Working within health & care

The sectors health & care, support and prevention which are constantly growing in terms of demand and job opportunities are showing developments and tendencies which are only done justice to by a much differentiated inspection and description of all people involved.
Here we can cover this subject matter only in extracts –moreover the characteristics in the individual project partner countries are very different. Especially interesting to us is the fact that organizations from the “new” EU-member states are part of this project partnership. In Western countries very often a clear-cut position is being put forward: qualified personnel from these countries migrate in (neighbour) countries with a higher wage level. However that can be phrased differently: the supply system of the Western states primarily benefits from the qualified personnel coming from and being drawn off the (neighbour) countries with lower wage level. The health sector is being exposed to an intense process of change and at the same time all the people working in this sector are facing specific requirements. The increase in life expectancy in addition with the changing social structures will produce an augmentation of qualified personnel for the care, support and attendance of elderly, multiply diseased and/or handicapped people. At the same time the requirements of the specific job descriptions are changing: for the higher qualified personnel in the health and care sector the key aspects of activity will be much more focused on health promotion, prevention, education, consulting, …., and case- and care management.
Generally one can say that the sector health, prevention, care, support, attendance, ….is on the increase in the whole of Europe (in terms of demand and as well in terms of the technical quality of the services on offer). At the same time the job descriptions and vocational trainings in this sector are still far from unitarily applicable European standards. Additionally the trend towards an amplified perception of the human body, health, sickness and diverse methods of prevention is having an effect on the creation and increase in demand in “new” services in this sector in many countries. With this, this job sector which traditionally focuses on the care of sick, handicapped and elderly people is being expanded into many further professions of the service sector which are not limited towards convalescence or care.
While in recent years the discussion within the European community has not only been on demographical questions but also on unitary standards for trainings and the aim to reach a cross-national mobility of professionals in this sector, the shortage in care and support forced policy and public in some Western countries (esp. Austria) into a direct and fiercely conducted discussion. Solutions have not been reached so far. Once more the public came to realize what a high input is being delivered by female family members in terms of support and what an impact its discontinuation or omission has on the care system. Within this discussion the conditions of employment of the nursing staff were discussed and the claim for binding regulations in order to protect the employees was pushed. With this discussion it got obvious how conflicting the situation and the handling of the personnel within the care professions are. Notwithstanding the fact that it is seen as objectionable and immoral that care personnel is exploited by doing a 2-week work shift (that is to say a permanent presence and availability in the residence of the patients in need of care), the decisions are still primarily based on monetary criteria - the less cost-intensive solution will be chosen in spite of all the other criteria. The interests of the employers are put first and with it the discourse on protection and safeguarding – the situation of the other party in this employment status (which is increasingly taken up by migrant women) scarcely attracts any interest and if so, it is only a peripheral one. Thus the majority societies put their focus on accomplishing the challenges of being able to offer the people in need of care the state of the art in terms of medicine and developments of the theory of care while primarily respecting the economical factors in combination with having to consider high quality standards within the care system. In this way the people delivering care services are bound to reliving the age-long inequality and the familiar forms of exploitation. Thus prevention, support and care for children, for the sick, handicapped and elderly are earmarked by:

  • a high input in time, including the frequent necessity to provide an around-the-clock service
  • a notably high physical and psychological pressure
  • high flexibility
  • a permanent training – according to the developments in the sector as well as the standards (availability of resources for further training)
  • an explicitly low prestige of these professions within society
  • this work is still dominantly executed by women
  • and within the group of women this work is increasingly sourced out onto migrant women

Thus a trade in services that is exclusively oriented on micro- and macro economical advantages of individuals and individual societies is recurring which is located mainly in the grey area in Austria in spite of interim development of rudimentary political solutions.
“…, simultaneously a condition which – in reference to the significance of the emotional component in the care profession - was characterized as “emotions-imperialism” by the sociologist Arlie Russel Hochschild is tacitly boosted: like in former times the raw materials were exploited form the colonies, nowadays personnel for the care sector in wealthy states is extracted from poorer countries. The “deficit in care” – the growing need in care personnel in the target countries – and the poverty in the countries of origin bring about a worldwide migration movement of care personnel towards rich countries.
By means of illegalization they are held cheap and docile. These working conditions are scarcely broached of: their own relatives in need of care have to be left behind, in lack of legal rights the dependence on the employer is huge, wages are low, the workload is high, the social status is marginal, the social security and the professional possibilities of change are non-existent (cp. Hausarbeits-Schwerpunkt in MALMOE 20)”.
The Austrian chamber of labor (Arbeiterkammer) predicts the following employment tendencies in this sector:
“In comparison to other professions in the health sector and in the social and charitable field only a meager growth in the employment of care personnel is to be expected. While the employment of women increases noticeably with +700, a decrease of male employees is being forecasted. Thus the percentage of women in this professional sector rises up to more than 90%”.