: as colf fisse (live-in domestic worker) and colf a ore (on a daily or hourly basis). In the early 1990s, the first model was very common among migrant women. Especially when migrant women arrived in Italy, they chose this option. In this way, they managed to find housing and work at the same time and they were able to send money back to their families immediately. Sending remittances back home was the most important aspect of their migration experience mentioned by the interviewed women. In nearly all cases, there had been mediators within the recruitment process: the Catholic Church was one of the most active agencies that put arriving migrants in contact with potential clients. Another important way of recruitment was the reliance on transnational social networks, through which the migrant women arrived. Those networks often consisted of relatives, sometimes colleagues and sometimes friends, providing the migrant women with money for travelling and all kinds of support during the trip. Typically a Philippine women says about her reasons to migrate: My salary was not enough to provide everything for the family. In the Philippines it is our condition that not only the husband has to work for the family. It should be always an equal relationship. Also me, I have the responsibility to provide something for the children. Me and my husband decided that I come here to work, I don’t know how long I will stay here, but as long as I can, I will … I don’t want too much for me, I just want to have enough for my children, when I have enough for them, when I can finance them to go to school, then I can go back to my country. Even if the women were well educated, migration seemed to be the only way to provide their own children with a decent education and to ensure the survival of the family at home. Most of the women interviewed embedded their migration within family strategies and they were able to rely on existing networks of co-nationals in Italy,

101

Care and social integration in European societies

especially when looking for an employer. Philippine women with no children of their own in their home country were responsible for the financing of their brothers and sisters or for their own future education. Their mentality was that they ‘had to sacrifice themselves’ for the wellbeing of their family at home, which is a concept that is advertised within the country of origin itself. In Italy, the Philippine women found jobs relatively easily in the vast informal sector – even if they had no permit to stay. Another national group that relied very much on transnational family strategies was that of the Peruvian women. Whole groups of women came to Italy after having concluded their nursing training at Lima. They normally relied on international money from relatives that had emigrated before to other South American countries or to the US. Families in Lima sold all their luxury goods to allow one person to go abroad. The more the situation in the home country deteriorated the more the women were likely to go away. Their gender-specific educational background allowed them to adapt quickly to the work of a domestic worker because they had worked as teachers or nurses beforehand.The Peruvian women also perceived Italy as a convenient country since it had an huge informal sector in which they could easily find a job and employers seldom asked for papers. And migrant work was needed: since the 1990s more and more women entered the labour market and needed somebody to do the remaining care work on a 24-hour basis. After baby minding, care of older people became a major field of employment for the migrant women. Once settled in the Italian context many migrant women working as domestic workers started to look for professional solutions that allowed them to become more independent. The motive for moving away from the live-in position is that in a live-in situation “we change dignity with money” (Gloria, 35, Philippine English teacher), meaning that there is nearly no privacy for the women and certainly in many cases de-qualification processes took place. What worked out at the beginning of the migration experience and guaranteed the financial success that those women achieved in the eyes of their families at home, was becoming more difficult the more the women became integrated in the new context. The migrant women then started to cohabit with co-nationals in flats, sometimes 10 people in a threeroom flat, and continued to work on a daily basis, as many hours a day as the market allowed. And there was a great demand for domestic workers even on an hourly basis. Long waiting lists for the state-run retirement centres contributed to the trend of hiring a migrant worker.The procedure of

102

Migrants’ care work in private households

hiring was faster, more individualised and much cheaper (for the employer) than relying on the institutional supply. Italian men often did not take much part in care work, and the changed position of the women on the labour market did not go along with a changed gendercontract in the care sector. Pittau (2001, cited in Schiffel, 2003) gives the following reasons for the growing need for care workers in Italian society: • Italian women participate much more than before in the labour market; • the population is ageing; • family structures changed and traditional models of the family became less common; • public welfare services failed to provide the necessary social support; • new lifestyles required the increasing use of domestic help. Research results indicate that established regionalised migrant networks of care workers at that time offered a more appropriate answer to the demand for labour in this field compared to state-run support structures. Migrant labour was the cheaper alternative, at least in the short run. The social and emotional costs of such care arrangements were left with the migrant women. The costs of training this imported professional labour were delegated to the developing countries. In summary, the example of Italy suggests that regional gendered networks were more efficient in solving the problem of the growing care deficit than were national solutions. And since the Italian side was easily able to rely on these migrant networks, only few attempts were made to find a sound and lasting solution on the national level, for example, incentives to change the gender-contract. Regulations in the field of care work focused on the improvement and on the management of the flows and stocks of foreign labour and not on ‘national’ solutions.

Germany Generally, since the Second World War, Germany has only a weak tradition in employing migrant workers for care work since its labour market relied for many years on the male breadwinner model. In the 1970s and 1980s, Germany recruited temporary nurses from South Korea and the Philippines for job vacancies in the care sector. Today, we find care workers with a migrant background in two categories of the care sector: as employees coming from a former guest-worker

103

Care and social integration in European societies

background and, second, as migrants entering Germany for the purpose of work. There is no doubt at all that a substantial number of German households rely on migrant work to satisfy their social reproduction and care needs and that the number of migrants in this sector is very high. Nearly three million private households in Germany frequently delegate housework (cleaning, washing, ironing, shopping, cooking) to paid domestic helpers (Schupp, 2002); estimates for some German cities state that one in eight households relies on domestic helpers (Friese and Thiessen, 1997).The trend towards a widespread acceptance of immigrants as domestic helpers is new for Germany, unlike Italy with its longstanding tradition of delegating housework (Lutz, 2002a; see Gather et al, 2002). Odierna (2000) names four factors that determine the employment of care and domestic workers in German households: high income levels; both partners working on a regular daily basis; scarce time resources within the household; prestige or cultural and normative factors.The author states that immigrant women from the countries of recruitment of so-called guest-workers (that is, Italy, Spain, Turkey), but also Polish women of the first and second generation were engaged in care and domestic work. Women from Latin America were increasingly employed in the 1990s and faced discrimination, depending on the colour of their skin. Like the ‘visible’ migrant women from Africa and Asia they have few opportunities to enter this sector of the labour market, often they are forced to work on an illegal basis (Schäfter and Schultz, 1999; Odierna, 2000, p 90). In some German cities, migrant workers with a guest-worker background make up 40%-45% of the personnel in ambulant care organisations such as Caritas (Busse, 2003, p 378) – these women with immigrant backgrounds are integrated mainly for two reasons. First, qualification requirements are low and correspond to the working biographies of these women who often have no formal education. Another reason for the recruitment of women with immigrant backgrounds is new for Germany and of growing importance in the coming years.The country is increasingly facing an ageing immigrant population that asks for and/or appreciates co-ethnic care personnel. Here the employment of women with migrant backgrounds is due to the changing attitude of German society towards a multi-cultural society in the big cities and is further due to the formally unskilled background that is needed to fill positions in ambulant care for older people. The bulk of jobs in the sector of domestic work and often also care for older people or children are on an informal basis and on an hourly

104

Migrants’ care work in private households

basis in Germany. The few data that exist indicate that the greatest share of legally hired migrant care workers went to the former Western Länder of Germany, which are economically better-off than the formerly Eastern Länder.As one privileged observer in the employment agency (Agentur für Arbeit) points out: The illegal market destroys the legal market. There is an enormous demand. People call me and ask how they can possibly legalise their illegal care-worker. It is estimated that today around two million elderly people in Germany have to rely on professional care with a clear tendency towards an ever bigger need in the near future. Less than one-third of the elderly people in need of care live in an old people’s home (Pflegeheim), 70% live on their own or with their family. Family members, however, are in many cases unable to cope and frequently unable to provide professional care. Ambulant care through organisations is often not enough to meet the needs and is very expensive for the family. A professional carer available all day long and during the nights costs up to €15,000 monthly, while the state contribution ranges from €380 to €3,500. For many families, the recruitment of an informal or illegal helper from Eastern Europe is the only possibility to find a reliable and fast solution (Tießler-Marenda, 2002, p 233).Thousands of migrant women from Poland, Russia, Ukraine as well as from South America do this work in German households. There is empirical evidence that such transnational networks, facilitating the introduction of migrant women into the care sector, have developed in Germany during the past years. Networks arranging illegal employment were established, too. In the report on illegal employment of migrants in Munich the Sozialreferat (2003, p 53) states: If a physician of Polish origin earns 500 DM (€250) a week with a full-time job in a private household in Germany, then this is three or four times as much as he would earn at home. This makes you accept long working days and difficult job circumstances. All persons involved in the deal benefit. In Germany too, personal contacts, especially word-of-mouth advertising, constitutes the most important information source for integration into the care labour market. In some German cities such as Berlin, Polish migrant women come on a rotational weekly basis for work and sometimes it is more difficult to find a place to stay than

105

Care and social integration in European societies

a job (Huning, 1998, p 98). Patterns of spatial concentration arise where the community of co-nationals is already strong, indicating that the existence of a permanent immigrant group paves the way for informal work in response to labour market demand. Family strategies seem to be of less importance for this kind of labour migration to Germany, while the shadow economy acts as a magnet for immigration (Cyrus, 1997; Miera, 1997; Huning 1998). Rotation and forms of solidarity support within the Polish community are still common and most migrants seem to work for their own sake and not for children or family left behind. The low qualification needed for a job in the informal economy serves the migrant because he/she is not paying social benefits. There has only once been an opportunity to recruit migrants legally for domestic work in Germany and that was in 2002. In this case, the length of stay in Germany was limited to three years. Official data on this legal recruitment of care workers from abroad counted the placing of 1,276 migrant workers from Eastern Europe, of whom the vast majority (1,002 persons) came from Poland, 123 persons from Slovakia, 90 persons from Hungary, 45 persons from the Czech Republic and 16 from Slovenia. The expert in charge of this programme reported that there was surely a big need for care workers on a 24-hour basis, especially in the rural regions.Today, it is no longer possible to recruit immigrants from abroad legally – except for au pair contracts (ZAV, 2002). Statistical documentation on the extent of au pair workers in Germany does not exist, so no valid estimate can be made for this group of care workers. On the political level the question of how to regulate the influx of care and domestic workers in the future is being vigorously debated at the present time.

