The Care Crisis: What Caused It and How Can We End It?

by Emma Dowling

An examination of the global economic crisis from the perspective of care

Valuing care and care work does not simply mean attributing care work more monetary value. To really achieve change, we must go further.

In this groundbreaking book, Emma Dowling charts the multi-faceted nature of care in the modern world, from the mantras of self-care and what they tell us about our anxieties, to the state of the social care system. She examines the relations of power that play profitability and care off in against one another in a myriad of ways, exposing the devastating impact of financialisation and austerity.

As the world becomes seemingly more uncaring, the calls for people to be more compassionate and empathetic towards one another—in short, to care more—become ever-more vocal. The Care Crisis challenges the idea that people ever stopped caring, but also that the deep and multi-faceted crises of our time will be solved by a simply (re)instilling the virtues of empathy. There is no easy fix.

The Care Crisis enquires into the ways in which the continued off-loading of the cost of care onto the shoulders of underpaid and unpaid realms of society, untangling how this off-loading combines with commodification, marketisation and financialisation to produce the mess we are living in. The Care Crisis charts the current experiments in short-term fixes to the care crisis that are taking place within Britain, with austerity as the backdrop. It maps the economy of abandonment, raising the question: to whom care is afforded? And what would it mean to seriously value care?

Genres: Nonfiction, Politics, Feminism, Social Justice, Research, Health Care, Sociology

256 pages, Hardcover

First published January 26, 2021

Reviews

[Lake · Rating 5 out of 5]

This was great. Well, it was bleak but a good comprehensive picture of care work and effects of austerity, and briefly brexit, in the UK. I especially appreciated the sections about radical community care and mutual aid getting co-opted by neoliberalism, and the disability justice assertion that receiving care is not a passive process.

[Louise Gray · Rating 3 out of 5]

This was an interesting analysis of a system which is failing and has, arguably, always been so. By examining the economic considerations of the caring function, the author manages to remove the emotion which can distort the capacity for rational analysis. I don’t think the analysis really reached a conclusion and maybe that’s okay - these are complex issues - but it certainly makes you think.

[Jonna Feliz · Rating 4 out of 5]

It's difficult to pen a review on something close to one's passion, and Emma Dowling's The Care Crisis: What Caused It and How Can We End It? strikes too close to mine.

Relevant and informative, Dowling provides readers with well-researched insights on what we need to do in regards to the care crisis. In contrast to what most people may currently think, it takes more than education and awareness to solve a problem that's rooted into our current systems and institutions. A complete overturn is needed. A major change in perspective. A forever conscious decision-making of being inclusive to attain a better society—one that is truly for the people, by the people, and with the people.

Being in the mental health profession, I have learned and unlearned a lot, especially over the past few years. There has been a time when I was 100% sold to society's current idea of self-care without realizing what it actually meant. I've learned that how self-care is currently advertised remains inaccessible for most people. A spa day, scented candles, essential oils, books, TV, film, plants, dining out—all of these are some sort of luxury. Even something as simple as a pen and paper may already be inaccessible and seen as luxury. Dowling reminded me to continually seek better approaches whenever I handle mental health-related activities. Instead of bringing "activity kits" for children, why not scout the area beforehand, learn what is accessible for the children, and use what you find by incorporating them into the activities? We need to teach them that self-care is not expensive. That it's not a luxury. That it's not something you can only do if you have the financial capacity. However, as Dowling wonderfully points out, whatever form of self-care we decide to do, it's only a temporary fix if we are unable to change the system.

I currently live in the Philippines—which can either be a third world or developing country depending on whom you'd ask—, and while I am aware that a first-world country, such as the United Kingdom, is extremely far from perfect, I find myself worrying on how imperfect and problematic it is. If a so-called first-world country continues to experience these problems and seems to be far from solving it, I wonder how long it'll take for the Philippines to be able to address the same issues. I've been actively volunteering since 2017, and I only now realize that while being a volunteer is a privilege, the idea of "needing" volunteers is a result of how messed up our system is. If the government is able to actually take care of its constituents, there would no longer be a need for volunteers.

