In this second blog post, Sara Wallin explores the gendered nature of care for older people in England. In a previous post, she laid out how marketization and austerity entrench the undervaluation of the social care sector and contribute to the increasing precariousness and exploitation of the paid and unpaid workforce. She also suggested that austerity does not offer a viable route to responding to increasing demand for long-term care, but rather exacerbates inequalities in access to care and support between social groups. In particular, the new financing settlement for adult social care contributes to a care gap – wherein people who do not qualify for local authority assisted care yet have limited wealth are becoming reliant upon the unpaid care provided in households and communities.
With one in ten people over the age of 50 having unmet care needs, the lack of access to care also impacts on household decisions, and without substantive expansion and reform of the social care system, these gaps are likely to intensify pressures on unpaid and informal care provision by family members and communities. Already, 1.2 million people in England aged 65 and over are providing unpaid care, and the number of carers aged over 85 has increased by 128% over the past decade. A report from Carers UK find that among the wider population, women are also more likely than men to be carers and are also overrepresented among the segment of carers who are caring for 50 hours or more per week. Whilst there are affective and emotional rewards for caring, the impacts have also been documented in terms of offsets in income and employment prospects as well as knock-on effects on physical and mental health. Showing the emotional damages of austerity on carers, Carers UK identified that the number of carers receiving carer’s assessments and services to help them care is falling – with 42% saying that the amount of care and support arranged by social services has been reduced, 12% have cut down on the amount of care and support they get because the cost has increased or their personal budget no longer covers it, and 13% said that the care or support service was closed and no replacement was offered. Over half (55%) of carers say that they are worried about the impact of cuts to care and support services over the next year. In this context of austerity led reduction of care services and the growing need for care, increasing burden of care is falling on the household, where women are largely responsible for care giving. At the same time, the downward pressure on wages under austerity and the increasing insecurity in the labour market means that women form the most part of the paid care economy.
Women’s gendered responsibility for care work and its implications for gender equality continue to be a key topic in feminist research. This body of literature begins from the critique of how care work is marginalised within mainstream economic analysis, which negates the central role that unpaid labour in the household plays in enabling activities in other spheres of the economy. It has also identified how care work has been commodified as a part of neoliberal policy reforms and globalisation, documenting the consequences of incorporating care services within markets in terms of unequal effects of rising costs for care combined with continued low pay for care workers. This body of research has also engaged with the characteristics of care – highlighting how such work tends to be embedded in affective relationships, often with strong moral obligations and with an emphasis on non-monetary rewards. Crucially, as I argue throughout this post, gender is however not a uniform, or static marker of identity and intrinsic difference but needs to be understood as a governing code that operates through discourse, policy and regulation in ways that perpetuate some gender norms and inequalities while transforming others.
The labour market for care workers is increasingly precarious, and actively engages with gendered and racialised inequalities. Approximately 1.45 million people work in the adult social care sector in England, and with 82 % of these being women the sector is a significant contributor to the gender pay gap. Formal social care work can be broadly characterized by poor working conditions, including regular breaches of the National Minimum Wage, time pressure, a lack of career progression, absence of formalised training and high levels of staff turnover. In addition, a growing proportion of workers are employed on zero-hour, part-time and temporary contracts and the level of unionisation is low. In addition, with nearly 1 in 5 care workers born outside of the UK private care providers have been a major employer of migrant labour. The need for a continued, and increasing, inflow of migrant care workers to meet growing demand has been established in recent research – yet in the current regulatory landscape migration policies contribute to a situation in which employers can exploit the vulnerable position of migrant care workers.
Looking at the adult social care sector in England, gender analysis has demonstrated empirically how women are positioned differently from men also as they receive care. Six years of austerity has had severe impacts on access to local authority-funded social care: almost 400, 000 fewer people access social care services now compared to 2005/6 and nearly 900, 000 people aged between 65 and 89 are currently not getting the formal help they need to carry out basic activities for everyday life. Gendered analyses of austerity have found that older women and single mothers have been the most affected by reforms to social policy and spending cuts. Women account for 67 per cent of local authority service users aged over 65 and they are more likely than men to have unmet care needs. Cuts to local authority services have also halted work on equalities in access and provision to Black, Asian and Minority Ethnic (BAME) communities and awareness raising around sexualities and gender identities. BAME carers have been hard hit by the loss of services within the community and practical and financial support from local authorities for BAME carers. As BAME communities are growing older, and becoming more geographically dispersed, there remain real challenges in terms of addressing social inequalities, discrimination and improving understanding around dementia.
This mere snapshot of gender issues in the social care sector shows the pressing need for reforms and regulation that centre on promoting equality and that protect care receivers as well as the care workforce.