Conclusions So why is care work in Europe increasingly becoming migrant work and why is the impact of national regulations and arrangements weak? This comparison of two European examples shows a range of similarities. First, in both countries, certain ties are especially helpful in the migration process; that is, bilocal (between the local level of departure and the local level of arrival) and transnational ties become highly functional in a globalised setting. Migrant networks and strategies and labour market needs seem to fit in a key-and-lock principle in both countries. Empirical evidence suggests that these transnational strategies are similar in different countries. Transnational strategies, second, had to go hand in hand with a high degree of informality. In

106

Migrants’ care work in private households

both countries migrant networks and migrant strategies fitted more neatly into the needs of the employing households – mostly because of difficult and lengthy procedures in the formal sector, but sometimes also owing to lack of knowledge about the existing institutional care system. Low cost is one of the strongest arguments for not regulating the informal contract for both the employer and the employee (both partners avoid paying social insurance contributions), ignoring the fact that this behaviour accelerates the informalisation of a whole branch and lowers quality standards in the long run. On the other hand, many employers would prefer to employ legally – if they could (as is the case in Germany). Third, both countries have run programmes in response to the existing need for migrant care and domestic workers. Fourth, both countries show an increasing need for care workers in the future because of their ageing populations. Fifth, the need to fill existing gaps within the reproduction (that is, care) sector by international work indicates that the gender contract within Western societies has remained unchanged (see Gottschall and Pfau-Effinger, 2002) even though the participation of women on the formal labour market has increased. Our regional examples also show differences: while Italy has a longstanding tradition of employing care workers and offers a vast informal sector that absorbs migrant workers very easily, Germany’s care traditions are quite different. First, post-war Germany does not have a tradition of live-in domestic workers, except during the period of promoterism in the late 19th century. Still, there has been one official programme to recruit migrant workers for the care sector, and there is certainly a huge supply of migrant workers (and huge demand for them on the German side). In Germany, the low educational entry barriers add to the high presence of care workers with migrant backgrounds, and there will be an increasing demand for care workers with a migratory background because of the ageing immigrant population. When comparing the two regional examples, we might conclude that Italy’s situation in the early 1990s resembles the migrant inclusion model in the field of care work in Germany in the early 2000s. In a way, in both countries the informal solution of employing care and domestic workers has resulted in a cheaper and more ‘efficient’ way of resolving social problems – delegating social, emotional and educational costs to the countries of origin and the migrants themselves. The growing presence of migrant workers in the care sector is thus a good example for the gendered geographies of power and this becomes evident in the ongoing feminisation of migration (Pessar

107

Care and social integration in European societies

and Mahler, 2003). Migrant women, being usually more vulnerable than men are during the initial migration stages, follow certain paths within the international division of labour. The care drain – documented by an abundance of work on migrant domestic workers (Hondagneu-Sotelo, 1994; Hillmann, 1996; Hochschild, 2000; Lutz, 2002a; Hochschild and Ehrenreich, 2002) – follows regional hierarchies, mostly from less developed to more developed countries, maybe leading to a feminisation of survival (Sassen, 2003) and to what Nyberg Sørensen calls “new policies of emotions”. Care work, especially migrant care work, is thus at the centre of fragmenting globalisation and indicates new forms of global governance. Further research should look on the gendered nature of migration on the local, national as well as regional scale taking place in this global setting and ask whether bilocal and transnational ties are a last or a lasting resource in global migration. Notes 1 Care work is defined here as all work that is related to social reproduction needs. It includes care work for children and older people, as well as household duties, domestic work. 2

The assumption that migration processes were gender-neutral and that the role of female migration was negligible led for many years to a genderblind view on migration (and did not generate much research on domestic servants, domestic workers). In the 1960s and the early 1970s female migrants were seen as an appendix to the male migrant workers; then the mainstream literature of the 1970s and the 1980s concentrated on aspects of emancipation: the importance of the (cultural) modernisation process that the individuals faced through their migration was at the centre of attention. Only in the 1980s and then, more momentously in the 1990s, was gender introduced into the research on migration. While neoclassical pull-and-push theories assumed an individual decision-making process to be behind the motivation to migration, as an individualised cost–benefit thinking of the migrant, many authors now highlight the importance of household strategies and the crucial question whether there are gendered responsibilities and gendered household strategies (Pessar, 1982; Boyd, 1989, 2003).

3

‘Sanatorie’, amnesties that allowed the migrants to legalise their stay in Italy if they could prove they had work, took place five times: 1986 (the total of all legalised immigrants was 25,602); Legge Martelli 1990 (the total of all immigrants legalised was 112,647); Decreto Dini 1995 (the total of all legalised immigrants was 210,223) Legge Turco-Napolitano 1998 (total of all legalised immigrants: 217,124); Legge Bossi-Fini, 2002 (the government,

108

Migrants’ care work in private households Internal Affairs, estimates that more then 700,000 migrants applied for legalisation, roughly 350,000 of whom were domestic workers; see Schiffel, 2003, p 31). 4

The qualitative data presented here stem from fieldwork for my doctoral thesis, published as Hillmann (1996).

References

Aguilar Jr., F. (ed) (2002) At home in the world?, Quezon City: MOST. Anderson, B. (2004) Devil is in the detail: Some lessons to be drawn from the UK government’s recent regularisation of migrant domestic workers, Mimeo,Warwick: Department of Sociology, University of Warwick. Boyd, M. (1989) ‘Family and personal networks in international migration: recent developments and new research agendas’, International Migration Review, vol 23, no 3, pp 638-70. Boyd, M. (2003) ‘Women and migration: incorporating gender into international migration’, in Migration Policy Institute (ed), Migration information source, March,Washington: www.migrationinformation.org. Busse, K. (2003) ‘Migrantinnen als Pflegekräfte. Erfahrungen und Perspektiven interkultureller Öffnung in der ambulanten Altenpflege’, Soziale Arbeit, vol 10, pp 377-85. Caritas (1997) Immigrazione – Dossier statistico, 98, Roma: Anterem editors. Cyrus, N. (1997) ‘Nadelöhr Wohnen’, in B. Neumann-Cosel and R. Amman (eds) Berlin – Eine Stadt im Zeichen der Migration, Berlin: VWP-Verlag, pp 92-4. Eurispes (2002) Ricerca eurispes sul lavoro domestico in Italia. La colf del 2002 è straniera, giovane, istruita, Rome: Istituto di Studi Politici, economici e sociali. Friese, M. and Thiessen, B. (1997) Modellprojekt Mobiler Haushaltsservice – Ein innovatives Konzept für die Ausbildung und Beschäftigung von Hauswirtschafterinnen, Bremen: Universität Bremen. Gather, C., Geissler, B. and Rerrich, M.S. (eds) (2002) Weltmarkt Privathaushalt. Bezahlte Haushaltsarbeit im globalen Wandel, Münster: Westfälisches Dampfboot. Gottschall, K. and Pfau-Effinger, B. (2002) ‘Einleitung: Zur Dynamik von Arbeit und Geschlechterordnung’, in K. Gottschall and B. PfauEffinger (eds) Zukunft der Arbeit und Geschlecht, Opladen: Leske und Budrich, pp 7-28. Hillmann, F. (1996) Jenseits der Kontinente. Migrationsstrategien von Frauen nach Europa, Opladen: Leske und Budrich.

109

Care and social integration in European societies

Hochschild, A. (2000) ‘Global care and chains and emotional surplus value’, in W. Hutton and A. Giddens (2000) (eds) On the edge: Living with global capitalism, London: Jonathan Cape, pp 130-46. Hochschild,A. and Ehrenreich, B. (2002) Global woman: Nannies, maids and sex workers in the new economy, New York: Metropolitan Books. Hondagneu-Sotelo, P. (1994) Gendered transitions: Mexican experiences of immigration, Berkeley, CA: California University Press. Huning, S. (1998) Schattenwirtschaft in Berlin. Das Beispiel polnischer Hausarbeiterinnen, Dortmund: Diplomarbeit an der Fakultät f. Raumplanung, Universität Dortmund. ILO (International Labour Organization) (2004) Towards a fair deal for migrant workers in the global economy, Report VI, Geneva: ILO. IOM (International Organization for Migration) (2003) World migration. Managing migration, Geneva: IOM. Khoser, K. and Lutz, H. (1998) The new migration in Europe, Houndmills: Macmillan. Lutz, H. (2002a) ‘At your service, madam! The globalisation of domestic service’, Feminist review, vol 70, no 1. Lutz, H. (2002b) ‘In fremden Diensten: Die neue Dienstmädchenfrage in Europa als Herausforderung für die Migrations- und Genderfrage’, in K. Gottschall and B. Pfau-Effinger (eds) Zukunft der Arbeit und Geschlecht, Opladen: Leske, pp 161-82. Miera, F. (1997) ‘Migration aus Polen. Zwischen nationaler Migrationspolitik und transnationalen sozialen Lebensräumen’, in H. Häußermann and I. Oswald (eds) Zuwanderung und Stadtentwicklung, vol 17, pp 23254. Morokvasic, M. (2003) ‘Transnational mobility and gender: a view from post-war Europe’, in M. Morokvasic, U. Erel and K. Shinozaki (eds) Crossing borders and shifting boundaries. Volume 1: Gender on the move, Opladen: Leske und Budrich, pp 101-33. Nyberg Sørensen, N. (1999) ‘Mobile Lebensführung zwischen der Dominikanischen Republik’, in K. Gabbert, W. Gabbert and B. Hoffmann (eds) Migrationen, New York/Madrid: Horlemann, Bad Honnef, pp 16-37. Nyberg Sørensen, N. (2004) Narratives of longing, belonging and caring in the Dominican diaspora, Mimeo, Copenhagen. Odierna, S. (2000) Die heimliche Rückkehr der Dienstmädchen. Bezahlte Arbeit im privaten Haushalt, Opladen: Leske. Parrenas, R.S. (2003) Servants of globalization: Women, migration and domestic work, Manila: Ateneo de Manila University Press.

