Obscuring the costs of home care: restructuring at work

Abstract

This study of displaced home care workers reveals how managed competition serves to produce a flexible and atomized work force. Laid off when their nonprofit employer could not compete in the local home care market, workers blamed their employer and their union for their jeopardy. Obscured from local view was the role of government policy in offloading services to the market, benefiting privileged participants in the hospital, professional and market health care sectors. Workers’ indignation at their own and their elderly clients’ unfair treatment dissipated: they had to attend to the practical imperatives in their lives, and were unable to locate a target for their protest. Resolving to be flexible and self-sufficient in the future, they struggled to rework identities as committed carers. The study illuminates how particular organizational and political processes render services more meagre and labour more flexible, and suggests particular possibilities for both accommodating and disrupting those trends.

How institutions matter for job characteristics, quality and experiences: a comparison of home care work for older people in Australia and Sweden

“…In these studies, policy change involves marketization in some form, often related to the emergence of New Public Management (NPM), which proponents argued would make public services more efficient and effective through the use of practices drawn from the private sector (Christiansen and Laegreid, 2002). Researchers have analyzed the introduction of managed markets in Ontario (Aronson and Neysmith, 2006;Denton et al, 2002) and in England (Rubery and Urwin, 2011), privatization in Japan (Broadbent, 2013), and NPM in the Netherlands (Knijn, 2000), England (Atkinson and Lucas, 2013), Denmark (Dahl, 2009), Norway (Vabø, 2006), and Sweden (Szebehely and Trydegård, 2012). These studies find that NPM involved time-and-task work re-organization or 'taylorization' of home care work, which workers reported made it more difficult to provide high quality care.…”

‘You Can’t Win’: The Non-Profit Double-Bind and Experiences of Organisational Contradictions in the Non-Profit and Voluntary Sector

“…This agenda has resulted in work intensification and deterioration of employment conditions (Aronson and Neysmith, 2006;Baines, 2004;Broadbent, 2014;Cunningham and James, 2009). Our research into non-profit care organisations identifies similar tensions for front line workers and highlights how communications around the pressures described by Tonkiss and Passey (1999) of 'doing well' (to comply with funders' priorities) and 'doing good' (to meet service users' needs and the organisation's charitable mission) can create irreconcilable contradictions.…”

Customer-driven management models for choiceless clientele? Business process reengineering in a California welfare agency

“…Under labels including new public management, new managerialism or simply restructuring (Harris, 1998;Heffernan, 2006), private sector management principles and practices have been advocated as means to reduce public sector costs, increase public sector accountability and empower service users. These umbrella terms refer to a wide range of practices, from outsourcing (Cunningham and James, 2009;Gill-McLure, 2014), managed competition (Aronson and Neysmith, 2006) and public-private partnerships (Hebson et al, 2003;Rubery et al, 2013) to the use of performance management, quantitative performance metrics, customer orientation and private sector human resource management practices (Bach and Bordogna, 2011). Within this broad international movement, state restructuring increasingly happens by adopting one of two ostensibly coherent and comprehensive operations management systems: business process reengineering and lean.…”