Appendix 5
Report of the Delegation to
SARE 2003
International Congress on
“Caring has a cost: The Costs and Benefits of Caring”
Houses of the Oireachtas
Tithe an Oireachtais
Joint Committee on Social and Family Affairs
Comhchoiste um
Ghnóthaí Sóisialacha agus Teaghlaigh
Report of attendance at
SARE 2003, International Congress on
“Caring has a cost: The Costs and Benefits of Caring”
San Sebastián, Spain
13 - 14 October 2003
The Committee was invited to attend the International Congress on “Caring has a cost: The Costs and Benefits of Caring”, which took place in San Sebastián, Spain, on the 13th and 14th of October 2003. The Congress was organised by the Basque Institute for Women (Emakunde), an organisation under the Presidency of the Basque Government and created by the Basque parliament to work in favour of equal opportunities for men and women in all fields.
The objective of the conference was to analyse the costs and benefits associated with caring from different perspectives: economic, labour, healthcare, psycho-social, social, etc. and to consider the personal and social consequences of this work, with a view to enabling the design of proposals to increase the benefits and reduce the costs.
The subject of this conference was of particular interest to the Committee as a review of the position of full-time carers is an ongoing item for consideration in the Work Programme for 2003. The Committee were of the opinion that representation at this conference was desirable and, it was agreed, at the meeting of 2nd July 2003, to send a delegation to the conference.
The delegation comprised four Deputies, Mr. Donal Moynihan, T.D. (Vice-Chairman), Mr. Michael Finneran, T.D., Mr. Seymour Crawford, T.D. and Mr. Seán Ryan, T.D. The Delegation was accompanied by Ms. Patricia Doran, Clerk to the Joint Committee.
The following summaries of the papers presented at the conference were obtained from the Emakunde web site at www.sare-emakunde.com.
Opening Paper:“Women carers: between obligation and satisfaction”.
Presented by:
Ms Marcela Lagarde y de los Ríos. Feminist Anthropologist and Member of Parliament, Mexico. Unfortunately, Ms. Lagarde y de los Rios was unable at the last moment to attend in person, but she presented her paper by video.
Summary:
Care taking is, at this point, the most necessary verb opposing patriarchal neo-liberalism and inequitable globalisation. Nevertheless, today’s societies, as many in the past, fragment care and the social organisations treat it as a natural condition: that of gender, that of class, the ethnic, the national and the regional-local.
Therefore, it is the women who vitally take care of the others (men, families, daughters and sons, relatives, communities, school children, patients, the infirmed and those with special needs, the electorate, the environment and various politicians and their causes). They take care of their development, their progress, their well-being, their lives and their deaths. Similarly, women and men peasants take care of production and the land; working women and men take care of production and the industries; the bourgeois care for their businesses and their profits, the free market and even the democracy exported to ignorant countries.
Paper:“Caring as an economic and social asset”.
Presented by:
Ms Teresa Del Valle Murga. Dept. of Philosophy of Values and Social Anthropology. University of Basque Country
Ms Alicia Garrido Luque. Dept. of Social Psychology. Complutense University of Madrid
Summary:
Ms Teresa del Valle Murga. The paper starts by considering caring as a social reality subject to constant change. Within the broad field of caring, emphasis is given to the care of dependent persons due to illness, disability or ageing. The new ways of caring are aimed at transferring care from the home and family to different institutions. This implies direct institutional involvement and an association between fields which have traditionally been separated, in this case domestic-familial and political-institutional relationships. Emphasis is therefore given to the necessary preparation to provide care. It covers: the persons for whom care is provided, the persons who traditionally have been allocated the responsibility of caring, and the persons (men and women) who should be responsible for providing care. The development of new care models is related to social changes, involving a relocation of responsibilities and their consequences.
Ms Alicia Garrido Luque. The objective of the intervention is to give some thought to how the demands for care generated by some sectors of the population (children, the elderly, the infirm, etc.) are being met. We will see that a large part of the work required to respond to the demands for care has to be done [in] the homes. The analysis of data from various empirical studies will lead to an estimate of the amount of non-remunerated work necessary to take care of other people. Along the same line, information about the distribution of this type of tasks in the domestic sphere will be provided.
Paper:“The psychosocial costs of caring: who cares for carers?”
Presented by:
Ms Inmaculada Mateo Rodríguez. Andalusian School of Public Health. Granada
Summary:
The increasing demand for care, the decreasing availability of unofficial carers and the reforms of the health systems and other welfare services are the three fundamental causes of the growing interest in the care provided in the unofficial sphere.