It's already 2021, and while the truth that there is no easy fix remains steadfast, there is also truth in our hope, our wanting, our actions that would lead to a better and more inclusive society. If you find yourself caring about the world even if it's only a bit, this book is a must-read.

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NOTE: Thanks to Verso and the author for providing me an advanced reader's copy via Edelweiss+ in exchange for an honest review! Any quote used in this review is taken from the provided copy, and the final print of the book may differ.

[Bela · Rating 4 out of 5]

The idea of “crisis of care” started coming up a lot around me when the covid-19 pandemic first broke out last year. Although this topic has been discussed by feminists for a while, it became a latent concern of our times, as our societies keep collapsing due to the (intentional) devaluating of care work. This book then appealed to me because Dowling proposes we bring “care” to the centre of our debates about the crises we are experiencing.
Overall, her aim is to unpack the causes and effects of the multiple “crises of care”, narrowing her analysis to context of the UK. Dowling explains how financialised capitalism operates to cut “expenses” on the provision of care so that it can be regulated by the markets. Her main point is to demonstrate that the “austerity” arguments cannot be sustained. While generating profit for investors, the privatization of care work has aggravated the crisis for those who really matter: the ones in need of care and the ones providing care.
The book is thus successful in offering an overview of “what caused” (or rather, exacerbated) the current care crisis (in the UK context),but offers little in terms of “how to end it”. Dowling unravels the many layers of how care work is undervalued, bringing in discussions on gender, race, childcare, elderly care, (dis)abilities, migration, and the role of neoliberalism in aggravating social and economic vulnerabilities. However, the book’s subtitle is misleading when it suggests a tentative plan to tackle the issues. Of course: there really is no simple and immediate solution to the care crisis - but that seems to be her main conclusion in the end.
That said, one thing I truly appreciated was Dowling’s approach from the material experiences of care. Because she relied on interviews and her own observations whilst conducting fieldwork, her understanding of “care” comes from the thoughts and feelings of those that live through this crisis in the frontline. As she introduces each chapter recounting the routines and experiences of her participants, she places their struggles as the most relevant facet of this global phenomenon.
Her investigation of “care”, then, is expansive. Care is not only about the material and physical activities that provide for human beings to live and survive, but also about the emotional circumstances that are part of human life. We all, indeed, care for one another. The problem Dowling brings attention to is how the idea of “care” keeps being co-opted by a neoliberal mentality.

[georgia m · Rating 3 out of 5]

This book looks at the landscape of care in the UK. I found the book to be lacking in the emotional and person-centred discussions that I was expecting, and instead it focused on the politics and economics of care and caring. While I appreciated this approach to ‘harden’ care and highlight its true cost, I found by removing the emotional I (ironically) cared less.

The book offers some interesting case studies, especially about social impact bonds and the privatisation of primary care. It also offered some interesting solutions involving the use of commons and remunicipalisation.

However, I was let down by the loss of the personal touch that I was expecting because of this (overly) political approach to care.

3/5 good, but I do struggle with economics lol x

[Ann Douglas · Rating 5 out of 5]

I've been reading a lot of books about care: why care matters, what it means to care for one another, and how we could reimagine our economy and political systems in a way that actually values care. This book is the best of the bunch. It's meticulously researched, beautifully written, and unapologetically radical in its politics. ("Care is about the maintenance of life for itself. Care is therefore more than the necessary labour of producing a healthy workforce. Caring for ourselves and for others can be about clawing back time and space beyond the logic of productivity that dominates our lives and is destroying the planet.") Highly recommended.

[Kate Page · Rating 5 out of 5]

This is really good. An excellent, nuanced analysis firmly underpinned by a critique of capitalism. It’s very readable and extensive in its exploration of the care crisis. I came to it because of an interest and experience of care for the very elderly, but it’s scope is broader than that. Really worth reading.

[Lex · Rating 3 out of 5]

A somewhat dry and academic read, but nevertheless covers an interesting topic in depth.

