Commission on the Crisis of Care in Austerity Britain
Tackling the UK’s social care crisis has long been an urgent policy concern, even before Covid-19 revealed glaring and grave deficits in care home provision. The crisis of care has disproportionate effects on women, especially BAME women, but policy in this area has systematically failed to address this social injustice. By setting up a Political Studies Association (PSA) Commission on the Crisis of Care, Professors Rai and Elias have been able to work with well-established feminist campaign groups, including the Fawcett Society and Women’s Budget Group, to make a series of recommendations that address the gendered effects of social care. This advice has been taken up by political parties and campaign organisations to help inform and shape national-level policy debates on the provision and governance of care in the UK.
Underpinning the impact is a) Rai’s work on gender and the international political economy, and b) Elias’ work on the gendered and racialised dimensions of migrant care work. Particularly important in framing the activity has been the concept of ‘depletion through social reproduction’ (DSR), which Rai defines as the harms that accrue to individuals and communities when the unpaid labour of social reproduction is not adequately accounted for and supported. In thinking about depletion, Rai and Elias make three core claims:
- Unpaid work is not without costs to those that care – depletion is a cost that carers bear.
- Depletion can have both short-term and long-term effects – on health and education, on employability, and even mortality.
- Without mapping depletion’s effects, we cannot make policies that mitigate these effects; the need for mapping depletion is therefore urgent.
In November 2016, the recommendations of the Commission were published in a widely-circulated report, accompanied by a launch event at the House of Lords. Hosted by Baroness Ruth Lister (Labour), the event involved extensive discussion of the report by Barbara Keeley MP (Labour), the Shadow Minister for Mental Health and Social Care; Dan Poulter MP (Conservative), former Parliamentary Under Secretary of State for Health Services; Caroline Abrahams, Director of Age UK; and Sam Smethers, CEO of the Fawcett Society. Written evidence was also submitted to a House of Commons ‘Communities and Local Government Adult Social Care’ Inquiry in January 2017.
The report generated two citations in Parliament, with Baroness Wheeler (Labour) stating in a debate on social care on 1 December 2016:
"In this regard, perhaps I may commend as a contribution to these issues a recent report by the Commission on Care entitled, Towards a New Deal for Care and Carers, which crucially looks at how the social care system is working in England from the point of view of care recipients, particularly older people, patients, carers and women, who we know because of their role as the main providers of paid and unpaid care, have been disproportionately affected. It is increasingly self-funders and unpaid carers who are having to fill the gap between diminishing publicly funded care and the growing care need."
The Assembly for London Labour Group cited the report in a 2019 publication on unpaid care work.
By collaborating with a range of NGOs, both locally and nationally, Rai and Elias have contributed to wider debate about the future of social care. Their interventions have had a direct impact on Fawcett’s work, as evidenced by the inclusion of the Commission’s findings in Fawcett’s General Election Manifesto, which was launched ahead of the 2017 General Election and received widespread media coverage, including an article in the Daily Mirror that discussed the Commission’s call for a National Care Service. The findings on the Commission have been included in the advocacy work of both Fawcett and WBG in relation to the gender impacts of both Brexit and Covid19.
Rai and Elias have developed networks with care campaigners by running public events. In 2016, they co-organised with Fawcett two large public events in Coventry and London involving care home providers (Homeinstead); think tanks (King’s Fund, Resolution Foundation; New Economics Foundation); trade unions (UNISON); charities (Age UK, ADASS, Alzheimer’s Society); as well as several campaign groups (Independent Age, United for All Ages, the International Longevity Centre, Coventry Women’s Voices, Coventry Older Voices, Culture Dementia UK). Complementing these events, Elias has spoken to anti-austerity campaigners in Coventry and Solihull. Rai has worked with the Carers Trust in Coventry on the issue of child carers and their depletion and is working with Carers Worldwide through the Warwick Interdisciplinary Research Centre for International Development. The Commission’s report has been acknowledged as a vital resource by three key industry stakeholders – the UK Care Home Association, the Social Care Institute for Excellence, and the National Institute for Health and Care Excellence.
Building on work of the Care Commission, Rai and Elias are developing further research into how the care crisis impacts BAME groups in the Midlands. Rai is Co-I on the Co-Power project, leading a work package examining how BAME older people and their carers experienced vulnerability, discrimination and other everyday forms of injustice during the Covid-19 pandemic (Elias is also a partner in the project and sits on its advisory board). The work with WBG is also being consolidated through this new project; the Director of WBG also serves on the Advisory Board of Co-Power project. The project will engage with local stakeholders to produce policy recommendations and will work with a local theatre group, EGO Performance Company, to create a performance piece based upon the research work.
Report executive summary http://www.commissiononcare.org/wp-content/uploads/2016/11/executive_summary-_for_web.pdf