The Challenge of the Care Workforce: Recent Trends and Emerging problems

This paper examines the paid care workforce in community services in Australia. Focusing on people employed in direct service delivery roles, I use unpublished data from the Censuses of 1996 and 2001 to document some important characteristics of the care workforce in community services, in which a large minority of care workers are employed in this country. International research has established that paid care workers suffer considerable labour market disadvantage. The paper presents evidence of deinstitutionalisation, deprofessionalisation, functional underemployment, and relatively poor pay for care workers in community service industries, which suggests that problems identified in other English‐speaking countries are also evident in Australia. I conclude by discussing the policy implications of these trends, and by raising some questions for workforce planning.     

From Subsidiarity to 'Free Choice': Child- and Elder-care Policy Reforms in France, Belgium, Germany and the Netherlands

This article analyses the patterns of reform in care policies in Bismarckian welfare systems since the early 1980s. Based on a comparison of France, Germany, Belgium and the Netherlands, the article shows that these reforms share similar logics and trajectories, which can be explained by the shared conservative and corporatist traits of Bismarckian labour markets and welfare state institutions and their impact on labour market adjustment possibilities and preferences. Indeed, we argue that care policy reforms have been very closely linked to specific employment strategies, and the politics of welfare without work and subsequent attempts to shift away from such a labour-shedding strategy go a long way in explaining both the nature and the timing of child- and elder-care policy reforms in Bismarckian welfare systems. The article also shows how a focus on promoting ‘free choice’ in all four countries has justified the introduction of measures that have simultaneously reinforced social stratification in terms of access to the labour market – meaning that some women have much more ‘free choice’ than others – and weakened certain labour market rigidities. To conclude, we argue that care policy reforms have provided a backdoor for the introduction of labour-cheapening measures and for increasing employment flexibility in otherwise very rigid labour markets.     

Nordic Employment Policies – Change and Continuity Before and During the Financial Crisis

The Nordic countries serve as models for successful employment and labour market policies. In this article, Nordic employment and labour market policies are analyzed from a comparative point of view. It is argued that Nordic employment and labour market policies have lost some of their distinctive features. Active labour market policies, for example, are now at the centre of policy priorities in many countries of the EU. And in some other respects, the Nordic countries have converged towards political patterns characteristic for states in central Europe, for example, de‐centralized patterns of wage bargaining and the partial lack of corporatist concertation. During the current financial crisis, specific patterns of crisis management can be observed in Scandinavia that make these countries distinct from many other countries in Europe.     

Strategic contextualisation: free movement,labour migration policies and the governance of foreign workers in Europe

Heightened levels of internal labour mobility since the European Union (EU)'s Eastern enlargements in 2004 and 2007 have shifted the context for member state policies geared towards the admission of non-EU workers. This article contends that the strategic use of the internal mobility regime by member states, as a justification for selective recruitment of labour from outside the EU, deserves more analytical attention. This contribution examines how labour migration policies (LMP) in the United Kingdom, France and Germany make use of the EU free-movement framework in current legislation, and how associated policy rationales are justified. In an interpretive policy analysis of legislative documents and decision-makers' meaning-making, as related in semi-structured interviews, the article identifies the logics, tools and rationales which link LMP to EU free movement. These links are shown to be highly selective and they serve common as well as nationally distinct governance goals. Across all three cases LMPs ascribe various degrees of relevance to EU internal labour supply, depending on the different skill levels of migrants targeted in respective policies. This shared pattern of economic coordination of LMP by skill level – in which the EU common labour market plays the role of delimiting additional migration in the skilled and especially low-skilled segments – is conflated with national migration control agendas. Member states draw on EU free movement to justify migration restrictions targeted at specific sending countries. As a result, the governance of the foreign workforce produces skills- and origin-based privileges rather than granting rights to mobile migrant workers in Europe.     

Home care development in Korea and Germany: The interplay of long-term care and professionalization policies

The aim of the study was to compare the effects of long-term care and professionalization policies on the development of home care infrastructure and the care workforce in reference to long-term care insurance systems adopted in Germany and Korea. A comparative analysis of the effects of the two policy systems allowed us to examine distinct forms of marketized home care service expansion. In both countries, the opening-up of care markets has brought about a significant expansion of home care services through the active participation of mainly for-profit providers. However, a trade-off between the rate of expansion, the quality of care services, and the stability of care infrastructure has emerged. The market-based expansion of home care services has resulted in difficult employment and working conditions for care workers in both countries. The country-specific organization of home care and related professionalization approaches has led to the development of a well-trained care workforce with less precarious conditions in Germany but not in Korea. Despite this difference, less well-trained care workers experience precarious employment in both countries.     

