Symposium 4: Covid-19 and the centrality of care: childcare, the State, and undoing ‘gendered’ responsibilities around paid and unpaid care work

Convenors: Elena Moore (University of Cape Town) and Sara Cantillon (Glasgow School for Business and Society)

This symposium examines the state’s response to the care for young children during the pandemic and the implications for challenging ‘gendered’ assumptions and responsibilities around paid and unpaid care work. It looks at case studies across the Globe (UK, South Africa, Brazil and Italy) to explore the ways in which the pandemic changes or reinscribes traditional patterns of care for young children. In almost all countries, the Covid-19 lockdown brought about the closure of all preschools, nurseries, early child centres, with parents and caregivers expected to work from home while caring for their children. The need for ‘time’ between care responsibilities and paid work did not only revolve around a ‘balance’ but also the ability to carve out time for paid work which was experienced unevenly across race, class and gender divides. During the Covid-19 outbreak, time became very short and was negotiated with different actors including the State. In some countries the state embarked on specific programmes to manage childcare services for essential workers. In others, the state failed to even be attentive to the care needs of parents. State responses to how childcare for young children was managed during the pandemic, comes back to how childcare has been enabled, supported and managed in different countries. Research findings since the start of the pandemic indicates the heightening of traditional patterns of care along race, gender and class lines. But it also suggests that men are becoming more involved in childcare and household responsibilities. By mapping out the response of the state to childcare across the Global South and North, we shine a light on how, and for whom, the pandemic has made ‘care’ visible and whether this ‘visibility’ is transient or in fact engendering longer-term change, particularly around the disrupting of gendered responsibilities for paid and unpaid care work.

4 named paper authors

  • Elena Moore and Nonzuzo Mbokazi, University of Cape Town: ‘‘We have not given it full consideration”: The South African state’s response to care and caring for young children during Covid-19
  • Sara Cantillon and Nina Teasdale, Glasgow Caledonian University: On the verge of collapse? Covid-19, the State and the provision of childcare. Exploring the pillars propping up the UK sector.
  • Renata Moreno, Sao Paulo: Covid-19, women’s work in childcare public services, families and neighbourhoods in Brasil
  • Allesandra Milleno and Lidia Manzo, University of Milan: Mothers, childcare duties, and remote working under COVID-19 lockdown in Italy: Cultivating communities of care

Discussant: Angela O’Hagan, Glasgow Caledonian University

Detailed description of the papers’ contributions

  • ‘‘We have not given it full consideration”: The South African state’s response to care and caring for young children during Covid-19
Elena Moore and Nonzuzo Mbokazi, Department of Sociology, University of Cape Town

This article demonstrates the state’s wilful neglect of care and caring by focussing on the needs of care for young children and their caregivers during the Covid-19 pandemic. We argue that the state’s ignorance of the different levels of care and care needs of young children including the early child development needs of the children and the needs of primary caregivers, professional caregivers and the wide sector of early childcare highlights the systemic failure of the state’s duty to care, protect and provide for children. Whilst other parts of the world were supporting at least some level of care for essential workers, the South African Minister of Basic Education as late as 30 April 2020 (5 weeks into heavy lockdown), answered a question at a press conference about when Early Child Development Centres (ECD) will reopen by saying that the question had “come out repeatedly”, but that they had “not given it full consideration”. Compared to other parts of the world, care for young children and their carers, was not even an afterthought. We outline how the failure occurred at three intersecting and connected levels. Firstly, the state failed to issue subsidies, cater for or support care centres with the ensuing result of thousands of job losses and ECD closures and suspension of food programmes. Secondly we demonstrate the failure of the state to treat primary caregivers as citizens in the design of the state economic relief package which excluded primary caregivers of children who already received a social grant on behalf of their child, from applying for a special Covid-19 grant, akin to a basic income grant. Thirdly, by drawing on the findings of care practices amongst a sample of low-income employed black South African mothers with young children during Covid-19, we argue that the state’s failure to be attentive to the needs of care and caregivers and the wider early childcare sector resulted in low-income black women carrying the responsibility and cost of care at a time of extensive job losses and food insecurity. The findings reveal the reinscription of traditional patterns of care based along gendered, racialised and classed lines. We argue that the negligence is indicative of the state’s marginalisation of matters of care even at a time when care became a central question across the globe. We reflect on how we understand care and its possible future in such contexts given the state’s inattentiveness to all levels of care for young children and their caregivers.

