Review | Backstage of the care economy

An rs21 member working in the care sector in Scotland reviews Helma Lutz’s new book on the European care economy.

The transnational care economy forms a fundamental part of contemporary social and economic life. With demographic shifts in Britain, millions more people are requiring care, and care migrants form a central part of Britain’s care workforce, covering huge gaps left by the sector’s recruitment crisis. Rapid developments in anti-migrant rhetoric and activity emphasise the urgency of our solidarity with migrants, and the sector of the migrant workforce employed in care makes up a large and important part of that group. Meanwhile the nature of care migration in Britain is currently shifting, with the ending of new care visas for overseas workers proposed in the government’s ‘Immigration White Paper’ in May, and with many care migrants currently in Britain not allowed to work or having their visas revoked. 

Our perspective on care and care migration in the 21st century must necessarily be international, with high numbers of precarious migrants making up the workforce, with variation across care regimes in different countries and with contemporary chains of care migration following historical routes of imperialism. Helma Lutz’s Backstage of the Care Economy focus on live-in care migrants for the elderly from Eastern Europe working in the wealthier nations of Germany, Austria and Switzerland. The ‘backstage’ in the title refers to what we might call the ‘background conditions’, the home lives of the migrant workers who are the focus of the book. Children and partners living in home countries in dispersed care networks of grandparents and family friends, remittances sent home, the unpaid care undertaken by working mothers in phone calls home. The study comes out of interviews with dozens of migrant care workers from Poland and Ukraine and their families and friends, as well as a discourse analysis of thousands of newspaper articles from Germany, Poland and Ukraine. 

Lutz is able to cover an impressive range of aspects of the global care economy- its commercialisation, and how it is thought about in media and popular culture. Lutz begins by describing transformations in the transnational care economy. While European welfare states have previously relied largely on care provided by women in families, care for children, the elderly and the disabled is now commonly externalised by the middle and upper classes to waged workers outside the family. We now find ourselves in a ‘care crisis’ with states cutting services, and unable to respond adequately to ageing populations and the reduced care resources available within families after the shift from a male breadwinner model to the two-earner household. At the same time as care services form one of the fastest growing labour markets in the 21st century, states have retreated from providing care and private companies have moved in to fill care gaps, leading to a proliferation of profit-orientated care companies and placement agencies. 

As Lutz shows us, this can play out differently in different states, with different legal regulations for live-in care in Germany, Austria and Switzerland. For instance, German care agencies collaborate with ‘posting agencies’ in ‘sending’ countries (e.g. Poland or Ukraine), and are only bound by the labour laws and lower wage costs of the ‘sending’ countries. In Austria, a spurious model of ‘self-employed’ care has proliferated, while in Switzerland caregivers must be treated as employees of an agency or household, though workers and unions continue to struggle against employers who can easily circumvent certain regulations, and who lobby for exemptions. We can compare this with Britain, where, as Connor Cameron and Lyra Unguent have described ‘Direct Payments schemes’ introduced in the 1990s as part of the marketisation of care, make some disabled adults employers of care workers. This then displaces class conflict and antagonism from the support worker-manager relationship onto that of the support worker and service user. 

A couple of chapters provide a theoretical and historical basis for the book. The second chapter gives us an overview of some useful concepts: the global care chain (GCCC), care circulation (CCC) and transnational social inequality (TSI). Together these provide for Lutz a framework for understanding such phenomena as the relationships formed through paid and unpaid work, circulation of ‘care flows’, and asymmetries between countries that send and receive care migrants. Particularly interesting are sections on post-socialism, with an analysis of the privatisation of care, the dismantling of public services and increase in outmigration, in the formerly socialist countries of Poland and Ukraine. The Polish state has returned to an ‘explicitly familialist’ care policy, meaning the provision of care is provided by mainly women in the family. This is due to the massive cuts to the formerly socialised infrastructure that promoted female employment like crèches, school canteens and retirement homes and the loss of jobs in areas predominated by women. Chapter six considers care migration from and to the post-socialist states through a reading of nineteenth and early twentieth century socialist utopians, compared with the experiences of ‘actually existing socialism’. The second part of chapter six provides us with a thorough overview of feminist debates around paid and unpaid work – the socialist feminists such as Nancy Fraser who connected gender justice with a critique of capitalism and ideas for gender equitable care regimes.