110

Migrants’ care work in private households

Perrons, D. (1998) ‘Maps of meaning: gender inequality in the regions of Western Europe’, European Urban and Regional Studies, vol 5, no 1, pp 13-25. Pessar, P.R. (1982) ‘The role of households in international migration’, International Migration Review, no 16, pp 342-64. Pessar, P.R. and Mahler, S. (2003) ‘Transnational migration: bringing gender in’, International Migration Review, vol 37, no 3, pp 812-46. Phizacklea, A. (2003) ‘Transnationalism, gender and global workers’, in M. Morokvasic, U. Erel and K. Shinozaki (eds) Crossing borders and shifting boundaries. Volume 1: Gender on the move, Opladen: Leske, pp 79-99. Pittau, F. (ed) (2001) La nuova realtà socio-demografica dell’immigrazione femminile, Milan: Casa editrice Carocci. Portes, A. (1997) ‘Globalization from below: the rise of transnational communities’, in A. Rogers (ed) Transnational communities programme, Working Papers WPTC-98-01, (www.transcomm.ox.ac.uk/ working_papers.htm 12.07.04). Ribas, N. and Oso, L. (forthcoming) ‘Filippinas in Spain: professional stagnation as an adaptation strategy’, in E. Spaan, F. Hillmann and T. van Naerssen (eds) Asian migrants on European labour markets, London: Routledge. Sassen, S. (2003) ‘The feminisation of survival: alternative global circuits’, in U. Erel et al (eds) Crossing borders and shifting boundaries.Volume 1: Gender on the move, Opladen: Leske, pp 59-77. Schäfter, E. and Schultz, S. (1999) ‘Putzen – was sonst? Latinas in Berlin: Bezahlte Hausarbeit als Arbeitsmarkt für Migrantinnen’, in K. Gabbert et al (eds) Migrationen, New York/Madrid: Bad Honnef, Horlemann, pp 97-110. Schiffel, N. (2003) Von Quito nach Rom: Lebenssituation und Handlungsstrategien ecuadorianischer Migrantinnen in Rom, Unpublished manuscript, Munich: Department of Geography, Universität München. Schupp, J. (2002) ‘Quantitative Verbreitung von Erwerbstätigkeit in privaten Haushalten Deutschlands’, in C. Gather, B. Geissler and M.S. Rerrich (eds) Weltmarkt Privathaushalt. Bezahlte Haushaltsarbeit im globalen Wandel, Münster: Westfälisches Dampfboot, pp 50-70. Schwenken, H. (2003) RESPECT for all: The political self-organization of female migrant domestic workers in the European Union, Mimeo, Kassel: University of Kassel. Shinozaki, K. (2003) ‘Geschlechterverhältnisse in der transnationalen Elternschaft’, Beiträge zur feministischen Theorie und Praxis, vol 62, pp 6785.

111

Care and social integration in European societies

Sozialreferat der Landeshauptstadt München (2003) ‘Dass sie uns nicht vergessen…’: Menschen in der Illegalität in München, Munich: Stelle für interkulturelle Zusammenarbeit. Tießler-Marenda, E. (2002) ‘Die neue Zuwanderungsregelung für Haushaltshilfen in Haushalten mit Pflegebedürftigen’, Zeitschrift für Arbeitsrecht, vol 7, pp 233-7. United Nations Secretariat (1990) Managing the extent of female international migration, UN Expert Meeting on International Migration Policies and the Status of Female Migrants, Mimeo, San Miniato: United Nations Secretariat. Vertovec, S. (2001) ‘Transnational social formations: towards conceptual cross-fertilization’, in A. Rogers (ed) Transnational communities programme,Working Papers WPTC-01-16, (www.transcomm.ox.ac.uk/ working_papers.htm 12.07.04). Waldinger, R. and Fitzgerald, D. (2004) ‘Transnationalism in question’, American Journal of Sociology, vol 109, no 5 (March), pp 1177-95. ZAV (Zentralstelle für Arbeitsvermittlung) (2002) Jahresbericht, Bonn: ZAV. Zlotnik, H. (2003) ‘The global dimensions of female migration’, in Migration Policy Institute, Migration information source, March, Washington: www.migrationinformation.org.

112

Chapter title running head

Part Three Welfare-state policies towards care work

In this part, the focus is on the diverse forms of welfare state regulation of care work. In the framework of both case studies and cross-national comparisons, the contributions analyse modes of regulation and their consequences for gender relations, the lifestyle of families, and the labour market position/social integration of women. Nearly every European society is included. Welfare-state policies affect all characterisations of care work: informal, semi-formal, as well as formal.The provision of public services with formal employment is therefore only one form of the welfarestate policies in this sector, for – as emphasised by Chapter Six – “the very essence of social care lies in … the care provided by family members and relatives”. On the basis of comprehensive studies, the chapters present the different new developments that have been developed in the course of the societal modernisation of the last few centuries for the support of families and the promotion of gender equality policies.

113

Comparative approaches to social care

SIX

Comparative approaches to social care: diversity in care production modes Anneli Anttonen and Jorma Sipilä

Social care: divergent emphases Social care is a growing concern in welfare states and an ever more frequent object of comparative social research. A greater focus on social care is necessary to construct a better understanding of the principles and functions of modern welfare states and family life. We start out from the view that social care arrangements are an integral part of the wider order and structure of a society, as Pfau-Effinger (1998), for instance, has suggested. The forms that care arrangements take are deeply rooted in social and cultural contexts and they vary considerably across countries and even inside one country (see Anttonen and Sipilä, 1996, 1997; Anttonen et al, 2003). In this chapter, our aim is to describe and evaluate the processes in which social care is going public. By the concepts of social care and social care services, we will underline the role of the state and local governments as well as other formal service providers. Although our main focus is in formal care providers, it is of great importance to look at changing boundaries between the private and public responsibilities. Indeed, social care as a concept comprises care-giving work done both in the informal and in the formal settings (Daly and Lewis, 2000). In this chapter, social care relates both to care as work and care as public policy. Our intention is, first, to present a classification of care production modes in a welfare mix framework; second, to describe the processes of care going public by focusing on national social care patterns in five different countries; and third, to seek cultural explanations as to why they have developed into distinct systems and to understand why these countries are now adopting partly similar ways of rearranging social care. Since social care, as both work and

115

Care and social integration in European societies

policy, is so pervasive in a society, we have found it useful to restrict our analysis on the two dominant sectors of social care: the day-care of small children and the care of older people.The countries included in the analysis are Finland, Germany, Japan, the US and the UK. The conclusions of this chapter are based on a cross-cultural comparison: an international research project with five national teams has been studying how social care patterns have been developed and how they respond to the needs of social care inside different societies. The participating countries have been selected to represent divergent emphases of welfare mix. Underlying the choice of countries was the observation that, in providing social care, Finland makes greater use of the municipalities than other countries, Germany of welfare organisations, Japan of the family, and the US of the market. Britain has been considering and experimenting with different dominant production modes. While anchored to its national and normative contexts, social care is exposed to many pressures when societies are changing. In all affluent countries, social care systems are undergoing reassessment and reorganisation. Economic globalisation and the continuing crisis in the public sector are generating mounting pressure to find more competitive but politically acceptable social care solutions. Individualisation has meant among other things de-familialisation and changes in informal care production (Lister, 1997). Families are not self-evident sources of informal care any more.

Diversity in care production modes When constructing a comparative framework for social care, the welfare mix approach is of great help. The approach suggests that there are various kinds of providers. Moreover, it deals with the question of how the care production modes change over time and across countries. The welfare mix approach (Evers and Wintersberger, 1990) underlines the role of the providing agent: it is a matter of significance whether social care is provided by a private enterprise, a local authority or a female family member. Since caring plays such a crucial role in the reproduction of individuals and societies, there are many social institutions that want to intervene in its provision. Churches, the state, local authorities, employers, trade unions and civic organisations are all keen to make clear their positions on how informal care is to be carried out or how it should be complemented by care services. Studies on care arrangements show that the very essence of social care lies in informal caring, the care provided by family members and

116

Comparative approaches to social care

relatives. All other arrangements are more or less complementary.The restricted availability of data on informal provision, and its relative non-comparability, however, limits efforts to evaluate the status of informal care. Formal care, in turn, lends itself more readily to comparison but the task is not easy. There are surprisingly large international differences in the scale, scope and targeting of formal social care services. One and the same function may be arranged through services provided by government, by private businesses, by voluntary organisations and other welfare associations or through various combinations of these sources. A key reason for the academic invisibility of social care is that its production is highly substitutable between different sectors of a society, in ways that the production of social security, for example, is not. Social care is produced by a more varied complex of sources and is driven by a greater variety of rationales and incentives. Table 6.1 presents the main distinctive characteristics of five different modes of care production outlined in the form of stereotypes. Simplifying matters somewhat, we can start from the fact that care is produced in homes, in different kinds of welfare associations (charities, mutual aid societies and welfare organisations), in public organisations and in the market. Most often care is the responsibility of family and kinship members. The rationales that drive it are complex: tradition, religion, reciprocity, love and obligation.Where families and individuals fail in terms of these codes of responsibility, they seek support from other sources such as the state, but shame and stigma may follow. The sphere of household and family is the locus for unpaid female caregiving work. Social care might also be a duty of voluntary organisation. Giving help to members brings moral and psychic rewards and even commercially or politically useful publicity to individuals and organisations. It raises the status of the people who act as helpers and helps to sustain forms of social order and cohesion. Local voluntary organisations may or may not be supported by the wider community through state subsidies or joint working with public agencies. Welfare organisations represent modern versions of charities and voluntary organisations. These organisations are often interest-based associations with strong welfare aims.They vary from alternative kind of groups to well-established ‘state-like’ organisations with paid professionals working together with public agencies and supported by state subsidies.They even might have legal responsibilities to perform in the field of social care. Social care is also a commodity exchanged for money or for other goods in the market. Commodity exchange is based on contracts and

