Critical To Care

Critical To Care: The Invisible Women in Health Services

PAT ARMSTRONG
HUGH ARMSTRONG
KRISTA SCOTT-DIXON
Copyright Date: 2008
Pages: 176
https://www.jstor.org/stable/10.3138/9781442687790
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  • Book Info
    Critical To Care
    Book Description:

    Who counts as a health care worker? The question of where we draw the line between health care workers and non-health care workers is not merely a matter of academic nicety or a debate without consequences for care. It is a central issue for policy development because the definition often results in a division among workers in ways that undermine care.

    Critical to Careuses a wide range of evidence to reveal the contributions that those who provide personal care, who cook, clean, keep records, and do laundry make to health services. As a result of current reforms, these workers are increasingly treated as peripheral even though the research on what determines health demonstrates that their work is essential. The authors stress the invisibility and undervaluing of 'women's work' as well as the importance of context in understanding how this work is defined and treated.

    Through a gendered analysis,Critical to Careestablishes a basis for discussing research, policy, and other actions in relation to the work of thousands of marginalized women and men every day.

    eISBN: 978-1-4426-8779-0
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-viii)
  3. List of Figures and Tables
    (pp. ix-x)
  4. Acknowledgments
    (pp. xi-2)
  5. 1 Introduction
    (pp. 3-13)

    Who counts as a heath care worker? The question seems straightforward, but the answer is far from simple. And it is far from irrelevant either to those working in care or to those needing care.

    Virtually everyone would agree that doctors and nurses are health care workers. However, even here there may be disagreement. Do we include as doctors those who practise chiropractic and homeopathy? Do we include nursing aides, assistants, and orderlies when we talk about nurses? When it comes to other jobs created by developments in technology and in the division of labour, there is even less consensus....

  6. 2 Counting the Work and the Workers
    (pp. 14-61)

    She has a care aide certificate from a college, and she worked for years providing palliative home care. In recent times, this meant working through a series of private agencies. She came to know many of her patients well, often working extra, unpaid hours because they were so alone. She left the job for several reasons. Every time someone died she went through two losses: the loss of someone she had come to know well, and the loss of a job. She found both highly stressful. The private agencies that employed her would often phone, leaving a message about the...

  7. 3 Determining Who Counts
    (pp. 62-74)

    The very term ‘ancillary’ implies a particular understanding of health care. It invokes a notion of clearly defined activities with definite boundaries between work that is central and work that is peripheral or not even part of health care. The notion of ancillary work fits best with a medical model of health care focused on the scientifically based treatment of body parts, with doctors as the central authority. Diagnosis and cure are directed by a physician whose expertise and authority are based on a command of scientific research that establishes causes and corrective treatments. Thus the physician is at the...

  8. 4 Identifying Contributions to Care
    (pp. 75-87)

    In this chapter, we begin by setting out what distinguishes health care from other industries. In arguing for the specificity of health care, we are laying the groundwork for the way we count the skills of health care workers and the way we assess current reforms strategies. Our understanding of the distinctive nature of health care work grows out of our feminist political economy and determinants of health approach. This understanding leads to the analysis of nursing work that follows, an analysis that is intended to show both the integral relationship between nursing and ancillary work and the critical role...

  9. 5 Making Gender Matters Visible
    (pp. 88-120)

    A determinants of health framework leads to the definition of ancillary jobs as health care jobs and of those who do the work as health care workers. Feminist political economy helps us understand how such low value can be ascribed to this work and these workers. Combining these approaches helps us understand both the invisibility and the undervaluing of this traditional women’s work, and women’s efforts to shape their own labour.

    We begin this chapter by exploring the nature of women’s care work, with the intent of showing how the blurred boundaries between paid and unpaid health care work as...

  10. 6 Exposing Health Hazards at Work
    (pp. 121-139)

    Health care work is dangerous to women’s health. A gender analysis helps us understand both what the hazards are and why they have been largely ignored. The segregation of women into jobs defined as requiring little effort helps render many of the hazards invisible. So does the focus on male work and the tendency to use male-dominated work as the standard for safe practices (Messing 1998b; 2004). Attention to patterns along lines of racialization is also required (Waehrer, Leigh, and Miller 2005), although we have even less research to inform such an investigation.

    The Canadian Institute for Health Information reports...

  11. 7 Challenging the Construction of Ancillary Work
    (pp. 140-169)

    Reforms that have an impact on ancillary health care workers in care are not simply local. They are found throughout the world and need to be understood within this global context. Several factors have combined to make ancillary workers a target for change over the last couple of decades. In the first section of this chapter, we look at the international pressures and developments that are shaping ancillary work. In order to successfully challenge both the definition of who is a health care worker and the conditions of the work, it is necessary to understand these international forces and question...

  12. 8 Developing Options
    (pp. 170-182)

    Feminist political economy, the theory that guides this book, teaches us to understand women’s work from the standpoint of political, ideological, and economic forces that operate across a range of interrelated contexts, from global and national to local and household levels. At the international level, investors are searching for new sources of profit and seek to make that profit both by selling more and by paying less, especially for labour. Health care has offered and continues to offer an unmined source for profit, given that services are primarily provided on a non-profit basis. Canadian governments, operating at home and abroad,...

  13. Appendix: A Guide to Canadian Data on Ancillary Workers in the Health Care Sector
    (pp. 183-194)
  14. References
    (pp. 195-218)
  15. Index
    (pp. 219-228)