The central chapters of the book provide a unique insight into the experiences of migrants – mostly women and mothers – in the German-speaking countries, and of children, fathers and other family members who remain in Poland and Ukraine. Lutz investigates how these people deal with the loss of closeness to their families, how they relate to ideals of ‘good motherhood( or fatherhood)’, how they ‘do transnational motherhood’, and how people in these networks experience emotional inequality and care deficits. While these migrants are working to support themselves and their families, there is a moral panic around ‘Euro-orphans’ that emerged in Eastern Europe over the past decades, marked by sensationalist reporting of mothers leaving children in the care of other family members as Lutz analyses in chapter four. These chapters, alongside a final chapter on the care economy after the Covid-19 pandemic, form the emotional core of the book, with quotes from mothers and fathers making difficult choices around work and care, experiencing guilt, managing children’s emotions, and facing judgment in relation to hegemonic ideologies of motherhood and fatherhood. 

Lessons for care worker organising at home

As a non-migrant support worker working for a charity in Scotland with adults with learning disabilities, Backstage of the Care Economy provides useful insights for organising in my workplace and in the sector more broadly. We learn about different nation-states’ care regimes, but also features that we experience here in Scotland’s care workforce: of commercialisation of care, exploitation of migrants, racialised and gendered divisions in the working class, and migrants dealing with care arrangements in their home countries. Among the non-migrant workforce, I find anti-migrant prejudice and racism is widespread. Stretched poorly paid workers take out resentment on foreign workers, racist service users and families harass or refuse support from non-white workers and white union members demand unions drop issues around visas and migration to focus on ‘native Scots’. But workers with racist views can have shifts in consciousness through education and shared struggle. Encouragingly, local UNISON organisers have told me that they have changed the views of white workers with racist views by getting them in discussions with migrant workers, where they learn about the thousands of pounds paid in visa fees and to recruiters, the high levels of education often held by migrant carers and the facts of being bound to your employer by visa requirements. 

At this year’s The World Transformed festival, Nandi Mwansa from the Pan African Workers Association (PAWA) described the challenges of coming from Africa to work as a carer in England – raising money for a visa, tests, a flight and a language exam, before having pay deducted for training she had already done and being unable to raise grievances for fear of having her visa revoked. Mwansa described having two children back home, and feeling the same fears and dilemmas around financial and emotional support that Eastern European carers Kasia, Halina, Mateusz and Malwina do in Lutz’s book. But Mwansa described how the PAWA union helped her find connections, to overcome isolation, to overcome fear, and for members to collectively understand their conditions. These are lessons some of the most vulnerable workers can give to all care workers, native and non-native, across Britain.

Racism and anti-migrant prejudice provide a distraction from dismal conditions across the sector, in Britain as in the German-speaking countries. While local authority workers receive £15 an hour, support workers at my work receive £12.60 an hour and often work 70+ hours a week to cover living costs. Turnover is very high, with it being not untypical for 25 per cent of workers to leave in a year. Workers do tiring, stressful work, often facing assaults and abuse from service users, and demands to work emergency shifts on days off. Many workplaces do not pay sick pay, and in domiciliary care services (where workers do short shifts in service users’ homes) workers are usually not paid for travel time and travel expenses between multiple shifts in a day. Union density hovers around 20 per cent, and workers are often isolated with very little opportunity to talk to their co-workers about issues.

But there are hopeful signs of militancy and organisation emerging in Scotland. This year – with companies offering reduced pay offers, workers at Enable Scotland, Silverline, and multiple councils have voted to strike, while a number of other workplaces have rejected pay offers. After a decade without strikes in third-sector care, co-workers who told me we couldn’t go on strike, now have to grapple with direct, immediate proof to the contrary. UNISON’s annual Scottish care worker conferences have been increasing in attendance for a number of years, with a large proportion of attendees being migrant workers, and Unite are campaigning around extra funding for care workers from the Scottish government. In my workplace, we have reanimated a union branch that has been inactive for years, appointed reps, and begun the work of building a fighting union. Plans are in place in Glasgow for a cross-union rank and file care organising network, similar to what was achieved by Care and Support Workers Organise (CASWO) in different parts of the country. With this upsurge in organising potential, we might look beyond asking for only fair pay and decent conditions, but start to ask questions around how care, work, and mobility should and could be organised. Lutz’s book raises questions around transnational mobility, gender justice, unpaid care and universalisation of provisions for all, that can sharpen our demands as we go ahead.

The Backstage of the Care Economy: Transnational Perspectives on the Commercialisation of Care is published by Pluto Books.