This paper will focus on the various aspects of unofficial care taking and its implications for gender inequalities. It will present the concept of unofficial care taking, its magnitude in our milieu, the profile of the carers, the impact of care taking and the models and strategies for supporting the carers. Thought will be given to the main traits involved in unofficial care taking that very directly affect its visibility and social recognition. We will present data that illustrate the fact that the “cost” of care taking is much broader than the sum of the hours devoted to certain tasks. Therefore, a variety of aspects in the main carer’s life is conditioned by her role: one does not work as a carer, one is a carer. The repercussions of care taking on health constitute one of the aspects most often addressed, and, specifically, the negative impact on the psychological sphere is much more evident and intense than the consequences for the physical dimension.
Lastly, we will analyse various models for approaching the relationship between unofficial carers and the official space, each of which has direct implications for the intervention and support strategies to be put forward.
Paper:“The economic and labour costs of caring”
Presented by:
Ms Arantza Rodríguez Alvarez. Dept. of Applied Economy. University of the Basque Country
Ms Cristina Carrasco Bengoa. Dept. of Economic Theory. University of Barcelona
Ms Susan Himmelweit. Open University. Great Britain
Summary:
Ms Arantza Rodríguez Alvarez. For decades, full and equal access to the employment market has been considered the principle means — and an absolute condition — of ensuring financial and social autonomy for women. However, the massive arrival of women on the employment market in the second half of the 20th century was not without contradictions. On the one hand, it is undeniable that although salary-earning has decisively boosted the transformation and social, financial, cultural and political advance of women the world over, this process has occurred in conditions of subordination which have helped to create new forms and structures of inequality both in the labour market and elsewhere. As a result of this, at the start of a new millennium, the relative status of women and men in the employment market reflects the tension derived from a combination of unquestionable advances and paradigmatic ruptures with sluggishness and regressions which show that the processes that generate, or promote the growth of, inequalities between the sexes, continue to operate.
In modern salary-based societies, job segregation by sex is the principal mechanism maintaining financial inequality between men and women and masculine superiority, since it establishes lower salaries and worse working conditions for women on the labour market. But this social organisation of employment on the labour market has its origin in the organisation of work within the family, in the division of household tasks between men and women, largely, when not exclusively, allocated to the latter. Professional and occupational segregation, and the deviation of women to specific segments of the labour market — part-time, temporary, etc. — is one example of how this market operates, excluding, dividing and creating hierarchies based on gender, based on actual or imagined availability differences derived from the unequal distribution of family burdens between men and women. The sexual distribution of work within the family thus corresponds to its distribution on the labour market. Access to women in unfavourable conditions is, therefore, one of the most visible costs of sexually dividing work on a household scale, and the social organisation of family care.
On the other hand, the precarious access of women to the labour market is a key factor helping to emphasise and reinforce inequality on a domestic scale, with women continuing to be financially dependent on men. The way the labour market works facilitates the continuation of the gender-based division of household tasks, and vice versa. The two processes are mutually supportive in a spiral which halts progress towards quality. In spite of the changes, the unequal division of work is maintained in as much as the position of women on the labour market continues to be heavily conditioned by their status within the family. This is therefore consolidating a new gender-based division of work based on the growing involvement of women in salaried employment and in the public sphere, but without questioning the division of labour in the private sphere, and without society having taken into consideration the new social demands derived from changes both to women’s lifestyles and to their very identity.
This paper analyses the paradoxical paradigm of the transformation and simultaneous (re)production of financial and employment inequality between men and women, resulting from the structures conditioning access and unequal participation in the labour market, but also from changes in the way work is divided and organised in the household. The first part contemplates the need to understand the production of employment inequality from a global perspective emphasising not the analytical and empirical importance of household work, but the absolute interdependence between the fields of commercial and household production. This means that to understand the relative status of men and women on the labour market, we have to relate the dynamics of employment with other fields of activity and labour which structure the conditions in which men and women participate (or not) in the labour market.
The second section analyses how the division of household work conditions women’s access to and participation in the labour market, continuing to create inequality between the sexes and with important costs for women. The third section explains how women’s participation in the employment market implies increased caring costs and the urgent need to reconsider the social organisation of work on the labour market and familial organisation, redefining new terms for the redistribution of responsibilities between the family, the State, the market and society.
