Defining Care, today, for children’s services

It’s impossible to ask the right questions when you don’t know the answers” (Dominique Manotti Escape 2013)

What is needed is sophistication not simplification. (NCERCC, repeatedly)

NCERCC is sharing this early draft of the introduction to a longer document which addresses the definition of Care, and its implications, today.

The purpose of this paper

NCERCC have been struck that in the considerations of the Care Review there has been no public discussion on a definition of Care, and any implications.

Also (and maybe before reading this paper?

NCERCC Blog What is the relationship of care work and love? – NCERCC

NCERCC Review Special issue of love in professional practice – NCERCC

Defining care

‘Care is conceived as all the supporting activities that take place to make, remake, maintain, contain and repair the world we, live in and the physical, emotional and intellectual capacities required to do so’[1]

Care is at the heart of making and remaking the world. It goes to make the very conditions for us to live; ‘there is no such thing as a baby only a baby and someone’ the words of Winnicott showing that care is essential and we grow up in a social world interacting from others, receiving care then contributing to care is part of the life cycle.

‘Very often what looks like an individual’s achievement could actually not have been accomplished without the support and assistance of a network of others.’[2] What is attributed to an individual does not come about as a matter of their actions alone, by necessity it requires others. Take education, emotional security precedes educational engagement, advancement, achievement, and attainment. Unless one experiences the world as a safe place there are obstacles to engaging in education as one needs to have a focus to threats that exist in the world, preoccupation is elsewhere. It is unsafe to let go of the current security to learn something new. All learning requires risk of what we already have. To take that risk requires we are certain we are being cared for. There is the secondary reciprocated delight from the parent at an achievement of talking and walking, later school achievements. That reciprocation is to the child from the parent for their achievement, but it also the parent recognising the investment in the relationship. It is a recognition of their actions as well as those of the child.

Care is generative and life affirming, assisting others to live well, but is unseen. It is so commonplace that we do not see it. This maybe a major reason why we value it so little. In a society that commodifies activity anything with little value receives low pay. ‘Agreement on what constitute acceptable standards of care is a profoundly social, cultural and political matter. It is the result of historically contingent, customs, negotiations, and struggle’.[3]

The origins of the word care are not the Latin cura (to look after something or someone, to ensure their wellbeing) but stems from the old English word caru which means sorrow, grief, and anxiety, or also ‘burdens of the mind’.

With this knowledge the term carefree takes on a different orientation, without a worry in the world.  This needs interrogation. It may be an aim for some with individualist ideas, but is it a reality? It would be to escape reality, an abrogation. The idea of an autonomous individual obfuscates the work of those who have cared for that person[4]. Connecting those caring and being cared for can only be achieved collectively. The ambition therefore is to be careful, here meaning being consciously aware of care being present, even when unseen, and knowing it is burdensome.

Currently this burden is unevenly distributed and overly weighing on some and not others. A redistribution of caring is needed. Care work is common work, in all its definitions. Common as universal, frequent, public. In the public area of children we have constructed such a means for the majority of us to be ‘carefree’, not involved with the caring for vulnerable children yet knowing that this is being taken care of. The burden is passed to others. Not needing to care about wat others are thinking or feeling is a marker of wealth and power. So public care is also exceptional, and such roles should be valued.

When addressing care for children with needs requiring specific services often the focus and discussions seem to be about anything but about care, more about infrastructure of delivery. This paper takes the view that everything starts from the consideration of care.

Thinking about caring is often approached hierarchically. Approaching the caring task horizontally caring is ever increasing circles, those needing care rely on others, those caring rely on others[5]. To be able to provide care requires reliance on a reliable environment. To be able to rely requires that one feels a confidence in being able to be reliant. It is intrinsic to the task of care that it always requires negotiation to refine the delivery, this is needs led negotiation and towards reducing the space between those needing care and those doing the caring. Frequently the negotiation is towards factors such as cost that approaches needs in a different way; this is to increase the space between.  The anxiety in this latter discussion can be seen as a displacement activity for anxiety of the task or the cost.  When does the discussion of care become about compromise? This leads to another question, what care do we want for our children? No family can meet all needs but what is the effect on development and identity of any change through budgetary constraints? It is an interesting observation that we make judgements concerning value for money of an intervention but not of the effect of not choosing the intervention. There is value added but not value reduced. Currently outcomes are looked at solely from the provider, what difference may occur if it were to be introduced for the decision-making process as an indicator as a QALY. The care response might not be all that it could be but worse there can be a care penalty[6] of not receiving the necessary care.

Care is a multiplicity of discussions, from the vocational, to the reality of the income necessary to provide the care. The formality applied to these discussions, hidden in contracting often, belies the deep anxiety of the absence of care unless someone recognises the necessity of interdependence and sets out to provide the care.[7]

NCERCC May 2021

[1] Fisher and Tronto Towards a feminist theory of caring in Abel and Nelson Circles of care: work, identity, and wone’s lives New York State University Press 1990 and England and Folbre Emerging theories of care work Annual review of sociology 2005 p381-99

[2] Emma Dowling The care crisis Verso 2021 p 28

[3] Quote from Emma Dowling p26 The care crisis Version 2021. View attributed to Himmelweit The Prospects for caring; economic theory and policy analysis Cambridge journal of economics 31(4) 2007 p581-99. 582

[4] Emma Dowling ibid

[5] This is explored in the accompanying NCERCC paper Containment

[6] An idea of Nancy Folbre resituated here. The care penalty and gender inequality in Argys and Hoffman The Oxford handbook of women and the economy OUP 2017

[7] These thoughts prompted by Emma Dowling The care crisis Verso 2021