Clap for carers? From care gratitude to care justice

As we write this short piece in late April 2020, Matt Hancock, the Conservative government’s Secretary of State for Health and Social Care in the United Kingdom, has just announced that the critical care workers during Covid-19 are to be issued with a blue badge. This is a ‘badge of honour’ to mark their commitment to the nation during this pandemic and recognise that they put their lives at risk working at the frontline of the outbreak. Yes, a blue badge. This comes after weeks of national displays of gratitude that began with support for the National Health Service (NHS) and then extended to carers. ‘Clap for carers’ sees neighbours stand on their doorsteps every Thursday at 8 pm, banging pots and pans, sometimes accompanied by supportive police sirens and flashing lights, to show our united public affection for those saving our lives right now during the coronavirus pandemic. During the crisis, the United Kingdom is showing its appreciation in highly visible ways: the nation’s windows are adorned with children’s pictures of rainbows; buildings are lit up in the blue of the NHS; murals of masked nurses as heroes are springing up on the side of buildings; farmers are ploughing NHS signs into their fields; and some people have even put their Christmas lights back up. Reflecting this surge of ‘caring’ nationalism, even Boris Johnson, the UK prime minister (who contracted Covid-19 after displays of macho bravado, which included boasting about shaking hands with Covid patients) stated on his hospital release that the NHS was ‘powered by love’. How ‘caring’ and sentimental this all seems right now.

This affective mood generated through the valorisation of our care staff may indeed be heart-warming, especially as a salutary response to our very real fears. Clapping as a public form of recognition is a demonstration of our collective feeling, perhaps finally socialising some understanding of how we all ultimately rely on care workers, who are grafting against the odds on the ‘frontline’ in a war against Covid-19. But let’s also not forget that to date (22 April 2020) 119 NHS staff have died, ¹ a number which does not include other affected care workers. Of these deaths, 53% are BME (Black and Minority Ethnic) under a government that is increasingly hostile to their very existence. Rightly, Matt Hancock has come under considerable criticism for the meagreness of the gesture of the badge in a context where the NHS has been subject to a decade of austerity policies. In the last decade, Conservative governments have enacted swathing cuts to health and welfare accompanied by the encroaching grip of financialization and the privatisation of provision (Toynbee and Walker, 2020). The irony of a Conservative government that voted against a pay rise for nurses numerous times, most recently in 2017 ² and that withdrew nursing bursaries while charging nursing students £9000 per year in tuition fees (leading to a drastic reduction in nurse applications) now declaring their ‘love’ and very publicly applauding the NHS, is not lost on some (Hamad, 2020).

Austerity mood

A sentimental mood alone, therefore, is not enough – another affect must be unleashed – anger, mobilised by knowledge of the litany of state-sponsored abuses that have already enacted a mass killing of ‘neglect by design’ (Skeggs, 2019) which makes those already vulnerable even more so. In the United Kingdom in 2019 austerity was to blame for 130,000 preventable deaths according to a report by the think-tank IPPR. ³ Before Covid, more than 50,000 older people died waiting in vain for care during the 700 days since the Government first said it would publish a Care Green Paper (Age UK, 2019). ⁴ About 17,000 people died while waiting to hear whether their claim for disability benefit had been successful since 2013. ⁵ Over the last decade, there has also been a stark rise in the use of foodbanks: over 2000 in the seventh richest country in the world. ⁶ Homelessness has also rapidly increased in the United Kingdom, with a child becoming homeless every 8 minutes (Shelter, 2019). This is on top of the enormous cuts to the NHS and the privatisation of a great many of its services. Taken together, these austerity policies have already led to a significant rise in UK mortality rates, which geographer Danny Dorling (2018, 2019) has been reporting for some time. These include rises in infant mortality, as well as decreases in life expectancy, especially among women – a trend that is extremely unusual for a wealthy Western nation, reversing decades of progress. Yet victims of austerity have been met with devastating stigma in a cultural war that secured consent for state-sponsored neglect (Tyler, 2020) before the pandemic hit.

It is important, then that these facts are clear and that the collective mood and emotional appeals like ‘clap for carers’ are not allowed to distract us from the conditions for care that pre-existed the coronavirus. With a blatant disregard for the lives of the poor and vulnerable, care has also become a valuable and lucrative space for profit. There are currently over 3,600 care home agencies in the United Kingdom, with a Byzantine structure of finance and regulation. Adult care homes are almost entirely privately owned and many have been taken over by big chains funded by global private equity, looking for a 12% return on their financial investments. ⁷ What should be a relatively low-risk and low-return operation has been turned into a high-risk and high-return enterprise via debt-based financial engineering that is more usually applied to other sectors like tech. When its risk-taking failed, this privatised sector was bailed out by public money amid the rising costs of care paid for by the state (Cresc, 2016). The lack of responsibility taken by the state for its vulnerable members and the acceleration of mechanisms by which those most in need also become a source of profit, are two major features of the welfare landscape. We should therefore be clear, that while we all now feel exposed to the impact of Covid-19, the most vulnerable in our society have been prey for voracious venture capitalists oiled by state indifference, long before the pathogen arrived. (At the end of April 2020, the number of deaths in care homes due to Covid-19 is only recently being accounted for in the total figures, at around 4,300 deaths in a fortnight, a figure which is said to be grossly underestimated ⁸ and twice the usual number of deaths in homes. ⁹ )

What kind of society do we live in where the elderly, disabled, and even abused children (Neyland, 2017) have become a lucrative source of capital extraction? Human suffering has been monetised as the costs of austerity and financial gambling are born by Covid patients and welfare workers, while hedge funds continue to capitalise on the defenceless. We have already witnessed hedge funds profiting from the crisis, with one proudly reporting 2.4 bn profit in a relatively short period of the global pandemic. ¹⁰

