Care on market terms – working conditions and orientations in the fragmented Danish domiciliary elderly care

Abstract

This article investigates the consequences of the application of market logics in the Danish domiciliary elderly care industry. Through qualitative interview case studies in two Danish municipalities and three private care providers, the authors compare how recent changes in the organisation of Danish elderly care work affect both working conditions as well as the orientations of workers. The theoretical framework used in the analysis draws Liegl’s identification of inner and outer marketization in the public welfare services (1999). To understand care work we draw on Wærness’ distinction between service and care (1984) as it is implemented by Eskelinen et al. (2006) who foresaw that privatisation will cause the development of two parallel forms of care work oriented towards either service practice (the private providers) and care practice (the public providers). In combination, marketization and care provides a theoretical framework for understanding how the market position affects employee orientations. The article shows how employee orientations are very much affected by the market position of the organisation as well as the strength of the individuals’ affiliation to the workplace (e.g. in terms of profession and job (in)security). For instance, in the small private providers the elderly are seen as customers and the overall precarious market position of the company is mirrored by the care professional who in turn is often less educated with lower overall security. In the public sector, working conditions are better but still under pressure from downsizing and cutbacks on quality. The pressure of increased productivity causes restructu- ring that positions certain workers in the periphery of the organisation. Here the orientations are characterised by feelings of less responsibility towards the elderly and a more short-term temporal orientation. In conclusion, the fragmentation of orientations in care work is not simply a question of either privatised service practice or public care practice. The competition and contradictory motivation is also found also in the public workplaces as the inner mar- ketization creates peripheral employees as in the private sector.