I am spending a lot of time right now thinking about care and the genuine crisis we face in providing enough of it – either voluntarily or at the right price and right quality - to the people like the very young and the old and frail who need it. Unlike other crises this one is impacting here and now, as well as being likely to get worse in the future. At this stage all I have to offer is some speculation, but I have been grateful for some lively comment on earlier posts addressing this topic and I am on the lookout for more guidance.
There are big challenges in even trying to frame the care debate. There is the problem of definition as care can mean anything from the concrete questions of state provision and funding mechanisms to the general capacity of a society for altruism and compassion. There is ambivalence about whether care is a primarily matter of social policy or of personal choice and responsibility. We pay people to care, we train people to care, we encourage people to care yet the whole point about care is that it should be freely given as part of what Avner Offer calls ‘the economy of regard’. Also, I am in no doubt that feminist economists are right that care fails to get the social status and academic attention it deserves because it is seen as ‘women’s work’.
Yet, we must try to get a better and more rounded grasp of care situating concrete policy debates in a more engaging conceptual and normative framework.
It may be that it is a mistake to think about child care and social care together. Whilst they feel like very different things (one associated with joy, the other with misfortune) in both areas there are issues of supply, affordability, quality, status and employment impact (on individuals and the wider economy). At the heart of both are these key issues:
Risk – having children is a good risk while needing social care is a bad risk (although, as Woody Allen said, the only good thing about getting old is that it’s better than the alternative) but they are both financial risks. How should the burden of that risk be distributed between the individual and family, society and the state?
Benefit – when we provide care are we merely benefitting the recipients of the care as a private act (which should be largely unregulated and unrewarded) or are we performing a task for wider society?
Responsibility – there is an apparent contrast between having children, which we choose and needing social care, which is generally as a result of a misfortune that befalls us. Yet, in both cases we make all kinds of decisions which govern the degree to which we need society and the state to step in and help us. We hear a lot of critical comment about teenage mums but much less about the decisions elders and their relatives make which increase the formers’ risk of isolation.
Of course, these are foundational issues for any review of the principles underlying the welfare state, but they are also questions whose answers must reflect changes in circumstances. In little mroe than a generation the whole care debate has been transformed by the rise of women’s paid labour and population ageing.
The way I have described things so far tends to imply this is a zero sum debate between the carer and cared for and the wider state and society (which is how the whole post-Dilnot debate was framed).
As I ponder my annual lecture, the question is whether, if we start from a different point, a more enlightening debate with new answers might emerge. As yet I am not sure what that point is.