The topic of the care crisis has returned to the focus of social debate since the beginning of the Covid-19 crisis. Around 16% of caregivers in long-term care consider leaving the care sector, according to a representative survey by the Federal Ministry of Social Affairs, Health, Care and Consumer Protection. In addition, more than 74% of employees in the care sector state that the work situation has deteriorated significantly. Furthermore, managers complain that the tight staffing situation is compounded by a shortage of applicants, which has deteriorated due to the Covid-19 crisis. All these findings show that care work is becoming increasingly precarious and that many problem areas accumulate here. Reason enough to address the issue of the care crisis scientifically and to give carers a voice. Therefore, Dr. Alexander Braun, Professor of Health Economics and Policy at the Institute of Health Management at IMC Krems, invited the sociologist and political economist Ass.-Prof. Dr. habil. Emma Dowling, Institute of Sociology at the University of Vienna, to a special Science Talk at IMC Krems.
Devaluation and turnaround in England
The author of the book “The Care Crisis. What Caused It and How Can We End It?” presented key findings from her many years of work on the relationship between the welfare state in England and care work. In front of more than 20 interested academics and experts from the care sector, she showed how care work is financed in austerity welfare states and increasingly marginalised in the course of paternalistic transfigurations. From the perspective of feminist and critical-political economy, Emma Dowling showed how the processes take place at different levels of the welfare state and how care work is systematically devalued. Mechanisms that show this devaluation and shift towards profitability are what Emma Dowling calls “care fixes”.
Comparable situation in Austria
A lively discussion showed that similar approaches can also be identified in the Austrian care provision system. Many care activities often take place invisibly and on the fringes of society. Emma Dowling’s concept of care fixes was taken up and applied to Austrian care. One example of a classic care fix that Emma Dowling showed is that of the leverage buyout. This financing structure works by private investors taking out a loan for the maintenance of care homes with a clear expectation of return. Emma Dowling says: “It is questionable how profits can be made in long-term care facilities when we know that productivity can hardly be increased. In senior residences for the wealthy, where services are offered for horrendous prices, these profit expectations can be met. But fundamentally, the data shows that facilities for the rest of the population cannot be profitable, and become insolvent.”
After a short introduction by the Head of the Institute and Deputy Academic Head Prof.(FH) Mag.(FH) Dr. Manfred Pferzinger from the Institute Health Management, the first results of the current project “LINK – Long-Term Care: Implications for Sustainable Careers” were also presented. The project, which is financed by the project fund Arbeit 4.0 of the Chamber of Labour of Lower Austria, is currently completing its first phase, in which 25 caregivers in long-term care were surveyed using qualitative interviews and asked about the challenges in their work environment. One core result was described by Dr. Alexander Braun in his presentation: “It is striking that many activities in care in general, but in long-term care in particular, are only noticed when they do not work. This was demonstrated in the Covid-19 crisis. Nevertheless, there is hardly any reaction to this. On the contrary, many problems increase as caregivers experience additional challenges, but these are often downplayed, because caregivers are fundamentally ascribed and expected to have an enormous capacity for stress.”