Ms Cristina Carrasco Bengoa. Economy has traditionally been defined as a closed system with a very narrow field of analysis: the field for economic studies has been the public business world, where work is interpreted as employment.
As a result of the narrow limits defined by economy, economic processes taking place outside such limits are invisible, and so are the profound and necessary links between these processes, considered to be “non-economic”, and commercial production. This invisibility allows the official economic system to transfer costs to non-monetary economies and make use of the caring provided by women as if it was an unending resource of which there is an infinite supply.
There are many varied ways of transferring costs to the economy of caring (that is, women’s work): salaries lower than would be required to reproduce the work force and the entire population, the social security work taking place in the home (socialisation, healthcare), caring for children, the elderly or the sick, the increasing care required from families in relation to healthcare (outpatient surgery with post-operative care at home, the presence of family members over night during hospitalisation, etc.).
This paper approaches the patriarchal-capitalist reasons why caring continues to be a non-economic activity, analysing the different ways of transferring care costs to work performed by women.
Ms Susan Himmelweit. Much of the difference between men’s and women’s engagement in the economy can be explained by the fact that women do far more paid and unpaid caring work than men. This causes a number of inequalities at both the macro and the micro level.
Many of these inequalities turn on the fact that care has remained as an unpaid domestic activity longer than other economic activities, although it is increasingly being carried out in the public and private sectors of the paid economy too. The paper will use some specific characteristics of care to explain the past and likely future development of care as an economic activity that has a crucial role to play in the socialization of individuals and the production and maintenance of human capabilities.
Specifically, care differs from other economic activities in being the development of a personal relationship. This limits its potential for productivity increases. Because of this care has moved more slowly than other goods and services from the unpaid to the paid economy. In the most developed economies, caring is now the core activity carried out in the home.
The difficulties of raising productivity in caring mean that an increasing proportion of an economy’s resources will have to be devoted to caring, even if needs do not increase. The private provision of care by individuals and households is unlikely to meet these costs, because the need for care and the ability to pay for it are unevenly and indeed often inversely related. This means that if care needs are to be met, governments will have to spend increasing proportions of GDP on providing care. This should in theory be quite acceptable, because the overall rise in productivity means that there is still an increasing absolute amount left over to devote to other (private or public) spending. However, spending more on care goes against the current emphasis by governments and international agencies on individual (usually meaning household) responsibility for care, and on reducing government spending as a proportion of GDP.
But unless the political will is found to increase government expenditure on caring more than proportionately to GDP, the quality of individual socialization and the production and maintenance of human capabilities in the economy will suffer. This will be a high price to pay.
Paper:“Caring and Health: women’s health and social benefits”.
Presented by:
Ms Mª Luz Esteban Galarza. Dept. of Philosophy of Values and Social Anthropology. University of Basque Country
Mr Antonio Guijarro Morales. Faculty of Medicine. University of Granada
Ms Patricia Provoste Fernández. Socióloga. Consultora externa de la Organización Panamericana de Salud (OMS). Chile
Summary:
Ms Mª Luz Esteban Galarza. The caring of third parties involves tasks of great social importance, considerable economic value and significant political implications (Finch, 1989⊗). However, the social responsibility of theses tasks is absolutely genderised and naturalised, and this is supported by the different social characterisations of the work carried out by men and women, and a cultural separation of what is rational (association with what is masculine) and what is emotional (with what is feminine) (Comas, 1993). This sexual division of work means that the functions assigned to women do not have the same social recognition, and women become mere intermediaries between the population and the experts. This responsibility does not lead to a suitable redistribution of the resources between men and women either.
At present, in the West, a re-launching of the ideology of female caring is occurring, a phenomenon that is applied to various areas (the care of the elderly, children, the sick, etc.) and that is related to social and political factors that are also different; including a drift to the right and weakening of the welfare state, a drop in the birth rate and changes in reproductive strategy, the aging of the population and a longer life expectancy and a greater presence of chronic and debilitating diseases. These are, in addition, social concerns that appear in direct relation to the success of feminism, meaning that they must be interpreted as reactions in the face of the advances of women.
A direct consequence of this is the various laws and measures that can be appreciated over recent years both in Europe and in Spain (at an autonomous community and a national level). Although there are differences between the various institutional policies, they are, overall, aimed at encouraging an increase in the birth rate and the alleged conciliation between family life and work, however, the use that is being made of the concept of conciliation does not permit the questioning of the obligatory nature of caring by women, which would be a sine qua non condition.