Differences and similarities in monetary benefits for informal care in old and new EU member states

This article presents an overview of the monetary benefits available in the context of long‐term care provided by family or other informal carers in 11 old and 10 new EU member states. All but one country in our sample offer at least some monetary benefits that can be used to help finance informal care. Old EU member states tend to direct benefits to individuals in need of care, whereas new EU member states place more emphasis on benefits for carers. Among new EU member states, monetary benefits are less often means‐tested and tend to be lower compared with benefits in old EU member states. Because social policies in many countries increasingly rely on monetary benefits rather than on benefits in kind and because the share of informal care in the overall provision of elderly care will scarcely decline, monetary benefit incentives for labour market participation need to be carefully monitored.     

Working late: policy relevance for older workers in the United States

The United States has seen a sizable increase in older worker labour force participation, although how much of this is due to public policy is uncertain. In fact, outside of academic and policy research circles, there has been relatively little attention paid to older workers and the challenges of an aging workforce in that country. Public policymakers have not demonstrated the same interest in expanding employment opportunities for older workers that they have shown for other groups, or that has been seen in other countries. Still, a number of significant pieces of legislation have been enacted over the past several decades that should be making continued employment at later ages easier, more attractive, or more essential financially. This paper examines those policies. However, because of confounding and conflicting influences from elsewhere, public policy initiatives focusing on older worker employment do not appear to be major contributors to rising labour force participation rates at older ages.     

New challenges for the welfare state: The emergence of youth unemployment regimes in Europe?

In this article we discuss the emergence of ‘youth unemployment regimes’ in Europe, that is, a set of coherent measures and policies aimed at providing state responses to the problem of unemployment and, more specifically, youth unemployment. We classify these measures and policies along two main dimensions: unemployment regulations and labour market regulations. Using original data, we show how seven European countries locate on these two dimensions as well as within the conceptual space resulting from the combination of the two dimensions. Our findings show cross‐national variations that do not fit the traditional typologies of comparative welfare studies. At the same time, however, the findings allow for reflecting upon possible patterns of convergence across European countries. In particular, we show some important similarities in terms of flexible labour market regulations. In this regard, the recent years have witnessed a trend towards a flexibilisation of the labour market, regardless of the prevailing welfare regime.     

Implementing Consumer Choice in Long‐term Care: The Impact of Individual Budgets on Social Care Providers in England

In common with many advanced welfare states, England has increasingly relied on consumerist principles to deliver both greater quality and improved efficiency in the long‐term care system. The Individual Budget (IB) pilots marked the next step in this process, through a new system of funding whereby greater control of resources is given to service users, in lieu of direct in‐kind care provision. IBs have the potential to transform the market for care services as well as the relationships between key stakeholders within it. Purchasing will increasingly be shaped by the demands of IB holders, with providers expected to deliver a wider range of personalized services. What will this mean for providers, and what can they do to prepare for these changes? These questions are relevant not just in England but in many other countries adopting similar mechanisms for devolving control over the design, delivery and funding of care to the end‐user. The article explores the early impact of IBs on providers' services, on their workforces, and on the administrative implications for providers of managing IBs. The study finds that providers were positive about the opportunities for better‐quality services that IBs can bring about. However, participants highlighted a number of obstacles to their effectiveness, and reported a range of potentially adverse administrative and workforce consequences which have the potential to jeopardize the consumerist policy objectives of increased choice and efficiency.     

Care earnings in the United States and 24 European countries: The role of social policy and labour market institutions

Care occupations are gendered and remain relatively poorly paid, particularly in the United States. Prior research on the ‘care penalty’ primarily points to individual, relational, and market-valuation factors in explaining the relative earnings of care workers. This study integrates these explanations with a comparative institutional perspective. Using higher-quality data and methods than previous comparative research in the field—that is, harmonized micro-data from the Current Population Survey and EU-SILC from 2005 to 2016, country and year fixed effects models, and a counterfactual analysis—we find that national variance in labour market and welfare state institutions explains most of the difference in the relative earnings of reproductive care workers between the United States and European countries. Higher rates of collective bargaining coverage, stronger employment protection and welfare state spending contribute to higher relative earnings for reproductive care occupations, and lower relative earnings for high-status nurturant care occupations. Differences in the relative earnings of care workers appear to be mostly a construct of social policy and labour market institutions rather than individual, relational, and market-valuation factors.     