117

118

Source of resources

Mutual sharing of work and money (reciprocity, obligation)

Collection, work contribution, mutual responsibility

Collection, membership fee, public subsidy, service fee

Service charge, public subsidy

Taxation, service fee

Modes of provision

Informal caring

Voluntary and charity work, volunteering

Welfare organisations, NGOs

Commercial service producers

Public authorities (state and local governments)

Local government and its subcontractors

Company, independent care worker

Non-profit or for-profit welfare organisation

Voluntary organisation, charity, church, community

Family, household, friend, neighbour

Care provider

Table 6.1: The welfare mix of care production modes

Entitled citizen (resident)

Consumer, customer

Consumer, customer

Person approved for help

Member of household or family, friend or neighbour

Recipient

Professional or semi-professional paid worker

Professional or unskilled paid worker

Professional or semi-professional paid or semi-paid worker

Unpaid volunteer

Unpaid member of household or family, friend or neighbour

Mode of recruitment

Care and social integration in European societies

Comparative approaches to social care

it can take place between strangers. Prudent people may prepare for future needs by accumulating savings or taking out insurance. Finally, social care is frequently a statutory duty of the most local state authorities. Such provision often has historical roots in public poor relief. More universal and modern forms of social care integrate the local community and legitimate local government and politics. Local government may receive support from the central state, usually finance. Each production mode has its own basic logic and the differences between care production modes are clear. However, the ‘pure’ modes presented in Table 6.1 have less and less to do with the modes of provision that are actually found in different countries. An inescapable point of departure for the welfare mix approach is that the actors in the field of social care creatively mix the above presented ‘pure’ principles with one another (for example, Evers, 1993). The classification presented earlier in this chapter helps us, however, to map the diversity of providers in social care.

Care going public: from poor relief to modern social care services We are in the midst of a process in which the care of children and care of older people ‘are going public’, to use a phrase coined by Helga Maria Hernes (1987). In all five countries, care has gone public and there are a number of well-known reasons for this development: • changes in the labour market (women’s increased labour market participation); • changes in demography (ageing of societies, the decline of birth rate); • changes in democracy (women’s increased influence in politics and working life); • changes in values and norms (the increase of individualism in lifestyles). The slogan of care ‘going public’ describes the process in which an increasing proportion of the care functions of a society is removed from the entirely private domestic sphere of the household towards a greater overlap with the formal economy of the market, the voluntary and charitable sector and the state. The process of care going public has taken different forms in different societies. There are, however, some general trends to be identified.

119

Care and social integration in European societies

Compared with other elements of social policy, the development of social care services has been slow in industrial societies. Our study shows that it has rarely been possible to turn care services into large social issues in the same way as has been done with monetary income transfers and industrial health and safety, for example. Social insurance is based everywhere on laws, and functions as a system on the national level. Social care services, on the other hand, have in most countries remained services produced in local settings with no clear national regulations. Nearly everywhere, users of social care services are individually assessed and entitlements to social care are needs tested, and means tests are often used. This is the case in social care for older people in particular. Perhaps one reason for this is that social care depends on human work and takes place in a personal relationship (Knijn and Kremer, 1997). With older people, there is a special problem because of the enormous variation in care needs. One individual needs the cleaning of his or her home; another needs medical help and assistance with shopping. It is therefore no cause for wonder that there is no country in the world where older people have unlimited access to social care services.The extensive socialisation of care is also hindered by expense. Looking after young children and dependent older people are labour intensive activities that have become relatively more expensive over time, because they are areas where technical and cost efficiency is very difficult to raise. It is clear that care both costs a great deal and produces crucial benefits for all societies. In the case of older people, the material benefit to the wider society is not so easy to discern, but day-care for children seems to be by its nature a very special type of social care service. Governments and the interest groups that represent them usually have a strong national interest in the upbringing of children; children are going to become the work force and are an investment in the future (Esping-Andersen, 2002). Although social care services have largely remained local and their development has been characterised by slowness, some of the services have achieved a legitimate position in the entirety of the welfare state. In the Scandinavian countries, social care policy attained new dimensions as children’s day-care was turned into one of the most important political questions of the 1960s. Day-care became a service intended for the entire population.The watering down of class society had reached the point where it was possible to approve of children from different backgrounds being placed in the same kindergartens. The politicisation of the day-care issue was connected to several

120

Comparative approaches to social care

processes of social change, such as the growth in the employment of mothers with small children, the change in the position of the family and the revolution in family and gendered values. The kindergarten system expanded greatly in Germany, too, so this was not just a Nordic phenomenon. When social services began to reach the whole population, their nature changed. Social welfare, which stems from the poor relief tradition, has changed partly into social service.The function of modern social service is not to help people at the bottom of society with their individual troubles but to fulfil a positive function towards respected members of the society.The task of social welfare has been constructed in a positive way to make it a service.The other side of the coin is that especially in old age care the access to social care services is in many ways limited, even in Finland, which otherwise represents the socalled universal social services state (Anttonen, 2002). It is most unlikely that demands for national subsidies to provide care in local communities will be met without a democratic state, nor without political action on the part of women.When social care services have become a political issue the state has two alternatives: it can rely on a public solution (local governments) or on private solutions (subsidies for voluntary organisations or private firms). Eventually, the choices between these two basic alternatives depend very much on the homogeneity of values in the society. In history, strong social or ideological contradictions (for example, among churches or ethnic communities) have inclined the state towards non-public solutions, while widely shared values have made the rationality of public solutions more attractive (Finland). Before moving on to the next section of this chapter, it remains to be pointed out that the socialisation of care (the process of care going public) has not shifted the family and the woman away from their central position in care. Japan represents the country that most heavily relies on women’s unpaid care-giving work in elderly care and childcare. It is also the country where the role of informal caring is changing most rapidly (Peng, 2002). In Germany, the care of young children lies still very much in the hands of mothers, while the status of elder care has changed due to the introduction of long-term care insurance in 1995. In Finland, childcare has gone public on a much larger scale than has elder care.To conclude, in each of the five countries informal caring is a decreasing resource that has to be compensated for by extra-familial care arrangements.

121

Care and social integration in European societies

Social care patterns in five post-industrial societies Finland, Germany, Japan, the UK and the US represent quite different welfare mixes of social care. In what follows, we try to summarise what is essential about the care provision modes and the changes that have occurred in them in the five countries (see Anttonen et al, 2003)1. In a welfare mix framework, the countries prove to be different, each of them having their own distinctive principles for the provision of social care (services). Social care has gone public in each of the five countries in the sense that its production is leaving the informal, domestic world of the household and family and it is increasingly being managed and produced outside the home in more public ways by the civil society, market and state sectors. Three key trends can be identified in the process of care going public: the extension of state responsibility, the extension of civil society responsibility and the monetisation of care.These three development trends might take place concurrently or one of them might dominate. Moreover, there is a difference when looking separately at childcare and care for older people. It is interesting to note that care of children and care for older people might follow different paths so that there is not always any coherent national social care pattern to be identified inside one country (see Table 6.2). Some states seem to invest more public money on care for older people than on childcare (for example, the US), and some others more on childcare than on care for older people (for example, Finland).Table 6.3 also brings out how essential the role of school and health care is in the total provision of care services. With childcare services, it is difficult to draw the boundary between social care and Table 6.2: National patterns of social care in Finland, Japan, Germany, the UK and the US Regulative idea of Country social care policy

Main providers of social care along families

State support for social care arrangements

Finland

State responsibility

Local authorities

High

Japan

Extended family responsibility Local authorities, welfare organisations

Germany

Family responsibility (subsidiarity)

Welfare organisations, local authorities

Average

UK

Family responsibility

Local authorities, market

Low

US

Family responsibility

Market, welfare organisations Low

122

Low

Mixed solutions + public provision

For-profit service provision High + mixed solutions

UK

US

a

NGO and public provision + payments for home care

Germany

For-profit service provision + mixed solutions + school (5+)

Mixed solutions + school (4+)

NGO + public provision (a right to childcare place)

Public provision + NGO provision

Public provision (a right to childcare place)

Main providers of childcare services (children 3+)

Source: OECD, 1999, p 120. Amount of home help services: share of population aged 65 and over

Low

Low

Medium

Public provision + NGO provision

Japan

High

Public provision + payments for home care

Amount of childcare service provision

Finland

Country

Main providers of childcare services (children under 3)

High

Medium/high

High

Medium

Medium/high

Amount of childcare service provision

Health care, private and publicly funded (Medicare)

Public social care services + mixed solutions

Care insurance + NGO and public provision

Public and private provision of health care + care insurance

Public provision of elder care services

Main providers of elder care services

Table 6.3: Childcare and elder care service provision in Finland, Japan, Germany, the UK and the US

High (16)

Low (5)

Medium (10)

Low (5)

High (14)

Amount of home help servicesa

Comparative approaches to social care

123

Care and social integration in European societies

education. With old-age welfare the critical boundary lies between social care and health care. The Finnish social care pattern (see Kröger et al, 2003) is, like that of the other Scandinavian countries, strongly state-led. The primacy of the public sector has after the Second World War received support from the political centre as well as the left. The Finnish case shows us that national and local governments are able to create social care systems with a large number of services. Until the 1980s, the role of the public sector as provider and financer of services grew bigger and bigger. The most typical features for the Finnish social care pattern are the universalisation of social care services, the growth of national regulation and national legislation as well as individualisation of social care benefits. In some cases, citizens have won social rights to care services. The essential point today, however, is that the state’s support is not only directed to the professional provision of social services in the municipalities; alongside them, financial support for those taking care of their family members, both children and the elderly, has expanded since the 1980s. In the 1980s, reforms were carried out which opened the doors to the practice of a more pluralistic social care policy than before. The municipalities were given the right to buy services from companies and associations, which has to some extent narrowed the role of the municipalities as service providers.The second important reform that has changed social care policy concerns service rights. In 1985, all parents of children under three received the right to day-care, and in 1990 this right was extended to all children under school age. As far as older people are concerned, the same kind of right to services has not been granted. All in all, the Finnish social care pattern has shifted in the last two decades from a state-led one closer to the welfare mix model. Germany presents a contrasting pattern to that of Finland (see Evers and Sachße, 2003). Among the five countries, Germany is the best representative of welfare mix in the field of social care. Social care services are numerous with a wide coverage and a multitude of actors operating in the field. Despite enormous political trauma, defeat in two world wars, dictatorship and division between East and West, there is a pattern of continuity in the evolution of social care for both children and older people. The role of welfare associations (Wohlfahrtsverbände) has been a powerful one in the modernisation of social services.The civil-societydriven welfare state project got underway when a large number of local associations were established in big German cities in the early

