Pat Armstrong – författare

Nursing homes are where some of the most vulnerable live and work. In too many homes, the conditions of work make it difficult to make care as good as it can be. For the last eight years an international team from Germany, Sweden, Norway, the UK, the US and Canada have been searching for promising practices that treat residents, families and staff with dignity and respect in ways that can also bring joy. While we did find ideas worth sharing, we also saw a disturbing trend toward privatization.

Privatization is the process of moving away not only from public delivery and public payment for health services but also from a commitment to shared responsibility, democratic decision-making, and the idea that the public sector operates according to a logic of service to all.

This book documents moves toward privatization in the six countries and their consequences for families, staff, residents, and, eventually, us all. None of the countries has escaped pressure from powerful forces in and outside government pushing for privatization in all its forms. However, the wide variations in the extent and nature of privatization indicate privatization is not inevitable and our research shows there are alternatives.

Nursing homes are where some of the most vulnerable live and work. In too many homes, the conditions of work make it difficult to make care as good as it can be. For the last eight years an international team from Germany, Sweden, Norway, the UK, the US and Canada have been searching for promising practices that treat residents, families and staff with dignity and respect in ways that can also bring joy. While we did find ideas worth sharing, we also saw a disturbing trend toward privatization.

Privatization is the process of moving away not only from public delivery and public payment for health services but also from a commitment to shared responsibility, democratic decision-making, and the idea that the public sector operates according to a logic of service to all.

This book documents moves toward privatization in the six countries and their consequences for families, staff, residents, and, eventually, us all. None of the countries has escaped pressure from powerful forces in and outside government pushing for privatization in all its forms. However, the wide variations in the extent and nature of privatization indicate privatization is not inevitable and our research shows there are alternatives.

Focusing on different dominant strategies, chapter authors analyze how innovative approaches might be employed to reorganize, retain, reduce, replace, and recruit workers. They assess each strategy in terms of promoting the right to care and explore limitations on the right to access quality care services and the right to provide quality long-term care. Ultimately, they argue that the conditions of work are the conditions of care, conditions that include the overall structures, policies and practices that shape the work and care.

The Labour Crisis in Long-term Care is a thought-provoking book that will appeal to students and researchers in health services, aging, labour policy, sociology of work and social work. Managers, researchers and leaders in health care and health policy decision-makers will also benefit from this important resource.

In Health Matters, contributors from a range of disciplinary and interdisciplinary traditions address multiple dimensions of health care, such as nursing, midwifery, home care, pharmaceuticals, medical education, and palliative care. Through their explorations, the book poses questions about the role that the forms of expertise associated with evidence-based health care play in shaping how we understand and organize health services. Authors critique instrumental, managerial ways of knowing health care and focus on how such ways of knowing limit our understandings of and responses to health care problems and are linked with the growing commodification, individualization, and privatization of Canadian health services. Working with analytic perspectives such as feminism, Marxist political economy, critical ethnography, science and technology studies, governmentality studies, and institutional ethnography, the volume demonstrates how critical social science perspectives contribute alternative perspectives about what counts as health care problems and how to best to address them.

In Health Matters, contributors from a range of disciplinary and interdisciplinary traditions address multiple dimensions of health care, such as nursing, midwifery, home care, pharmaceuticals, medical education, and palliative care. Through their explorations, the book poses questions about the role that the forms of expertise associated with evidence-based health care play in shaping how we understand and organize health services. Authors critique instrumental, managerial ways of knowing health care and focus on how such ways of knowing limit our understandings of and responses to health care problems and are linked with the growing commodification, individualization, and privatization of Canadian health services. Working with analytic perspectives such as feminism, Marxist political economy, critical ethnography, science and technology studies, governmentality studies, and institutional ethnography, the volume demonstrates how critical social science perspectives contribute alternative perspectives about what counts as health care problems and how to best to address them.

With particular attention to lessons learned in Canada, Sweden, and Norway, the contributing authors argue that publicly-funded care homes remain critical to care arrangements but require policy and practice transformations to produce equitable and supportive conditions. Attentive to the specific contexts and tensions that shape care, chapters address key questions about care home quality and labour in relation to gender, race, ethnicity, religion and class. The book analyses the physical and social boundaries that set the conditions for quality of life and care, moving beyond the minimum to explain how nursing homes can provide joy.

Offering alternative approaches to the complex challenges facing this vital public service, this book will be a key reference for students and scholars of health policy, comparative social policy and social work. Its integration of statistical, policy and practice analysis with ethnographic research will prove invaluable to those concerned with long-term care policy and practice.