[John Mihelic · Rating 4 out of 5]

Today I'm going to talk about the Care Crisis by Emma Dowling. It is a new release from Verso and the subtitle “is what caused it and how can we end it”. Overall it's a pretty good book. It does identify a lot of the problems with our caring organizations from the elderly all the way on down to the youth. I think the big problem for me with this book was that it was more focused on the British context. And they fund their care a little bit differently than we do here in America. But what we do have in common is that there is a lack of funding and support for the organization of the people who do care in both countries.

This of course is a little bit is a bit disappointing because I think there's an idea that the European system and model is a little bit better in terms of healthcare. But especially in the English context we've seen how neoliberalism has brought its Market upon everything.

The English have less distributed governments in terms of taxing. They have their local Council but they're reliant on getting grants from the central government and these grants have been cut over time so the organizations that are reliant on funding for them are just in trouble. Here in America I know personally I work for a caring organization and though we have multiple funding streams that complicate our financials if there is a cut from our funders we have other fullbacks. That's less so here in the context that Dowling describes. So what happens is there's less time and people are more stretched and people that need care either don't get it or it's at a substandard level.

When this book is at its strongest it is in describing the various problems we have with the caring organizations. It does fall off a little at the end, the last two chapters. The penultimate chapter is one that talks about self-care and it kind of feels like it's from left field and doesn't fit in with the rest of the book really. And then the final chapter is the inevitable what is to be done chapter and it just doesn't feel as if there is a way to push back against neoliberalism because it is working within that context and really the entire social system and economic system needs to be reformed and unfortunately I don’t think it's going to happen tomorrow. But overall it's a worthwhile read.

[Amanda Rivera-Griffith · Rating 4 out of 5]

This was an interesting book dealing with the economics of care. It was interesting to see how the cost of care is very much offloaded onto those who are underpaid and overworked. While this book will not make you feel more optimistic about today’s society or the ways in which the United States handles healthcare, it will leave you more informed.

[Frances De Guzman · Rating 4 out of 5]

Very insightful in how we as a society view care work and why it is inherently flawed. Applying this to the context of the PH is eye opening and enraging.

[Tadeáš · Rating 3 out of 5]

While we are talking about multiple crises such as climate change, inequality, and cost of living crises, the care crises seem to be discussed the least often and sidelined. What Dowling frames as care crises is the growing gap between the care needs and the resources made available to meet them or the externalization of care work onto families and communities while diminishing their capacity to perform it. As also COVID pandemic has also shown, we’re in a situation where those workers that society needs the most are concurrently some of the most undervalued of all - a process that Nancy Folbre calls care penalty - those who provide care end up being disadvantaged in many different ways. Throughout the book, she illuminates numerous examples of how neoliberal logic puts the solution of systemic care problems on the shoulders of the individuals or financial markets often only deepening the crises.

Her depiction of the austerity measures and financial cuts after 2008’s financial crises in the UK and its impacts on care provision is staggering. As a result of budget cuts, lots of care services have been privatized and financialised. However, leaving the provision of care to the for-profit market economy and financial markets proved to be disastrous. In order to make care profitable, the strategy of „economies of scale“ and optimization doesn’t directly apply to the care sectors as increasing productivity of care workers translates to worse working conditions and also the quality of care services. The logic of profit-maximization applied to care leads to increasing prices and care being unavailable for many, suppressing wages and eroding working conditions, or financial wealth extraction, where public funds are pretty much transferred to the richest. While she describes the context of the UK, the more international and global consequences are crucial, as to solve the care crises in one place may simply mean shifting it elsewhere or onto somebody else - a process she calls a care fix (throughout the book she describes several different types of care fixes) - often through the so-called global care chains where it’s more and more women from the global South or Eastern Europe that fulfill the care needs of Northern Europeans.

While the book offers a very well-researched analysis of what’s wrong with the current economic system in relation to care, I would have hoped for a bigger focus to be given to solutions and already good-working cases of decommodified care provision throughout the world, as the chapter on solutions is rather brief. I’m also thinking about the potential of politically connecting care workers' struggle with environmentalists - as both of these groups are fighting for the reproduction of ourselves, and yet the links are rarely made.

