Private for‐profit home care providers have grown unevenly in Europe and through varied processes. Yet, more research focusing directly on private providers is needed to identify and explain European patterns in their growth and in their modes of operation. This paper examines the case of Ireland, where private providers have grown significantly in recent years and transformed the national landscape of domiciliary care. First, it is shown that the amount of public funding received by private providers increased from €3 million in 2006 to €176 million in 2019, in contrast to amounts allocated to non‐profit and public providers that have increased only slightly. Second, those trends are explained through policy analysis and by drawing on in‐depth semi‐structured interviews (n = 12) with private home care providers and government officials who have been central to the privatization of care. The paper gives a direct voice to key figures in private home care, and through a critical reading of interview materials, argues that the neoliberal nature of the Irish state has driven the growth of private provision, in particular, through policies of competitive tendering and fiscalization. Providers' own lobbying activities have also played a role, albeit a secondary one. Ireland has traditionally followed a laissez‐faire, family‐based system comparable to Southern European countries. Its experience is thus directly relevant to that region, but further research should also compare and contrast the development of private providers operating in other European long‐term care regimes.
This article examines home care professionals’ views on working conditions during the COVID-19 pandemic. In particular, it identifies similarities and differences between private, public and non-profit providers. The article seeks to shed light on the impacts of marketisation/privatisation on working conditions during the pandemic. Statistical tests on 350 questionnaires received from care workers in Ireland demonstrate the difficult working conditions during COVID-19 and variations by type of employer. We discuss an apparent ‘return of the state’ in home care provision during the pandemic, which may have dampened differences between types of providers.
The marketisation of European home care has given rise to significant private for-profit providers growth. However, little research has focused directly on commercial companies to examine the mechanisms through which they emerge, grow and shape long-term care policy – this is this paper’s task. Drawing on the literature on business power, the recent concept of “institutional business power” is introduced, defined as the power flowing from the entrenched position of business actors in the provision of public social services. The paper identifies the mechanisms through which private providers have grown and assesses the extent of their institutional power by examining their influence on policy and the support they obtain from relevant home care stakeholders. The limits of providers’ institutional power are also discussed. The paper relies on semi-structured interviews with representatives of public, private and non-profit home care providers.
PurposeThe purpose of this paper is to compare home care workers' views of their employment conditions by provider type – private for-profit vs public and non-profit – using the case study of Ireland.Design/methodology/approachAn online survey was distributed to care workers (n = 350) employed by private for-profit, public and non-profit home care providers in Ireland. Returned questionnaires were analysed statistically in R using chi-squared tests to systematically compare key aspects of employment conditions.FindingsAnalysis shows that conditions are perceived to be significantly worse for those employed by private for-profit providers (and to a lesser extent non-profit organisations) compared to the public provider. There are wide disparities between public and private sector conditions in terms of contracts, pensions, unsocial hours pay and travel time allowances. The main area of convergence is in relation to employer support, where although the public sector performed better, the difference between the three provider types is smaller.Originality/valueRelatively little research compares working conditions in private for-profit providers vs public and non-profit providers in Ireland and other countries. The findings can be understood in the context of marketisation reforms and may partly be explained by a lack of regulation in Ireland's home care sector and low unionisation rates amongst care workers employed by private for-profit providers.
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