  • On the verge of collapse? Covid-19, the State and the provision of childcare. Exploring the pillars propping up the UK sector.
Sara Cantillon and Nina Teasdale, Glasgow Caledonian University

While historically childcare in the UK has been understood as a family and individual responsibility, policy dramatically shifted under the New Labour government (1997-2010) with the initial roll-out in the late 1990s of universal free part-time early education for 3 and 4 year olds in England, with similar policies operating in the other UK nations. This was accompanied by various forms of tax credits and childcare vouchers aimed at reducing childcare costs for working parents (Naumann, 2015). Despite substantial investment, the UK system is complex and the cost of childcare has remained high compared to other countries. There have also been long-term problems with availability and the underfunding of childcare providers to deliver the free state entitlement (Coleman et al., 2020). In this paper, we argue that Covid-19 has exposed not only the centrality of care to social and economic life (WBG, 2020), but also the fragility of the UK childcare sector – with it recently being described as on the ‘verge of collapse’ (Siddiq, 2020). Indeed, despite the UK government’s recognition of the importance of childcare to allow key workers to work during the national lockdown, the childcare sector has since been neglected in its recovery planning. We draw upon a range of qualitative and quantitative data, reports and studies published since the start of the pandemic to explore through a gender and intersectional lens the factors or key pillars propping up the UK sector. This includes grandparents, family and friends as informal and wraparound carers, especially for lower paid workers; and the reliance of state policy on poorly paid and undervalued childcare workers and mothers reducing their hours or moving into part-time work to reconcile work-family responsibilities. The paper concludes by considering the consequences for gender equality and transcending gendered notions of the division of labour, as well as the conceptual importance of care work as central to the intersecting and intertwining of the social and the economic, and the policymaking underpinning it.

  • Childcare, food security and responsibilities: State inefficiency and women’s work during the pandemic in Brazil
Renata Moreno, SOF

In Brazil the access to childcare facilities is characterized by great regional and income inequalities. Therefore, women’s work (paid and unpaid) in families and neighbourhoods plays a key role in providing childcare in a scenario of care injustice, intensified by the neoliberal adjustment policies since 2016. This article discusses the effects of the covid-19 pandemic on childcare arrangements from the perspective of women’s work, considering the interfaces between State and family, and State and community. The analysis runs along two axes. The first focuses on women’s work: the role played by childcare workers (of public facilities) in their relationship with children and their families during the pandemic, in face of the slow response of public authorities; and the pandemic effects in the daily paid and unpaid work of women who are responsible, in their families, for children. The second axis of analysis discusses the effects of the disruption of day care centres on the food security of children, critically analysing the insufficient response of the State on this matter. The analysis problematizes the processes (public, private and/or precarious) of taking responsibility for care, its changes and continuities during the covid-19 pandemic. The reference of this analysis is the city of São Paulo, particularly a public day-care centre and its surroundings in a peripheral neighbourhood of this capital.

  • Mothers, childcare duties, and remote working under COVID-19 lockdown in Italy: Cultivating communities of care
Alessandra Minello, (Florence University) and Lidia Manzo (University of Milan)

Drawing on a virtual ethnography and expanding on existing research, the paper explores how the increase in remote working has created unequal domestic rearrangements of parenting duties with respect to gender relations during the COVID-19 lockdown in Italy. We also discuss the resources that mothers have mobilized to create a network of social support in the organization of care.

Symposium 3: Technology, care and temporality: ‘care’ at a distance and in an instant?

Convenors: Kate Hamblin (University of Sheffield) and Giovanni Lamura (INRCA-IRCCS: National Institute of Health and Science on Ageing; Centre for Socio-Economic Research on Ageing)

This session explores some of the myriad ways time and technology in care arrangements and systems are interconnected. In many countries, technology has been part of policy approaches to promote ‘ageing in place’ and can facilitate the balance between care and paid work for those supporting others (Hassan) and as a means to negotiate spatial distance when caring networks are not co-located. This has implications for care, which technology can render instantaneous, while disrupting its more traditional aspects such as proximity and touch (Lariviere). We are also observing a shift in policy and practice over time as digital and mainstream devices are used in care arrangements, by necessity as analogue solutions become obsolete and as part of a drive for innovation, bringing new challenges for regulation, ethics, privacy and risk (Hamblin) and issues related to the ‘digital divide’ in the skills to use and access to these devices, with implications for practice (O’Loughlin et al.).

The following papers are included, with discussant Professor Andreas Hoff (Zittau-Görlitz University of Applied Sciences):

  • Technology and Social Care in a Digital World: UK Policy and Practice Shifts, Kate Hamblin, University of Sheffield, UK.
  • Care at a distance? Temporal and spatial dimensions of technology-mediation in care, Matthew Lariviere, University of Sheffield, UK.
  • Role of healthcare professionals in supporting digital technology use for successful ageing in place, Kate O’Loughlin, Meryl Lovarini, Lindy Clemson, Ageing and Health Research Group, Faculty of Medicine and Health, The University of Sydney, Australia.
  • Current challenges for the deployment of information and communication technology solutions for Informal Carers, Alhassan Yosri Ibrahim Hassan, NRCA-IRCCS, Centre for Socio-Economi​c Research on Ageing, Italian National Institute of Health & Science on Ageing, Ancona and Department of Economics and Social Sciences, Faculty of Economics “Giorgio Fuà”, Università Politecnica delle Marche, Ancona, Italy.