The impact of population aging in rich countries: What’s the future?

The paper examines the impact of population ageing on macroeconomic outcomes, inflation and labour force participation employing a sample of 23 OECD developed countries from 1960 to 2014 and accounting for the institutional context. Controlling for collective bargaining coordination the results show that a larger elderly share of population would lead to lower real GDP growth, albeit mostly in countries with low population growth rates. Ageing puts substantial downward pressure on inflation due to subdued aggregate demand. Also, results demonstrate that the ageing of the workforce tends to reduce labour supply. To mitigate any adverse effects of population ageing, a combination of labour market policies, pension reforms, greater investment in human capital and technological innovation should be prioritized in policy making.     

The ABC of Child Care Politics

The care and education of children below school age is an area of intense public debate and the subject of considerable policy innovation in Western democracies. Child care raises complex philosophical and policy issues ranging from broad questions about the relative responsibilities of state, market and family to technical aspects of policy design such as the interaction of child care subsidies with income support, family payments and taxation. Across the developed world, countries are finding new ways to address the growing need for child care, with market‐based solutions looming large in several countries. This paper analyses Commonwealth policy towards long day care in Australia since the early 1990s. It explores the shift towards market‐based, for‐profit care for children below school age, especially the growth of publicly listed child care corporations. In allowing a single corporation to assume a dominant position in the provision of long day care, Australia has embarked on a vast experiment in the care of children, unparalleled in other countries.     

Keeping Australia's Older Workers in the Labour Force. A Policy Perspective

As in other western industrialised countries the structural ageing of the Australian population has significant labour market implications. Government has responded with a range of policies to persuade older workers to abandon early retirement and/or remain in the workforce past traditional retirement ages. But whether this generation of workers will be prepared to change their retirement plans in response to policy encouragement, and whether current policy measures will translate into significant numbers of older workers extending their labour force participation is uncertain. Using the Australian Survey of Retirement Attitudes and Motivations (ASRAM) a recently completed, nationally representative survey of Australian workers aged 40 – 59 years we find that while the Government message about working longer is getting through, older workers are relatively unresponsive to current policy measures. Other policies, especially policies outside the financial realm, are needed to maximise the number of older Australians in the labour force.     

The turn to optional familialism through the market: Long‐term care,cash‐for‐care,and caregiving policies in Europe

Cash‐for‐care (CfC) schemes are monetary transfers to people in need of care who can use them to organize their own care arrangements. Mostly introduced in the 1990s, these schemes combine different policy objectives, as they can aim at (implicitly or explicitly) supporting informal caregivers as well as increasing user choice in long‐term care or even foster the formalization of care relations and the creation of care markets. This article explores from a comparative perspective, how CfC schemes, within broader long‐term care policies, envision, frame, and aim to condition informal care, if different models of relationships between CfC and informal care exist and how these have persisted or changed over time and into which directions. Building on the scholarly debate on familialization vs. defamilialization policies, the paper proposes an analytical framework to investigate the trajectories of seven European countries over a period of 20 years. The results show that, far from being simply instruments of supported familialism, CfC schemes have contributed to a turn towards “optional familialism through the market,” according to which families are encouraged to provide family care and are (directly or indirectly) given alternatives through the provision of market care.     

Diverging Paths? A Comparative Look at Childcare Policies in Japan,South Korea and Taiwan

This article compares state policies to support childcare in Japan, South Korea and Taiwan, using fuzzy set ideal type analysis to determine the nature of institutional arrangements with respect to labour, money and time provisions. We then note their implications for familialization and defamilialization in the three countries. Our analysis suggests a common pattern towards the increased use of financial support amongst the three countries over time; however, this commonality does not mean their childcare policies are converging, as the financial supports differ in focus, with Japan concentrating on familialization by valuing family care, and Korea exclusively employing policy to facilitate the use of market‐based care services. For its part, Taiwan has been strengthening familialization by increasing the leave compensation to value time off to provide care. The different labour, money and time dimensions vis‐à‐vis the familialization/defamilialization matrix suggest varying implications of institutional arrangements for gender.     