124

Comparative approaches to social care

19th century. After the First World War, a fierce struggle took place over the direction in which the welfare state should head. The Social Democrats wanted to make social and health care a duty of the public sector, but they lost the fight to the nationwide welfare associations and bourgeois parties. This pluralist model was reinstated after the Nazi period and extended to the East after re-unification in 1990. The high number of central welfare organisations also reveals the importance of ideological cleavages in Central Europe: political and religious communities have their own national organisations, and so too do the uncommitted ones. Both the kindergarten and social insurance emerged after unification in 1870 and have remained core determining ideas ever since. Under Bismarck, Germany was the pioneer of social insurance. Similarly, in the late 20th century, when health insurance proved to be insufficient for the care for older people, Germany was the first nation to develop long-term care insurance. It was a compromise built on the main elements of German care policy: informal care work still constitutes the core, but now it is supported with money coming from care insurance. At the end of the 1990s, the traditionally strong German investment in kindergartens for over-three-year-olds was further strengthened when kindergarten care for children over three years of age became established as a legal right for parents. Social care pattern in Japan strongly reflects the contradictions inherent in modernisation (Takahashi, 2003). On the one hand, Japan has long clung to the idea that care is the duty of the family. Japanese people live in three-generation family units more often than people in our other countries and the norm still exists, although it is weakening, that women should care for their parents and parents-in-law. On the other hand, Japanese women participate in paid work as much as women do in Germany and in Britain. Since state policy has stressed the family’s responsibility for care, public care services have been seen as stigmatising. However, families have often been able to avoid this by arranging for the long-term care of their older people within the health care system. By the early 1960s, social welfare legislation was thoroughly revised and complemented. Yet, the field of social care services was poorly developed. The Japanese middle class in particular became in a way trapped between the poor relief ideology and the culturally preferred reliance on family care. The principle of social care without stigma available for everyone who needs it was introduced in the legislative reforms of 1990. The care insurance legislation in 2000 was a further development of this idea. The government has taken a much more

125

Care and social integration in European societies

active role than earlier to promote service delivery both in childcare and in elder care. The Law on the Welfare of Children (1998) was enacted to facilitate parental choice and to increase flexibility in service provision so that it would be more responsive to the needs of users. Since 2000, private day-care providers have also been accepted to operate as authorised providers. The current Japanese old-age welfare offers a wide range of care services for older people. Still, the health care system has the main responsibility for the care of older people.According to the new system, municipalities are responsible for the provision of social care services. To conclude, social care needs are growing so fast in Japan that it can hardly stop moving further towards a caring state in the Western meaning. In the UK, the policies and provision that affect the care for older people and childcare present as a series of paradoxes rather than a coherent story (see Baldock, 2003). The Beveridge Report and the associated legislation that created the post-war ‘welfare state’ made no provision for either. Both childcare and care for older people remained essentially private, family responsibilities. However, a part of the services for elderly people was provided by health care without stigma. In these respects, the British experience most closely resembles that of Japan. State intervention took place only selectively where private provisions failed. Thus neither state nor private for-profit provision were explicitly supported by public policy.The result was a great variety of ad hoc solutions and huge variations in access to help. Accordingly, social care services have not entirely thrown off their poor law inheritance and access to them remains unequal and contingent upon administrative discretion, geography and even social class. At the turn of the century both childcare and care for older people have at last received a degree of systematic political attention, but in quite different ways.The ‘New Labour’ administration is the first postwar government to put in place a comprehensive childcare policy to encourage more women into paid employment.The same government has rejected, on grounds of cost, the recommendation of the Royal Commission on Long Term Care to establish a system of universal state support for the social care of older people. Unlike the US, Britain has a mixed economy of social care by default rather than by intention. In the US, social care arrangements both at the beginning and at the end of life are market-reliant systems (see Heffernan, 2003).Yet, social care services are not produced only by private and for-profit providers, for the role of voluntary agents is also notable. The main difference between the US and the other four countries in our study is that, in

126

Comparative approaches to social care

the US, the role of the public sector as service provider is very marginal. A decision by Franklin Pierce (1854) to keep the federal government out of any responsibility for care has had long-lasting consequences. In the field of elder care mutual aid societies and other welfare organisations have played a crucial role. Accordingly, the public almshouses (county old-age homes) turned out to represent the most negative form of social care. In the case of the US, it should be pointed out there has never existed any kind of national kindergarten movement, although welfare associations have taken some responsibility for the care of those children who live in risk situations. The same principle applies to the public sector, which has provided day-care services for families who cannot otherwise arrange childcare while parents are working. Traditions of hostility towards state intervention and the heterogeneity of the population have led to people relying on a combination of family and for-profit providers in children’s day-care. The high proportion of children in day-care is the result of the structure of the market: wages and tax rates are low and so are the wages of the care staff.There are also limited subsidies in form of tax reductions for parents and public financial support for providers. In the field of elder care, the history more resembles other industrial countries. The Medicare system, which came into force in the mid1960s, is a compensation system for the medical expenses of old people, but it also supports to some extent home care, though in different ways in different states.The market also has a central role as a provider of services for old people.The US experience gives us some evidence that market-driven solutions do work in some contexts.Well-off families are able to purchase social care at the market price whereas low-income households to much greater extent have had to rely on informal care resources. The real costs of long-term care, however, are so high that even well-off American citizens meet problems on the care market. Today, the US is a country with one of the highest numbers of working women. This could suggest that social care had become a major social policy issue. This is not, however, the case. It is precisely the area of family support where the US welfare state really makes a difference, alongside Japan, when compared to European welfare states. There is no big breakthrough visible on the horizon to improve the support given for the care work of ordinary households such as now can be seen in the care policy of Germany, Japan and the UK. The short country description shows that all of the modes of care provision (Table 6.1) can be found in all of these countries. The ways of social care provision are not, however, permanent. In every country,

127

Care and social integration in European societies

there have been political struggles that have led to care provision modes being changed.There is no reason to believe in a cultural determinism in which it is assumed that a social care pattern that prevails at a certain time will survive from one age to the next. In times of major social and political change, social care arrangements can be among the first aspects of welfare provision to be questioned and ‘reformed’. Historically public opinion tends to swing back and forth between two extreme positions, one stressing the responsibility of individuals and families for their own welfare, and the other expecting the wider society to take responsibility for at least some aspects of care (Midre, 1995, pp 115-35).

Understanding cultural diversity in care provision modes: individualistic and familistic care policies The restriction of public social care to poor relief was a self-evident part of 19th-century social policy, which was based on the family model upheld by the male breadwinner ideology (Lewis, 1992). A worker became a man who had an economically dependent wife to take care of his daily needs and to look after his home and children. By the end of the 19th century, there was a powerful familistic undercurrent flowing through emerging social policies. The concept of a familistic social policy thus refers to a model in which the obligations of men and women become differentiated as the wagelabour-based societal model spreads. Social policy founded on the male breadwinner model has nevertheless allowed certain tasks to slip out of the compass of the family. For example, in the course of its expansion health care has begun to take some of the responsibility for care of older people, since no clear boundary can be drawn between health care and social care. It has always been possible to designate old people needing care as sick. As a central institution in society, school is also performing a care task during the time children are at school. In many countries preschool has come to form an almost all-day day-care institution. When analysing the care of older people, Daatland (2001) comes to the conclusion that familistic social policy was the norm in more or less all countries in earlier years. However, this policy was in the Beveridge-type welfare system (the UK) and later in the Nordic countries replaced by provision according to individual needs and rights: for the latter, Daatland coins the term ‘individualistic social policy’. The countries with systems based on individualistic social policy have today the most developed social care services. Another

128

Comparative approaches to social care

factor common to them is that the legal obligations of adult children to support their parents were removed from legislation in the 1950s and 1960s. Globally, only very slowly has acceptance come for the idea that responsibility for the care of children and older people or infirm parents can belong to someone other than family members and in particular female family members.Yet, the extent to which the family is responsible for the care of its members varies considerably from one country to another. At one extreme there are rich countries like Japan, where families right down to the present day have had wide responsibility for care. Familistic states tend to see the welfare state and the family as alternatives, even as opponents. Services and other public initiatives are seen as intruding on family territory. Services may be crowding out the family, and represent a moral risk. (Daatland, 2001, p 18) At the other extreme there are countries like Finland, where the state and municipal authorities have assumed a very broad responsibility for the care of small children as well as some responsibility of older people in need of help. In the countries where there has been a shift from familistic to individualistic social policy, the whole ideology of care has changed. Support for care provided in homes with various benefits and services in kind has now begun to be seen as a positive matter.The individualistic position tends to see the family and welfare state as complementary rather than as mutually exclusive. Social care services are seen as a supplement to family care and they are not thought to threaten family solidarity. Rather it is a feature of the individualistic model that families are considered to be more willing to provide help when care-giving work will not exhaust their members. While care has been going public, familistic social policy has had to give way.This does not mean that families and unpaid domestic work no longer constitute the foundations on which the Western way of life is built. Social reproduction must to a critical extent take place in the home, for neither the state nor any other formal institutions can afford to take care of all children and older people around the clock. The fact that familistic social policy has given ground only means that it is no longer left solely in the hands of families. Many feminist theorists (for example, Pfau-Effinger, 1998; Lewis, 2001) have paid attention to the transformation of the male breadwinner model. In countries where the model can be today described by the concept of dual breadwinner

