This paper uses qualitative data from a cross-national study of ‘cash for care’ schemes in five European countries (Austria, France, Italy, The Netherlands and the United Kingdom) to consider the concepts of empowerment and independence in relation to both care-users and care-givers. The paper locates the schemes along two axes, one of regulation/non-regulation, the other whether relatives can be paid or not. Each of the schemes has a different impact both on the care relationship and on the labour market for care. In The Netherlands where relatives can be paid, for example, a fully commodified form of informal care emerges; but in Austria and Italy with low regulation, a mix of informal and formal care-givers/workers has emerged with many international migrant workers. In the UK, direct payments allow care-users to employ local care-workers who deliver care for various lengths of time; while in France a credentialised system means that care-work is delivered by qualified workers but for very short intervals. The main conclusion is that none of these schemes have a simple outcome or advantage, and that the contexts in which they occur and the nature of their regulation has to be understood before drawing conclusions about their impact on empowerment and independence on both sides of the care relationship.
This article suggests that the literature on care, which originally was
heavily influenced by a gendered perspective, has now taken on other
important variables. However, it is argued that if we look at the particular
impact of the marketisation and privatisation of long-term care, we can
see that gender is still a useful perspective on the production of care, especially
paid care. The reordering of the delivery of domiciliary care
within the ‘mixed economy of welfare’ is having important effects on the
labour market for care and is likely to lead to further inequalities between
women, both now and in old age. The article proceeds to look at the
impact of these inequalities on the consumption of care in old age, particularly
by elderly women and considers factors that may provide women
with the resources to purchase care and/or pay charges for care. The
article argues that gender does still matter, but that its impact has to be
understood within a context of growing inequalities between women,
and an analysis that takes account of wider social and economic relations
within kin networks and between generations.
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