What has been happening in the care sector is the privatisation of the gains alongside the socialisation of the losses; the monetisation of care has had real and devastating effects on the lives of the carers and the cared for – and we must remember this when we clap. The elderly suffer abuses of the system, some of which have been exposed in the reporting of care home scandals, and which we have seen in our own personal experiences. ¹¹ We know that the care sector in the United Kingdom is characterised by low wages and high staff turnover. We know that the pressure to extract capital from care has put extreme pressure on the ability to care itself, as carers are routinely given just 15 minutes at a time to care for ‘clients’ with complex needs. We see the impact of zero-hours contracts on working conditions as the space for actual care is eroded, while the management of care for the extraction of profit is prioritised by the bigger chains in the private sector. ¹² We also see this artfully explored in Ken Loach’s 2019 film Sorry We Missed You where equivalences are drawn between the male delivery driver who must meet targets to deliver boxes, and the female care worker trying to reach homes within short time scales to patch up human suffering, both with no employment rights or protections. In this structure, carers as well as the cared for are suffering, which suggests that we will all, at some point, painfully feel the human cost of the crisis of caring.

Who cares?

Boris Johnson might display sentimental affection now, but he is the leader of a party that brayed and laughed in 2013 at the stark rise in people using foodbanks. ¹³ We should know that this Conservative government really do not care, but what has become increasingly clear through the development of the pandemic is that the public do. People have been innovatively developing ways of supporting each other: Mutual Aid UK reports over 3,500 groups ¹⁴ and over 750,000 people have volunteered to help the NHS. Foodbanks proliferate more widely and homeless charities work tirelessly to accommodate people. All of this is occurring not just after the brutal effects of austerity, but also the 40-year promotion of individualism beginning with Margaret Thatcher’s declaration that ‘there is no such thing as society’. Incredibly, this was recently reversed by Boris Johnson who conceded that ‘there really is such a thing as society’, because now society is vital to our very survival. ¹⁵ Following years of the denial of class – beginning with Thatcher, supported by Blair and New Labour, dodgy sociologists, and a craven media (Skeggs, 2004) – we have seen some extraordinary, even if momentary, reversals: such as The Financial Times editorial team calling for a new social contract that includes social provision ¹⁶ and the Telegraph (traditionally a stalwart right-wing government supporter) criticising the government as ‘shambolic’. ¹⁷ The flagship BBC Newsnight programme, certainly not known for its radicalism recently, broadcast a challenging news report questioning ideas about the virus being a ‘great leveller’; the presenter Emily Maitlis criticised the ‘trite reporting’ about ‘fortitude and character’ as promoted by the government. ¹⁸ It was a powerfully affective performance in recognition of deeply entrenched inequality. Disappointing though it is that it takes the white middle-brow media to endorse what many have known for some time to break through the wall of strategic wilful ignorance.

Time to care

It is important therefore that this current affective mood of heart-felt appreciation is also translated into demands for material change and there is evidence that during the clap for carers, we can also hear calls to ‘give them their PPE and pay’. We will all need social care at some point in our lives. Social reproduction is fundamental to the maintenance of human life and flourishing; it is crucial to the reproduction and maintenance of the workforce for capital, and yet it has been the most devalued of sectors of the labour force. While we have focussed on the context of the United Kingdom, the degradation of social care has been fundamental to the advance of global capital and is one of its key internal contradictions, periodically resulting in a crisis because capitalism undermines its own background conditions of possibility (Fraser, 2016). This has happened primarily because the work of care has largely fallen to women around the world, and the exploitation of their invisible labour has enabled the accumulation of capital into the hands of relatively few men. In the United States, the legacy of slavery has meant that domestic care workers have been for a long time locked out of labour reforms and protection, presenting a gendered and racialised history of care that abets carers’ exploitation. ¹⁹ Oxfam’s 2020 Time to Care report shows the direct relationship between the unpaid and underpaid formations of care in advancing structural global inequalities, estimating that the monetary value of the unpaid care of women workers over the age of 15 around the world is in the region of $10.8 trillion, three times the value of the world’s tech industries. ²⁰

This is the landscape of care that preceded Covid-19 and is seldom made apparent in the nationalised public displays of affection. Recognition and gratitude for care must now turn into care justice. How then do we put the humanity back into care? How do we restore some commitment to alleviating human suffering, and value time and emotion to support our basic human love for each other? This would require a large-scale social project that must restore collective thinking through the heart of government and the establishment of a caring state ²¹ with a newly extended ‘care imagination’ (Chatzidakis and Segal, 2020). But this must also begin with gaining public support for an ideological shift away from the individualised, competitive and monetised frameworks that have tried to ease out responsibility and compassion. Our affective sense of national pride for our carers and the NHS now dealing with our devastating ‘man’-made social frailty must also be accompanied by other socialised emotions – those which can illuminate and internationalise the injustice that hides behind the rhetoric of the ‘heroic’ frontline in the face of a global pandemic. This is a frontline made all the more perilous by the cruel workings of the extraction of capital at the expense of humanity.

Feminist theorists have long called for a revaluation and appreciation of care, pointing out that ‘Moralities built in the image of the independent autonomous rational individual largely overlook the realities of human dependence’ (Held, 2006: 10). Care is based upon fundamental human needs, interdependencies and vulnerabilities; care labour has always been hard, back-breaking work that is at the heart of our societal structures and yet it has always been denied its rightful social value. Right now, at the same time that it is being rhetorically lauded, it is also being directly exploited by the wealthiest of society. We need more than clapping to re-right these long established forms of injustice. After all, it has taken a global pandemic to publicly and politically care about care at all.