Migrant Care Work Going Dutch? The Emergence of a Live‐in Migrant Care Market and the Restructuring of the Dutch Long‐term Care System

In recent years, a live‐in migrant care (LIMC) market has emerged in European countries with specific care, migration, and employment regime features. In countries with relatively low levels of formal long‐term care (LTC) provision, people in need of care and their families have started purchasing LTC directly from individual – mostly migrant – workers who live‐in with the person in need of care. Previous research has shown that this arrangement is facilitated by the availability of cash‐for‐care benefits that can be freely used by the beneficiaries, and/or by low levels of regulation of employment and migration. The Netherlands traditionally features strong, universal and generous LTC policies. However, recently, the phenomenon of LIMC has also appeared there. Based on exploratory qualitative research, this article examines the features of Dutch LIMC and the factors that foster or hinder its development. Our findings show that the ongoing restructuring of the Dutch LTC system – particularly the emphasis on informal care and decreasing accessibility of institutional care – are important factors pushing an LIMC market. At the same time, various institutional factors limit its growth, particularly the high levels of regulation of the Dutch care, migration and employment regimes. Further cutbacks in the care sector might push more families to this market in the near future, and change the character of the Dutch LTC sector. The Dutch case is relevant for other countries with longstanding traditions of generous LTC services which currently undergo retrenchment, and sheds light on routes to institutional change.     

Employer‐oriented labour market policies in Sweden: Creating jobs and the division of labour in the public sector

In many European countries, greater importance is accorded to labour market policies in which employers are involved in activating unemployed people. Such employer‐oriented policies target employers’ demand for labour and attempt to influence their willingness to hire, train or guide (often disadvantaged) unemployed groups. Using data from a qualitative interview study of an employer‐oriented programme in a medium‐size city in Sweden, the present article aims to develop knowledge about how these policies are used to influence employers to hire unemployed workers and how jobs created in this context differ from regular jobs. The article argues that creating jobs through new arrangements for the division of labour, with the promise of relieving regular staff of unskilled tasks, may influence employers’ willingness to hire the unemployed when used alongside other kinds of policy instruments. However, the article also shows that this new division of labour, with programme participants performing mainly unskilled tasks, has been difficult to realize, as new staff gradually come to perform an increasing number of regular working tasks.     

Combining Work and Care: Carers' Decision-making in the Context of Competing Policy Pressures

Issues related to paid work and care are of global importance, reflecting the twin pressures of population ageing and efforts to increase labour market participation. Informal carers of sick, disabled or older people can experience tensions between policies aimed at support for care and support for employment. This article discusses a study of carers’ decision‐making around work and care, drawing on evidence from interviews with 80 working‐age carers in England. Carers are not homogeneous; their circumstances and needs differ reflecting age, gender, ethnicity, labour market participation, and the condition and/or needs of the person they support. This diversity is illustrated by contrasting rural and urban carers’ decisions and experiences about work and care. Key factors that impact on carers’ decisions are: current and anticipated financial need; the constraints arising from receipt of carers’ and other means‐tested income maintenance benefits; personal identity; job opportunities and scope for flexibility; social services provision; carers’ own health. Distance, travel times and transport are unique additional challenges for rural carers who (wish to) work. These difficulties are further intensified when they intersect with other factors such as the Carer's Allowance, the local labour market and social services provision. The findings are evaluated in terms of the adequacy of current government policy measures.     

Marketisation policies in different contexts: Consequences for home‐care workers in Germany,Japan and Sweden

Market‐oriented restructurings of long‐term care policies contribute significantly to the aggravation of care workers’ situations. This article focuses on the effects of broader long‐term care policy developments on market‐oriented reforms. Germany, Japan and Sweden are three countries that have introduced market‐oriented reforms into home‐based care provision embedded in distinct long‐term care policy developments. Conceptually, this article draws on comparative research on care to define the institutional dimensions of long‐term care policies. Empirically, the research is based on policy analyses, as well as on national statistics and a comparative research project on home‐care workers in the aforementioned countries. The findings reveal the mediating impact of the extension and decline of long‐term public care support and the corresponding development of the care infrastructure on both the restructuring of care work and the assessments of the care workers themselves.