In this presentation, we will make a theoretical-methodological proposal that comes from the anthropology of health, that allows us to look at caring tasks at the three different levels on which they occur: self-care (domestic), informal network (through associations) and the institutional network (the health area and others). This also allows for both the visualisation and the re-sizing and recognition of the activities that are carried out outside the health network which are, on the other hand, majority. In addition, it will review the role of the welfare network and of the society that surrounds these questions, suggesting as an absolute priority, sharing the responsibilities between men and women.
⊗ Finch, J. (1989) Family Obligations and Social Change. Cambridge: Polity Press
Mr Antonio Guijarro Morales. A slave grandmother is an adult woman with direct housewife obligations, taken on voluntarily and with pleasure for many years. They do not always have grandchildren.
As time goes by, their family obligations increase whilst their strength weakens, although their willpower does not.
The time comes when, although they want to, they cannot carry on with the family load, which is now excessive, and diverse symptoms or illnesses appear or become more serious, which are not able to be cured appropriately.
For psychological and educational reasons they are unable or unwilling to ask for help. They frequently deny that their problems are caused or made worse by the family load, although deep down they know it, and they confess it in secret to their friends or family, but not to their children. Some of them fear that they might say “Don’t worry, we won’t bring the grandchildren round over the next few months so as not to bother you”. This, for them, is worse than dying.
If the family does not partially remove the overload, their illnesses do not get better and can lead to death, sometimes due to suicide. If the family frees them suitably, allowing them to enjoy pleasurable contact with their grandchildren, but with other people taking on the set tasks or direct responsibility (safety of the grandchildren, etc.) the prognosis is very good.
Ms Patricia Provoste Fernández. We present some advances in the characterisation and analysis of the care and health production services provided in the domestic and institutional spheres by women in their capacity of carers of the family group.
Based on structural factors that are having an effect on an increase in home health production, two types of empirically observed situations are examined. The first is the home care of highly incapacitating illnesses. The second focuses on the care of the family group, which, in the context of the reforms made to the care model, is in increasing demand by the public health system.
Lastly, conceptual and methodological considerations are formulated about including these common services as products in the national budget and about the costs for women, particularly for those in the lower income brackets, advocating a new social contract between the public health system and women as health producers.
Paper:“Towards the socialisation of care”.
Presented by:
Ms Mª Jesús Izquierdo Benito. Dept. of Sociology. Autonoma University of Barcelona
Ms Katja Repo. Department of Social Policy and Social Work at the University of Tampere. Finland
Summary:
Ms Mª Jesús Izquierdo Benito. The sexual division of work has consequences of a general scope. In its economic aspect, the differential socialisation of women so that they are sensitive to the needs of others and willing to satisfy them, disqualifies them from attending to their own needs and defending a position in society. As far as men are concerned, they are placed in an advantageous situation, as this is a mechanism accumulated over time, a situation that favours the broadening of the breach of inequality between men and women. With regard to the emotional consequences, these are mixed. Women feel powerful, exploited, worn out and taken for granted, at the same time. Those who are the object of caring also develop contradictory feelings, of gratitude and resentment, the need they have to be cared for puts them in contact with precariousness and dependence, chalking up a heavy personal debt that they will be unable to pay off, which leads them to devalue the care they receive and the people who provide it, and to react with hostility to the care.
With the growing presence of adult women in the employment market, caring has been partially moved over from one private area, the family, to another, the market. This impedes socialisation in solidarity through the exercise of caring. Citizens mistakenly conceive themselves as autonomous beings who must personally meet the cost of the caring for dependent people, who are excluded, in practice, from the statute of citizens. For this purpose, they are given an instrument that allows them to take on privately the expense of the caring, a housewife. This specialisation and privatising of the caring tasks prevent citizens from conceiving themselves as people who are sometimes dependent and sometimes autonomous.
Reinforcing the social dimension of citizenship means that preventing the relations of power and dependence from being specialised by sectors of the population, in such a way that the consequences of a task with such a high emotional impact as caring, falls exclusively on women. It also requires their socialisation, as these days, caring tasks are left to intuition and the emotional and physical availability of the carer, unaffected by scientific development and far removed from the principles of fairness. In a democracy, on whom do people requiring care depend? On women, on having enough money or on social solidarity?