[William Palmer · Rating 3 out of 5]

This is a very well researched book and clearly from a point of expertise. It gives a great account of the impacts of austerity as well as what it means to care. I do feel, though, that whilst the book argues well against the current situation and policy decisions, it fails to argue for its conclusions beyond them being different from the present. The conclusion would be improved by examples of the solutions suggested. Furthermore, the text is very academic and dry so it is sometimes quite impenetrable. Whilst it was not in the original remit of the book, and likely there was not time to thoroughly integrate it, there is not masses of discussion of the impact of Brexit and even less discussion of the impact of covid. Whilst it's difficult to keep any political book up to date, and many of the problems are similar to before or have been exacerbated by these events, it further dampens the conclusion at is clear any "fixes" to this crisis will have to account for the lasting impact of both of these events.

[Brumaire Bodbyl-Mast · Rating 5 out of 5]

A worthwhile look into the issue of care in the UK and Western World more broadly- and care is used in a somewhat general sense, along with its more particular sense (ie care work) throughout this book. Dowling wrote the large body of it prior to COVID, and its split focus on different failings or weak aspects of the care system served to be predictive as to what would become a problem in the UK during the pandemic, though it doesn’t take much logical thinking to surmise that poking holes in a public health system like the NHS would naturally weaken the response of a society to COVID. Her discussion of several societal trends, some privately propelled, such as the continued buyout of the NHS and the massive privatization of care, or the policies of self care resulting from austerity politics, which drive to blame the individual and frame those who seek/receive healthcare as frauds. The way the chapters are structured into broad topics with little vignettes makes it an easy and digestible read. It also proves poignant even to audiences outside the UK.

[Ross Goldstone · Rating 2 out of 5]

Whilst covering an important topic, this book is not written particularly well and is probably a third longer than it should be. Unfortunately the momentum is lost when the discussions turns away from social care and towards other topics, including ‘clean beauty’ and ‘clean eating’. The points being made in these sections could have been made in a few sentences. I pressed on towards the end of the book but there were not clear solutions proposed, which was a surprise given the critique throughout.

[Nathan Shuherk · Rating 3 out of 5]

An interesting topic with good information that’s hyper specific, but there’s no solid conclusion. The writing is needlessly dry (the amount parenthetical phrases is maddening - which is not something I would normally point out in a review, but is sort of startling and completely takes out the reader from a natural flow).

[Sean Dunnsue · Rating 3 out of 5]

really interesting analysis of the structural factors that gird (or perhaps more accurately, undermine) the care systems in the UK. certainly, many of dowling's takeaways are applicable to other high-powered countries with poor care infrastructure, of which there appear to be troublingly many. valuable insights for shaping the values and principles around which our society is oriented.

as a slight critique, i do feel like the text got a bit repetitive at times. the thesis was clear, and well evidenced, but could the ideas in each chapter have coalesced more succinctly, so as to build momentum over the course of the text? possibly! but in any case, a tremendously important and inspiring work.

[Joseph · Rating 4 out of 5]

Great study. More information on other countries would have been also useful. This is a study of the UK care system.

[Andrew Westle · Rating 4 out of 5]

I remember in the middle of the 20-21 lockdown, being asked how I felt in a meeting, and responding “I feel exhausted”. I was burnt out, tired and was not feeling myself, I didn’t want anyone to treatment different, or didn’t need anyone to ‘save me’, I just needed to be heard, instead I received a phone call, after this meeting from someone in management to tell me I was out of line, and risked brining the mood down of the team. Maybe quite an inconsequential moment, but set me off to read more about care in different formates and in different ways. It is easier to talk about care and throw around notions of care, it’s quite another to create a culture of care in neoliberal structures.
What I loved about this book was the way it dissected care in so many different ways, at times the picture is really bleak. It’s a well researched book, that is insightful and illuminating. Why is it that we place care as such a low priority in a social in which it’s the one thing we can do for others that doesn’t need to be economically based. It’s structure around economic productivity that have shaped ideas of care. For example “self-care” which is a prime example of neoliberalism.
Anyway that’s some of my rambling thoughts in a book that deserves to be read and engaged with widely.

[Lili · Rating 4 out of 5]

jelentem az olvasói krízisem még mindig tart, erről csak assignmentet írok (de am jó volt)