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Why it is vital we properly recognise the care economy – opinion

Fixing aged care is set to be a key priority of the new government under Prime Minister Anthony Albanese. So is a more affordable and improved system of child care, reform of the NDIS, and strengthening Medicare and the health care system.

What binds these issues together is their recognition as part of the ‘care economy’. Data on the size and significance of the care economy can be alarming. Reflecting the huge growth in the provision of formal services in these fields since the 1960s, there has been a continuing rise in employment in aged and child care, disability and health care.

Employment in the ‘health care and social assistance’ sector, as the ABS calls it, has been the most rapidly growing form of work and is now the largest field of employment in Australia and in comparable countries.

Most workers in the care economy are women. Wages are low in comparison with those in comparable fields, and employment conditions are increasingly precarious. Income growth and career prospects lag well behind most other areas. No wonder there are staff shortages.

Much care continues to be provided by women and men, working in their own homes, families and neighbourhoods without pay. They work as family carers, volunteers and members of a wide range
of non-profit community organisations.

But the meaning of the term is not really captured by simply adding up all the statistics. The point of identifying care as an economy that is essential to the functioning of the modern world is to recognise that in a global market system, the complexity of the way that care is produced, exchanged and used
can no longer just be ignored or taken for granted. Nor can it be understood simply as just another specialised sector of the larger economy.

Instead, recognition of the care economy draws attention to the unique way that care is produced, distributed and used. It serves to meet fundamental needs in a manner that shapes and reshapes the lives that all people lead. It is both a product of the system of our market society, and a force that in turn helps shape the families, communities and nations in which we live.

Recognising the care economy in this way is comparable to the acknowledgement of climate change and the environment. Both are foundations on which the world as we know it depends.

Meanwhile, the ongoing policy failures in aged care and problems with childcare, disability and health care have typically been regarded as essentially local. But problems in the care economy are experienced internationally and require a longer-term, global perspective alongside one that focuses on national policies and local solutions. There is also much to be learned from the experience of other countries.

It is often argued, correctly in my view, that these problems are an expression of gender-based discrimination leading to the disadvantage and unequal treatment of women. In Australia, for example, national governments over the past decade have promoted the virtues of employment in traditionally male dominated industries such as mining, while presiding over deteriorating wages, staff ratios and employment conditions in aged care and childcare.

But the care economy perspective also helps identify other factors involved. In contrast to many other areas of the economy where production costs have fallen, care services are delivered on-site, at the point of consumption and continue to be produced almost entirely by people working one-to-one. Not surprisingly, the overall proportion of GDP spent on costs of care have risen.

Attempts to drive the costs of care down have focused on reducing the core costs, ie wage costs. Is it any wonder that these career-killing strategies have not attracted sufficient highly qualified staff?

While markets have been promoted as a solution to all problems, the care economy, internationally as well as in Australia, would not exist without government funding, support by non-profit community groups and unpaid family care.

This mix came about because access to care is essential and markets have failed to provide acceptable solutions for the majority of citizens. We should not forget how these foundations need to be maintained and improved, not abolished.

Drawing attention to the way that care operates as a social investment and not just a cost, can lift debate about care, both paid and unpaid, and help create hope for a better future.

Michael Fine is Honorary Professor in the School of Social Sciences at Macquarie University.

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