129

Care and social integration in European societies

model, there are more social care services available for citizens than in countries where the main breadwinner is even today a male worker. Our main argument in this chapter is that care is going public but in a slightly different way in different societies. Earlier, we pointed out that the process of care going public relates to at least increasing state responsibility, civil society responsibility and monetisation of care (or marketisation of care). These three development trends might take place concurrently or one of them might dominate. However, there is a difference when looking separately at childcare and elder care. It would seem to be the case that in the care of small children (under three years of age) it is easier to stick to the familistic ideology because all children have at least one parent to whom according to the law the care and maintenance obligation belongs (Millar and Warman, 1996). In the field of elder care all the countries tend, however, to organise institutional care services because many old people would be extremely vulnerable for lack of any immediate family. In an OECD analysis (1999, pp 119-20), institutional care for older people was of surprisingly similar proportions in the five countries. The share of the population aged 65+ living in institutions was lowest in the UK (5.1%) and highest in Germany (6.8%). In countries with a strong familistic social policy, there has not been much enthusiasm for organising day-care services (pre-school constitutes an exception), while in countries with an individualistic social policy orientation support for the care of small children with services and money has been generally accepted. It is evident that the individual social policy orientation is gaining more ground everywhere. When we have examined the care policy of the present day, the centrality of the expansion of day-care in Germany, Japan and the UK stands out. Childcare is becoming more and more public, when governments in different countries now actively promote women’s labour market participation. The lines presented earlier in this chapter are weighted in different ways in the countries we have studied. The strategic choice made by the US has been to favour paid employment for women as well as men and the purchase of care from the market.The Japanese relied for a long time on the availability of unremunerated domestic work meeting stronger and stronger obstacles to maintain ideology on extensive family responsiblity. The Finns, for their part, first built a service system which was heavily subsidised by the public sector and then created alongside it payments for care schemes at home covering both small children and older people.

130

Comparative approaches to social care

The basic choices made have been crucially affected by the position of women in the labour market. In the US, the proportion of women in the work force has long been rising and is now at a very high level. In Finland, women’s share of the work force was very high at the end of the 1980s but fell to some extent after the introduction of children’s home care allowance and the economic recession of the early 1990s. The US and Finnish strategies support women’s full-time employment, while the German, Japanese and British solutions have in practice preserved the tradition of part-time female employment. Recently care allowances have become a new alternative to public support for care giving. As to which are superior, services or care allowances, opinions are divided, also among feminists (for example, Sipilä and Simon, 1994). Put briefly, services support participation in working life and at the same time economic growth; on the other hand, they are usually more expensive for the state than allowances. Allowances create a ‘right to care’ and ‘right to mother’, which are also recognised feminist goals. Obviously, the paid employment strategy improves the economic position of women more than allowances, not to mention unpaid domestic work. However, it is not equally obvious that paid employment is the most desirable way to allocate resources given the particular nature of care work and those cared for. High quality care calls for a personal relationship and it consumes a great deal of time; neither of these can be very easily achieved within organisations based on paid work. Our conclusion is that several parallel strategies are needed to support care. As to the question of the alternatives which different societies have for replacing family care, it would seem that neither voluntary work nor a genuine market would suffice as a substitute for the family. Although social care represents, in Richard Rose’s (1989) terms, an area where there is a high substitutability between the monetary and the household sectors, the market will scarcely be able to provide a sufficient volume of care services for all citizens without public support. In societies that hold equality and justice as their ideals, only the state or a form of social insurance subject to public control will be able to build a viable system for financing care. Even if the services themselves can be produced by many kinds of providers: families, associations, companies and municipalities, it seems that modern care policies cannot rely on any of the five providers of social care. None of them seems able to create alone the resources required. Each of them needs public support. This may not be called convergence, but certainly this means partial convergence. Differences

131

Care and social integration in European societies

in national patterns will persist, but all of these patterns will be based on welfare mixes and public financial support. Finally, in some countries the process of care going public has already met its limits. In countries where care has gone most public, such as in Finland and Sweden for instance, the governments have carried out reforms that have shrunk the scope of public service provision and limited citizens’ access to some social care services by tightening eligibility rules or/and by elevating service fees that earlier used to be nominal ones (Anttonen, 2001; Palme et al, 2002). This means that forerunners and latecomers in the field of public policy of care are facing the same problem: how to produce care in a situation where neither family-based care nor state-led social care service provision can be the only solution. Note 1 The five country descriptions are based on chapters published in Anttonen et al (2003). The authors of those chapters are listed here. Finland: Teppo Kröger, Anneli Anttonen and Jorma Sipilä. Germany: Adalbert Evers and Christoph Sachße. Japan: Mutusko Takahashi. UK: John Baldock. US: Joseph Heffernan. References

Anttonen, A. (2001) ‘The politics of social care in Finland: child and elder care in transition’, in M. Daly (ed) Care work: The quest for security, Geneva: ILO, pp 143-58. Anttonen,A. (2002) ‘Universalism and social policy: a Nordic-feminist revaluation’, Nora, vol 10, no 2, pp 71-80. Anttonen, A. and Sipilä, J. (1996) ‘European social care services: is it possible to identify models?’, Journal of European Social Policy, vol 6, no 2, pp 87-100. Anttonen, A. and Sipilä, J. (1997) ‘Cinco regimenes de servicios de atencion social’, in L. Moreno (ed) Union Europea y Estado del Bienestar, Madrid: CSIC, pp 431-58. Anttonen, A., Baldock, J. and Sipilä, J. (2003) (eds) The young, the old and the state: Social care systems in five industrial societies, Cheltenham: Edward Elgar. Baldock, J. (2003) ‘Social care in the UK: a pattern of discretionary social administration’, in A. Anttonen, J. Baldock and J. Sipilä (eds) The young, the old and the state: Social care systems in five industrial societies, Cheltenham: Edward Elgar, pp 109-41.

132

Comparative approaches to social care

Daatland, S.O. (2001) ‘Ageing, families and welfare systems: Comparative perspectives’, Zeitschrift für Gerontologie und Geriatrie, vol 34, no 1, pp 16-20. Daly, M. and Lewis, J. (2000) ‘The concept of social care and the analysis of contemporary welfare states’, British Journal of Sociology, vol 51, no 2, pp 281-98. Esping-Andersen, G. (2002) ‘A child-centred social investment strategy’, in G. Esping-Andersen with D. Gallie, A. Hemerijck and J. Myles (ed) Why we need a new welfare state, Oxford: Oxford University Press, pp 26-67. Evers,A. (1993) ‘The welfare mix approach: understanding the pluralism of welfare systems’, in A. Evers and I. Svetlik (eds) (1993) Balancing pluralism: New welfare mixes in care for the elderly, Aldershot: Avebury, pp 3-31. Evers, A. and Sachße, C. (2003) ‘Social care services for children and older people in Germany: distinct and separate histories’, in A. Anttonen, J. Baldock and J. Sipilä (eds) The young, the old and the state: Social care systems in five industrial societies, Cheltenham: Edward Elgar, pp 55-79. Evers, A. and Wintersberger, H. (eds) (1990) Shifts in the welfare mix, Vienna: Campus. Heffernan, J. (2003) ‘Care for children and older people in the United States: laggard or merely different’, in A. Anttonen, J. Baldock and J. Sipilä (eds) The young, the old and the state: Social care systems in five industrial societies, Cheltenham: Edward Elgar, pp 143-66. Hernes, H.M. (1987) Welfare states and woman power: Essays in state feminism, Oslo: Norweigian University Press. Knijn,T. and Kremer, M. (1997) ‘Gender and the caring dimension of welfare states: toward inclusive citizenship’, Social Politics, vol 4, no 3, pp 328-61. Kröger, T., Anttonen, A. and Sipilä, J. (2003) ‘Social care in Finland: stronger and weaker forms of universalism’, in A.Anttonen, J. Baldock and J. Sipilä (eds) The young, the old and the state: Social care systems in five industrial societies, Cheltenham: Edward Elgar, pp 25-54. Lewis, J. (1992) ‘Gender and the development of welfare regimes’, Journal of European Social Policy, vol 2, no 3, pp 159-73. Lewis, J. (2001) ‘The decline of the male breadwinner model: implications for work and care’, Social Politics, Summer, pp 152-69. Lister, R. (1997) Citizenship: Feminist perspectives, Basingstoke: Macmillan. Midre, G. (1995) Bot, bedring eller brød? Om bedømming of behandling av sosial nød fra reformasjonen til velferdsstaten, Oslo: Universitetsforlaget.

133

Care and social integration in European societies

Millar, J. and Warman, A. (1996) Family obligations in Europe, London: Family Policy Studies Centre. OECD (Organisation for Economic Cooperation and Development) (1999) A caring world: The new social policy agenda, Paris: OECD. Palme, J., Bergmark, Å., Bäckman, O. (2002) ‘Welfare trends in Sweden: balancing the books for the 1990s’, Journal of European Social Policy, vol 12, no 4, pp 329-46. Peng, I. (2002) ‘Social care in crisis: gender, demography, and welfare state restructuring in Japan’, Social Politics, Fall, pp 411-43. Pfau-Effinger, B. (1998) ‘Gender cultures and the gender arrangements – a theoretical framework for cross-national gender research’, Innovation, vol 11, no 2, pp 147-66. Rose, R. (1989) Ordinary people in public policy: A behavioural analysis, London: Sage. Sipilä, J. and Simon, B.L. (1994) ‘Home care allowances for the frail elderly: for and against’, Journal of Sociology and Social Welfare, vol 20, no 3, pp 119-34. Takahashi, M. (2003) ‘Care for children and older people in Japan: modernizing the traditional’, in A. Anttonen, J. Baldock and J. Sipilä (eds) The young, the old and the state: Social care systems in five industrial societies, Cheltenham: Edward Elgar, pp 81-108.

