Personalisation and Citizenship: comparative critical reflections Kirstein Rummery Professor of Social Policy University of Stirling

Background Managing demand: commodification of services, moves towards consumerism Feminist concern with how to recognise and compensate for care: womens citizenship and a gendered analysis of work New hybrid of work/care: neither fully paid/employed workers, nor unpaid family care What are the critical implications of these changes? Ethics of care versus disability rights

Commodifying care Reduced pool of domestic labour: womens gains in the public sphere? Cost containment versus the quality of care issue – commodifying care is the middle way? Rise of disability rights: control over delivery of services, rejection of family care as the most exploitative

Personalisation developments United Kingdom: Direct payments/individual budgets Netherlands: personal care budget Italy: companion payments France: personalised payments Austria: cash benefits for care USA: consumer choice programmes

Governance and cash-for-care National vs regional governance Discretion -> scope for inequity Governance of schemes: policing individual lives? Or protecting vulnerable workers?

Inequality and the division of work Gendered division of care/work Levels of payment Employment protection Polarising the care market Feminised professions

Lifecourse and social divisions Exacerbating social divisions Class, inequality and choice Carers and users Power dynamics in family sphere Gender Commmodification Power, resources, control Choice

Wellbeing and citizenship Hugely popular with users and formal and informal carers! Why? Allows for complex social identities Fills in gaps in formal services Ethic of care: allowing women to be paid for care work opens up citizenship opportunities

Outcomes: carers and users

Choice, empowerment, control Whose choice? (users versus carers) Whose empowerment? (is power finite? Does giving users power take it away from carers?) Whose control? Can carers control what they do if they are paid? Marketisation of previously unregulated relationships: empowering or exploitative for carers (women?) Kinship relationships: does being paid to care increase its status and value? Flexibility: the flexibility to combine giving/receiving care/paid work – disabled mothers

Balancing the needs of users and carers Recognising the value of care work Recognising the value of choice Choosing who does what, and how Choosing whether, and how, to care Personalisation: opening up choice and control for users AND carers?

Conclusions: What type of scheme offer greatest benefits and lowest risks for social citizenship? High degree of formalisation offers protection and offsets negative gender effects (France, Netherlands) Some degree of protection, high degree of discretion -> potential negative gender effects (UK, USA) Low degree of protection -> high risk of negative gender effects (Austria, Italy) What is good for users/disabled people is good for carers/women too (France, Netherlands) Need benign-but-powerful welfare state to offset risks of the market