Critical to Care

by Armstrong, Pat

• ISBN13: 9780802093332
• ISBN10: 0802093337
• Format: Hardcover
• Copyright: 2008-06-14
• Publisher: Univ of Toronto Pr

Summary

"Who counts as a health care worker? The question of where we draw the line between health care workers and non-health care workers is not merely a matter of academic nicety or a debate without consequences for care. It is a central issue for policy development because the definition often results in a division among workers in ways that undermine care.Critical to Care uses a wide range of evidence to reveal the contributions that those who provide personal care, who cook, clean, keep records, and do laundry make to health services. As a result of current reforms, these workers are increasingly treated as peripheral even though the research on what determines health demonstrates that their work is essential. The authors stress the invisibility and undervaluing of 'women's work' as well as the importance of context in understanding how this work is defined and treated.Through a gendered analysis, Critical to Care establishes a basis for discussing research, policy, and other actions in relation to the work of thousands of marginalized women and men every day."

Author Biography

Pat Armstrong is a professor in the Department of Sociology at York University and holds a CHSRF/CIHR Chair in Applied Health Services and Nursing Research. Hugh Armstrong is a professor in the School of Social Work and the Institute of Political Economy at Carleton University. Krista Scott-Dixon is a research associate at the Institute for Work and Health in Toronto.

Table of Contents

List of Figures and Tables	p. ix
Acknowledgments	p. xi
Introduction	p. 3
Critical to Care: Invisible and Undervalued	p. 4
Counting the Work and the Workers	p. 6
Determining Who Counts	p. 7
Identifying Contributions to Care	p. 8
Making Gender Matters Visible	p. 9
Exposing Health Hazards at Work	p. 9
Establishing the Context: Further Explanations	p. 10
Developing Options	p. 11
Building on the Past, Moving to the Future	p. 12
Counting the Work and the Workers	p. 14
Clerical Work	p. 19
Assisting Occupations in Health Care	p. 36
Visiting Homemakers, Housekeepers, and Related Occupations	p. 42
Cleaning/Housekeeping, Laundry, and Food Services	p. 44
Security Work	p. 52
Managers	p. 52
Unpaid Ancillary Work	p. 56
The Composite Picture	p. 59
Determining Who Counts	p. 62
Feminist Political Economy	p. 63
The Determinants of Health	p. 66
Identifying Contributions to Care	p. 75
The Specificity of Health Care	p. 75
The Origins of Ancillary Work	p. 82
Conclusions	p. 87
Making Gender Matters Visible	p. 88
Women's Care Work	p. 88
Skills and Care	p. 91
Defining Skills	p. 92
Gender Skills	p. 93
Health Care Skills	p. 96
Regulation and Training	p. 103
Resistance	p. 105
Moving into the Labour Force	p. 105
Unions and Professions	p. 109
Women's Individual Responses	p. 116
Conclusions	p. 119
Exposing Health Hazards at Work	p. 121
Infection and Respiratory Diseases	p. 123
Lifting, Bending, Twisting, and Musculoskeletal Injuries	p. 124
Chemicals, Needles, and Cuts	p. 126
Lack of Employment Security and Control	p. 127
Workplace Organization	p. 130
Workplace Violence, Bullying, Sexual Harassment, and Racism	p. 135
Lack of Respect	p. 138
Conclusions	p. 138
Challenging the Construction of Ancillary Work	p. 140
International Contexts and Trends	p. 140
Rising Health Care Expenditures	p. 140
New Public Management	p. 143
Health Care as an Opportunity for Profit	p. 146
Global Markets and Workers	p. 150
The Health Policy Context in Canada	p. 152
Public Health Care in Canada	p. 153
Privatization	p. 156
Integration and Teamwork	p. 160
Evidence-Based Decision Making	p. 162
Accountability	p. 164
Public Health	p. 167
Regionalization and Decentralization	p. 168
Conclusions	p. 169
Developing Options	p. 170
Implications for Policy, Research, and Action	p. 171
First, We Need an Active State	p. 172
Second, We Need Better Management	p. 175
Third, We Need to Promote Unions and Other Forms of Collective Organization	p. 177
Fourth, We Need More and Better Research	p. 180
Conclusions	p. 181
A Guide to Canadian Data on Ancillary Workers in the Health Care Sector	p. 183
Introduction: Interpret Data with Care!	p. 183
Methodology and General Overview	p. 184
Notes on the Labour Force Survey	p. 185
Notes on Census Data	p. 185
Defining Ancillary Occupations in Health Care	p. 186
The Importance of Industry	p. 189
Form of Employment	p. 191
Immigrant and Visible Minority Status	p. 193
References	p. 195
Index	p. 219
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