134

Social rights and care responsibility in the French welfare state

SEVEN

Social rights and care responsibility in the French welfare state Jeanne Fagnani and Marie-Thérèse Letablier

Although the French welfare state is characterised as a conservative corporatist welfare regime in most research comparing social protection systems in Europe, it differs from the other corporatist welfare states when social care is taken into account. Following the Esping-Andersen classification (1990), conservative welfare regimes build on corporatism and rely on families taking responsibility for providing care for children, older and disabled people. However, the French welfare state differs from other corporatist-conservative countries in that the state has responsibility for providing social care. However, is it a woman-friendly welfare state? Social care services have a real impact on the social integration of women, but what about the impact on gender equality? While caring for older people remains an important issue, the focus of this chapter is childcare and family policies. Recognition of care work by the French welfare state is associated with strong support for the family as a fundamental social institution.The social security system is still based on the family unit and not the individual.The legitimacy of state action in this domain is not questioned. Family policies receive widespread support and are constantly a subject of public debate (Hantrais and Letablier, 1996). First, this chapter reviews the historical background to the state–family relationship in France to provide an understanding of the place of social care in the French welfare state. Then, it looks at the extent to which the rights of families to provision for care are written into labour law, the tax and social security systems. Legal recognition of family rights to care has an impact on women’s employment patterns and on women’s social rights as well. They also impact on the management of childcare. In this field, state support for childcare is both generous and diversified. Childcare benefits and services form a complex system in which responsibilities are shared

135

Care and social integration in European societies

between state and families. Enterprises, non-profit organisations and the market play a minor role in comparison to the state. However, the broad consensus among economic, political and civil society over the legitimacy of the state to intervene in family affairs conceals divergence over the principles behind public action and over the measures being implemented. Should women, especially mothers, be encouraged to provide care at home and be paid for it, or should they be encouraged to participate in the labour market through allowances for childcare outside the home? Policy actors are divided over the issue. However, since the 1980s, the trend has been to encourage women to be employed and to develop childcare provision for young children.

Historical background: the French welfare state and social care France has an explicit and institutionalised family policy that implies legal recognition of the family as a social institution playing a major role in the maintenance of social cohesion. Since the end of the 19th century, childcare has always been an important issue in family policy. The principles underlying public action towards childcare are imbedded in Republican ideas that organise the sharing of care responsibilities between families and the state. The history of public childcare in France is bound up with a conception of the state (l’État paternaliste) that has an obligation to protect maternity, childhood and the capacity of women to work outside the home. This conception developed at the end of the 19th century when motherhood was considered to need attention from the state for demographic reasons. It was closely associated with citizenship. Maternity leave was created at the beginning of the 20th century. Until the 1960s, French family policy was still influenced by the pro-natalist concerns of the interwar period and explicitly supported the traditional ‘male breadwinner model’; single-earner families were provided with a ‘Single Salary Allowance’ (Martin, 1998; Fagnani, 2000a). The aim of this scheme was to confine women to the role of full-time mothers and housewives because it was assumed that this would contribute to the welfare of young children. In fact, policymakers were very much concerned about the relatively high infant mortality, and their priority was to reduce it in the post-war period.Accordingly, the labour-force participation rate of mothers remained very low until the mid-1960s.

136

Social rights and care responsibility in the French welfare state

From the 1970s onwards, however, dramatic changes were introduced in family policy. The level of the ‘Single Salary Allowance’ was progressively reduced and restricted to low-income families, and eventually abolished by 1978. Against the background of an acute labour shortage, the French government began to set up communityfunded day-care centres in an attempt to attract women into the work force. Indeed, there was a growing demand for qualified women to occupy jobs in the tertiary sector (education, health, social services, administration and banking). At the same time, as a result of an interactive process, the increase in the participation of married women in the labour force stimulated demand by couples for the expansion of public day-care facilities and other social services. Essentially stemming from the urban middle classes, they were actively supported by the women’s movement, which put strong emphasis on equality issues in the labour market.All of these factors provided a strong impetus for family policy change: French family policy began to incorporate the model of the ‘working mother’. The transfer of a growing proportion of unpaid private care-giving responsibility into paid public provision progressively took place. Particularly at the beginning of the 1980s, under Socialist governments, funding allocated by both local authorities and the National Family Allowance Fund (Caisse nationale d’allocations familiales, or CNAF) for the construction of crèches was substantially increased. This coincided with, and allowed, the entry of many mothers with young children into the paid labour force1. Since the early 1980s, the number of childcare places in crèches has increased regularly to reach a total of 201,000 in 20022 (crèches collectives and crèches familiales3). Around 15% of children under the age of three were being cared for in crèches in 2002, whereas 29% were cared for by a registered childminder and 38% by one parent receiving a parental leave allowance (Table 7.2). At the same time, benefits in cash were being implemented in order to reduce childcare costs for the families and to restrict informal work. Although mothers remain the main providers of care for children under three, state intervention in childcare is approved and desired by parents. It is still linked to a conception of the state as a protector of childhood and a guarantor of equal opportunities for children. These conceptions of childhood and the upbringing of children are rooted in the principles of the Third Republic (Rollet-Echallier, 1990). Children are a ‘common good’ and the wealth of the nation which, in return, has some obligations towards them. Therefore, childcare came to be considered as a state responsibility and a public issue. Family policy also is a childhood policy, which is part of a larger societal

137

Care and social integration in European societies

project according to which the state has to contribute to children’s education from as early as possible (Jönsson and Letablier, 2003). The idea of an early and collective socialisation for children is well perceived. It was intended to provide children with an equal opportunity to participate in society, no matter what their economic or social origins are. Education is one of the pillars of the Republican project. Childcare support was also part of a pro-natalist concern: parents should not have to arbitrate between the mother’s paid work and an extension of family size. The demographic issue has been a vital component in family policy since the 19th century. Just after the Second World War, when the social security system was created, family support was still aimed at encouraging families to have more children and also at raising the income of large families. Although incentives to raise the birth rate have become much less explicit, family policy measures are still imbued with these ideas: family allowances are given only after the second birth, and their level increases with the number of children. The current situation results from this history and from the ideology of ‘freedom of choice’ for mothers to care for their children or to remain in employment, which has driven public policies for the last decades. Even though a process of formalisation of childcare work was going on, caring rights have been recognised for families, especially under the form of paid leaves which maintain the social security rights of carers (however under a low income ceiling) as if in employment. During the 1990s, the French government attempted to promote a sharing of parental responsibilities, so that men and women could contribute more equally to paid and unpaid work. Paternity leave was created in 2002 with the idea that, by involving fathers in parental responsibility as soon as the child is born, the parental responsibility could be shared more equitably in the future. Furthermore, greater equality within the family should be a condition for improving equality within the work sphere. The laws reducing working time from 39 hours to an average of 35 hours a week were also expected to improve the work–family balance and to improve equality between men and women. Whereas the main objective of the laws was to create jobs by encouraging work-sharing, other objectives were an increase in work flexibility by modernising and restructuring work organisation, and an increase in the time devoted to the family or to leisure and other social activities. One of the outcomes has been the narrowing of the working time gap between men and women. When looking at the outcomes in terms of work and family life balance, it appears that the reduction of working time has frequently

138

Social rights and care responsibility in the French welfare state

had a positive impact, especially for working parents with young children. A survey conducted with a large sample of parents with children less than six years old shows that 60% respond that they perceive a positive impact of the reduction of their working time on the reconciliation of their work and family life (Fagnani and Letablier, 2004). More often than other parents, who report a negative impact of the reduction of working time on their daily life, those ones face better working conditions, better human resource management in their enterprise and a family-friendly employer. More frequently than the dissatisfied, they have regular working time and standard hours. Fathers, as well as mothers, say they spend more time with their children, especially when the reduction in their working time is calculated on a weekly basis. This working policy is not neutral in terms of gender equality and in terms of care work sharing between men and women. The rules governing working time that apply to all workers, both men and women, are considered to be more equitable than individualised arrangements that encourage part-time work. However, changes in the domestic sphere are still very low (Algava, 2002).

Caring rights of families In the meantime, part of care work was transferred from the household to public and private institutions, new formal forms of family-based care work substantially gained importance over the two last decades. They are based on a specific type of social rights; that is the rights for families to give care. These rights are connected with temporary life phases during which parents provide care for their children, or adults to a dependent relative, handicapped or old. Not only cash for care is provided to the carers who stop working for a while, but also social security rights are given for those who carry out the care work. Although the amount of the payment is not always a replacement wage, home caring is viewed as a transitional stage of the life course deserving financial transfers from the state and protection by social security systems. In this part of this chapter, we look at the extent to which the right of families to provide care for relatives has been written into labour regulations, the tax and social security systems.

Caring rights in labour law Most of the rights in the Labour Code relating to caring concern leave that employees are allowed to take when they are parents or when

139

Care and social integration in European societies

they have to care for a disabled person or an elderly relative. Hence, maternity leave, paternity leave and leave for caring a sick child can be seen as fundamental rights of families to care for their relatives. • Maternity leave: every pregnant woman is entitled to 16 weeks’ maternity leave which can be extended to 26 weeks for a third child or multiple births, and in cases of health problems. Redundancy during maternity leave is forbidden, and employees cannot be fired during the four weeks following leave. Maternity leave is paid for by the health insurance system: women employees receive their wage while on leave but under a certain ceiling. The difference between the former salary and the replacement wage can be supplemented by the employer. • Paternity leave: since January 2002, fathers have been eligible for a two-week paid leave following the birth of a child4. It is a right to care written into the Labour Code, as is the maternity leave. • Parental leave: after maternity leave (or adoption), parents can take a parental leave or work part time (not less than 16 hours a week) if they have been working in the enterprise for at least one year. Parental leave is linked to employment rights, and is not paid, but parents can apply for a child rearing allowance, granted under specific conditions of employment. The duration of parental leave is one year but can be extended twice until the child is three years old, with one more year in case of illness or disability (Fagnani, 2000b). • Leave to care for a sick child: every employee is eligible for an unpaid leave to care for his (her) sick child under the age of 16. Legally, periods of leave cannot exceed three days (or five days in specific cases), but this is a minimum and most collective agreements have special arrangements as in the public sector where employees can take 14 days a year to care for a sick child. • Parental leave to care for a child with a serious illness: in cases of a serious disability or illness of a child aged under 16, every employee with at least one year of employment in the enterprise is entitled to paid leave to care for her/his child, or to work part time. The level of the allowance depends on the duration of work in the enterprise and on the family structure. A similar period of leave is possible for employees who need to care for a relative at the end of life, either a child or a parent living in the same house.

