The Retreat of the State and Long-Term Care Provision: Implications for Frail Elderly People, Unpaid Family Carers and Paid Home Care Workers

Market-Modelled Home Care: Impact on Job Satisfaction and Propensity to Leave

“…With the introduction of managed competition, the CCAC's and agency's relationship moved from a system largely organized and run by the non-profit sector, focused on providing quality care to those in need of service, to becoming more business-like, one of purchaser and supplier and one that provided opportunities to both the non-profit and for-profit service providers (Aronson and Neysmith 2006;Baranek, Deber and Williams 2004). Because contracts were awarded based on market share, there were no guarantees of service volumes which were dependent on the CCAC's annual budget, the way in which they allocated services and their administrative costs.…”

“…Fearing loss of contract with the next RFP, agencies submit their proposals based on a low service fee and often they are unable to absorb changes in volume or an increase in client acuity (Aronson, Denton and Zeytinoglu 2004). As a consequence, workloads have increased as SPOs make more client visits per day with fewer resources to clients with greater care needs (Aronson, Denton and Zeytinoglu 2004;Aronson and Neysmith 1997;Woodward et al 2004). Workers have been faced with fewer continuous hours of work and a lack of job security as they were expected to follow their clients (Aronson, Denton and Zeytinoglu 2004).…”

“…Job insecurity associated with the threat of closure and cutbacks has increased dramatically and to date, agencies have lost many of their employees and some have closed. The future of each agency is uncertain (Aronson, Denton and Zeytinoglu 2004;Aronson and Neysmith 2006;Denton et al 2006a). …”

“…This may be attributed in part to the fact that work in the home has typically been devalued as low status and characterized by poor employment conditions across Canada (Armstrong and Armstrong 2003;Aronson, Denton and Zeytinoglu 2004;Aronson and Neysmith 1996). The casualization of labour, work intensification, low wages and benefits, and increases in job insecurity are seen as characteristic outcomes of quasi-market approaches to labour-intensive service work (Aronson and Neysmith 2006;Ladipo and Wilkinson 2002;Light 2001). The impact of the implementation of policy that introduces market principles on the retention of home-care workers, however, is far less clear.…”

Exploring the experiences and perceptions of precarious employment on subjective wellbeing among women aged 24-44 living in Northern BC

“…Ferrarini (2006) demonstrated that the labour markets are gendered institutions operating at the intersection of the productive and reproductive economies. Feminist scholarship has also examined the ways in which neoliberal policies and restructuring processes disproportionately affect women and visible minorities (Aronson & Neysmith, 1997). Brodie and Baaker (2008) argue that in Canada and elsewhere, research has demonstrated that privatization and the erosion of social programs force health and child care back onto the family and the unpaid work of women (p. 54).…”