Ms Katja Repo. On the Nordic Social Care Model: Finland as an example. The Nordic countries — Denmark, Norway, Sweden, and Finland — are usually clustered together as representatives of the so-called Social Democratic or Nordic welfare state. One of the distinctive features of this model is its commitment to social care services on a universal basis. According to Anneli Anttonen (1997), these countries are to be seen primarily as ‘social service states’. This means that public social services are mostly provided by local authorities and used by all social classes.
In this presentation, using Finland as an example, I will describe the Nordic welfare state model from the perspective of social care. The presentation will concentrate on some of the women’s issues involved. I will discuss how social care services and payments for care are related to women’s two roles as mothers and workers. Focusing on how care of children is supported and socialized in Finland, I will consider the benefits and costs of the socialization of caring to life choices of women. The presentation will then conclude by connecting this particular question to the general features and principles of the Nordic social care model.
Paper:“Care work in Europe”
Presented by:
Ms Claire Cameron. Thomas Coram Research Unit. University of London. Great Britain
Summary:
Formal care services for young children and older people in Europe are in increasingly in demand as, despite fewer children being born, more mothers work longer hours outside the home and the population ages, requiring support into more advanced years. The project we have been coordinating has been trying to understand paid care work better. Its overall objective is to contribute to the development of good quality employment in caring services that are responsive to the needs of rapidly changing societies and their citizens. The project is funded by the European Union as part of its Fifth Framework programme and involves research partners in Denmark, Hungary, Netherlands, Spain, Sweden and the UK.
In this presentation I will give some details about the study, which builds on other work we have been doing at Thomas Coram Research Unit into care work, and I will provide some context. I will describe some characteristics of care workers, before examining the concept of care, and related concepts in more detail. One problem with ‘care’ as a concept and as a field for providing services is that its borders are fluid and can merge with related fields such as health, education and pedagogy. The last part of the presentation examines the issue of quality in employment, drawing on the EU’s indicators for quality employment, and research literatures. The position of the care worker in two countries, Denmark and England, will be compared.
The main conclusions of the study to date are that care is a problematic concept, interpreted differently both across countries and within countries, with varying borders. Paid care work is mostly work done by women, and mostly for low wages. It is very rewarding work: the most rewarding aspects are the human relationships that can be developed with young children and older people. Where care is combined within pedagogical traditions and particularly in Scandinavian countries, where the public sector takes a leading role and statutory attention is paid to the work environment, employment can be of good quality. In other countries, such as England, where the welfare regime is dominated by state regulated private market provision and personal and family based solutions to care needs, the quality employment in care work is harder to find.
Final Paper:“Professional and personal care: assessment indicators”
Presented by:
Ms Soledad Murillo de la Vega. Dept. of Sociology. University of Salamanca
Summary:
My lecture will focus on the following main points:
1. The amount of time dedicated to caring for others is never to be discussed or debated in intimate relationships among couples, especially in the beginning. Only when living together and the first signs of family responsibilities appear, will it be a priority for both to find solutions to deal with them. Either discussions are carried out and pacts made, or else one must appeal to gender conformity in order to delegate and also free the other from the responsibility of caring.
2. Care is prematurely learned in the family socialization scheme, the female subject of every home lends a great amount of time to caring for people living within the home, as well as those with illnesses, or who are convalescent. This situation therefore, makes for the organizing of time which should be revised in order to ensure an equal share of the caring.
3. The male roles find their own main credentials and identity within the workforce. Paternity is not considered to be the male’s presence in the home, but quite the contrary. It is his presence in an area which is considered antagonistic with what is considered domestic: the productive space. From this standpoint, what legitimacy can women find in order to ask for co-responsibility?
4. Care is not exempt from serious problems of interaction. Taking care of an illness implies paying attention to the smallest detail — medical (especially) — besides having a direct contact with the patient. This can originate extraordinary conflict which puts a strain on the relationship. The care should be shared and if it is not, the person who can not share in the responsibilities should pay for his/her substitute through an external contract. Care has other slopes which I will analyze: care quality (based on serene and loving interaction) and care assistance (based on the supervision mentioned above).
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Each of the papers was followed by a colloquium and contributions were made by members of the delegation.
Interest was expressed by a local radio station in the attendance by the delegation, and an interview was given, in which the ongoing work of the Joint Committee on the position of full-time carers was outlined.
____________________________
Mr. William Penrose, T.D.,
Chairman of the Joint Committee.
25th November, 2003.
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