140

Social rights and care responsibility in the French welfare state

Caring rights and social citizenship Caring rights are not only related to labour law. They are recognised in the principles governing access to social rights. Married or cohabiting women who are not in paid work are eligible for health insurance benefits because of their link with a male breadwinner.This system of derived rights can be viewed as a form of recognition of care work performed at home by women, as wives and mothers. In the 1990s, these rights were extended to same-sex cohabiters.

Caring rights in pension schemes Pension schemes take account of caring duties in different ways.Women used to be the only recipients of these family benefits, but a decision of the European Court of Justice in response to a claim by a French widowed civil servant who had raised his children, recognised that these rights have to be given to any person who has spent time caring (Lanquetin and Letablier, 2003). Currently, the rules have been reviewed in France in the public sector to take account of the decision of the European Court of Justice. Family benefits can be no longer derived from maternity but are to be recognition of care work. Whatever the reasons for these rights, they can be found in all pension schemes and represent a considerable amount of money. However, in spite of their importance and their generosity, the diversity of the rights related to care in pension schemes is a source of inequalities among recipients from different pension regimes (general regime, civil servant regime or various professional regimes). Some rights can be found only in certain regimes: for instance the right to retire after 15 years of work for women with at least three children in the public sector, irrespective of the age of retirement. Other rights can be found in all pension schemes but are implemented in different ways. The widow’s pensions exist in all regimes, but under very different conditions.The wide variations in implementation produce inequalities between recipients. Not only does the substance of entitlements differ but also the funding mechanisms: some are funded by the pension insurance system itself, others by family policy funds, or by a specific solidarity fund for older people. Currently, caring rights of families in pension schemes are well established, but most experts state that the complexity of the system, and the inequalities it generates, are in need of reform. Six different ways of taking caring rights into account can be distinguished according to their objectives or their impact:

141

Care and social integration in European societies

1. early retirement for mothers without any reduction in the pension; 2. an increase in the level of mothers’ pensions in relation to home childcare work; 3. an increase in the pension of the breadwinner according to the number of dependent persons (non-working wife and children); 4. an increase in the pensions of both parents as a reward for their care work; 5. ensuring a standard of living for widows, especially for women without personal social insurance; 6. or by ensuring a minimum income for retired people. The changing context may make necessary a reform of these benefits, but their principles are still valuable because women continue to handle most of the caring duties at home, even when they are in paid work, and hence cannot have similar career paths to men, nor similar pensions. Finally, this development of rights to give care widens the conception of social citizenship which is no longer limited to formal employment but takes account of other types of work that need to be supported.

Childcare policy The historical background explains why childcare has been a major issue on the political agenda in France. A broad consensus is still found among social partners and economic actors as to the responsibility of the state towards children, and towards social care in general. Some commentators advocate a dramatic increase in collective childcare facilities but the idea is not on the political agenda, and the development of crèches was not given priority by the government that came to power in 2002. Since unemployment has been a major preoccupation for successive governments and for public opinion, the increase in subsidised individual care arrangements has been perceived as a means to create employment (Fagnani, 1998). The wide diversity of state support can be explained by the combination of these two policy areas, family and employment. The result is a great diversity of care arrangements. In addition to public collective facilities like crèches, private care by childminders and family helpers has developed since the 1980s. This private care is subsidised both by the state and by the social security. One of the aims of this support was to limit an extension of informal employment in the social care sector. Since 1994, the increase in funds allocated by the CNAF for crèches has been limited when compared with the much higher funding

142

Social rights and care responsibility in the French welfare state Table 7.1: Public expenditurea devoted to individualised child– care arrangements (1994-2000) (in units of Constant Million €)

Child rearing benefit (APE) Allowance to employ an approved childminder (AFEAMA)b Allowance for childcare in the home (AGED)c

2000

% of increase 1994-2000

2,799.43 1,694.95 134.60

+197 +147 +57

Notes: a Paid by the social security system (all schemes). b AFEAMA (Aide à la Famille pour l’Emploi d’une Assistante Maternelle Agrée): an allowance provided to working parents who have at least one child aged under six cared for by a registered childminder. This childcare allowance covers the social security contributions to be paid by the employer of the registered childminder. An additional and income-related financial contribution is also given to the family: €203 maximum for a child under three years old. c AGED (Allocation de Garde d’Enfant à Domicile): income-related amount partly covers social security contributions due by a family who employs someone at home to care for their child(ren). It also allows income tax deduction for part of the costs. Source: CNAF, Bureau des prévisions, 2002

allocated to childcare carried out by individuals (childminders or nannies at home) or to the child rearing allowance scheme (Table 7.1). In 2000 and once again in 2001, against the background of a growing demand for childcare arrangements and under pressure from the women’s movement and some family associations, the Ministry of Family Affairs decided to substantially increase the number of places in crèches: €228 million were devoted to public childcare facilities5. France is also strongly committed to almost universal enrolment of children under the age of six6 in nursery schools, which are run by the Ministry for Education. Open 35 hours a week, nursery schools are routinely closed on Wednesdays, but are supplemented by a halfday session on Saturdays. All these schools have canteen facilities. By the age of two, 260,000 children (36% of those aged two) and nearly 99% of children aged 3-6 are attending nursery schools.

The development of individualised and subsidised childcare arrangements By 1994, to fight unemployment by exploiting the job-creating potential of the childcare sector and to meet the demand for flexible childcare arrangements, the government decided to increase childcare allowances coupled with tax concessions to help families meet the costs of individualised childcare arrangements, such as registered childminders or nannies in the child’s home (Table 7.2). With the aim of decreasing the unemployment rate, the government also decided, in the same 1994 Family Law to encourage economically

143

Care and social integration in European societies Table 7.2: Subsidised childcare arrangements for children under three living with dual earner parents: breakdown according to the childcare arrangement % Public facilities Crèches Nursery schoolsa

15 16

Individual childcare arrangement Registered childminderb Mother or father receiving the child-rearing benefit Nanny at home (with childcare allowance)

29 38 2

Total (N = 1,590,000) Notes: a Some children attending pre-school may have a stay-at-home mother. b Childminder is a person who cares for children in her (or his) home for pay. Around 70% of children aged under three are cared for either by a publicly subsidised childcare arrangement or are attending a crèche or a nursery school: breakdown according to the childcare arrangement. Source: CNAF-DREES, 2003

active mothers to opt to stay home after the birth of a second child by providing them with a flat-rate benefit (APE) on the condition that they stop working or seeking work, or work on a part-time basis.The allowance amounts to about €500 per month when the parent is caring full time, and less if the parent cares part time.This benefit is provided until the child reaches the age of three. Either the father or the mother is eligible for this allowance after the birth of at least a second child and under the condition that they have being working for at least two years out of the five preceding the birth. Only 2% of recipients of this allowance are fathers. Low-income parents receiving the APE and hence interrupting their paid work to care for a child have their social contributions related to pensions being paid for by the National Family Allowance Fund. For others who have higher income, employers can contribute to their pension scheme though they are not employed; otherwise they have to contribute by themselves. Finally, France provides a good example of the development of rights for parents to give care. Generally, these rights are going with some forms of payment and with social right connected with the temporary phases of life dedicated to care work, either for children or for elderly people. However, a large part of childcare work has been transferred from the family to public institutions or to private carers. Thus, care work has become visible and formalised through payment.

144

Social rights and care responsibility in the French welfare state

Social care and changing patterns of social inclusion How do policies related to social care contribute to changing patterns of social integration for women? Do they result in new patterns of social marginalisation? Is this type of welfare-state policy efficient in promoting gender equality? We have seen how far French family policy has recognised the caring rights of families. However, it has not greatly changed the gender order still associated with the male breadwinner model. Pfau-Effinger’s work (1998) has highlighted the importance of distinguishing between the gender order inscribed in social policies (or family policies) and the gender culture; that is, norms and values underlying social practices and the division of labour between men and women. In the French case, whereas cultural values concerning education and socialisation of young children are widespread, as well as norms concerning the involvement of mothers in paid work, the gender division of domestic and parental work changed very slowly (Brousse, 1999). Moreover, the emergence of a large social care sector raises new questions concerning working conditions, employment status of carers, lack of training and low wages and career expectations. Numerous jobs were created in this sector, but very few men have taken them up.

Caring responsibilities and the social inclusion of mothers Since the mid-1990s, the Socialist government initiated a new family policy based on new principles of public action: more social equity in family support, a focus on parents’ responsibility rather than on family values, an improvement in gender equity and equal opportunities in the labour market. Care arrangements and social integration became a main focus for family policy, which appears to have lost part of its autonomy as a specific policy field. In fact, family policy is being more and more linked to other fields of public policy: employment, working time and social policies. The restructuring of childcare support was a major component of this new family policy. The need to reduce unemployment entailed meeting the demand for an increase in childcare facilities, as more and more mothers are in paid work and tend to remain in employment when they have children. In addition, the Socialist government expected to improve social integration by promoting employment, not only for the unemployed but also for women. Gender equality also became a major issue underlying public policy. Whereas in the 1980s, family policy attempted to promote the idea of

145

Care and social integration in European societies Table 7.3: Activity rates of mothers according to number and age of childrena (1990-99) Lone mothers

Without any children