Symposium 2: Time Use Studies, Care Work, and Care Responsibilities: Conceptual, Methodological, and Epistemological Issues

Convenor: Andrea Doucet, Brock University

In many countries, the COVID-19 pandemic has led to what many commentators are calling a ‘she-cession’ where women are reducing their paid work hours and opportunities or leaving their jobs altogether. Although these decisions are negotiated within complex personal and socio-political contexts of gendered commitments and structures of paid work and unpaid care work, for families with young children, the pandemic has revealed, intensified, and exacerbated women’s long-standing responsibilities for care work and domestic life. Time-use studies (surveys and diaries) are currently the most widely used and trusted methodological approach for measuring gender divisions of housework and care. In the past decade there have been considerable methodological advancements in how to study and assess daily time use. At the same time, there is a growing critique of the efficacy of time-use studies for assessing and measuring care responsibilities and a call for attending more to conceptual and methodological complexities in how care time and temporalities are viewed, lived, and experienced by diverse populations. This symposium explores and debates conceptual, methodological, and epistemological issues in assessing and measuring unpaid care work and care responsibilities. It brings together several leading writers on care, gender divisions of housework and care, and time and temporality.

Paper authors and titles:

  • Melissa Milkie (University of Toronto, Canada): Parents’ Time “With” versus “For” Children: Social Status Dimensions
  • Oriel Sullivan (University College of London, UK): Changing Activities, Housework and Care during Periods of Different Social Restrictions in the UK
  • Brenda S.A. Yeoh (National University of Singapore, Singapore): The Critical Temporalities of Serial Migration: Negotiating Care Relations among Migrant-Sending Families in Southeast Asia
  • Andrea Doucet (Brock University, Canada): Care responsibilities and time: Methodological, conceptual, and epistemological issues

Discussant: Nancy Folbre (University of Massachusetts, USA)

Symposium 1: The IN-CARE project: Socioeconomic inequalities in care use and provision across countries and over time

Convenor: Marjolein Broese van Groenou, Vrije Universiteit Amsterdam

Ageing societies and recent reforms to long-term care (LTC) in many countries are likely to make informal care by kin and nonkin increasingly critical for fulfilling the care needs of older people. To date, it is unknown whether informal care falls disproportionately on disadvantaged populations. The IN-CARE project (a collaboration of Dutch, British, German research teams; examines if and how LTC reforms exacerbate existing social disparities in care use and provision in older age, which fits nicely into the TCC theme of Time and Temporality in Care. To this end, this project compares the socioeconomic status (SES) gradient in formal and informal care across Europe over time. A particular effort is made to include macro-level indicators of LTC systems in cross-level analyses across countries and operationalize these according to the typology of (de)familialization of Saraceno. The first paper presented in this symposium concerns a description of the macro-level database and how it may be used in exploring the macro-micro link in studies on care use. In the second paper, the UK team studied SES-inequality in care receipt across European nations with different care systems; the third paper presented by the German team studied the same question but now among caregivers, and the fourth paper by the Dutch team studies SES-inequalities in care use within the Netherlands over time (1995-2015). The symposium will start off with a short description of the IN-CARE project (2019-2022). Tine Rostgaard will be our discussant.

Individual abstracts

Ellen Verbakel, Radboud University

This presentation describes the newly created database on long-term care (LTC) indicators created by the IN-Care project and available to other researchers. Following the theoretical contribution of Saraceno (2016), we argue it is important to use more fine-grained distinctions of familism and defamilisation in LTC policies, because the consequences for inequality in care use and provision may differ. In particular, we study supported familism (e.g., informal caregiver support), supported defamilisation through the market (e.g., in-cash benefits for care users), and defamilisation through public provision (e.g., availability of beds in residential care). We constructed indicators for each type of LTC support policy. This presentation (1) outlines the theoretical ideas on the impact of LTC policies on SES inequality in care; (2) describes the LTC indicator dataset created by the IN-Care team, which will become available to other researchers; (3) presents basic descriptive information on the LTC indicators.

Ginevra Floridi, Ludovico Carrino & Karen Glaser, King’s College London

As the prevalence of LTC rises in European societies, it is important to evaluate the consequences of different forms of care for the wellbeing of care recipients. Crucially, if the consequences of care for wellbeing vary by socio-economic status (SES), this may lead to greater inequalities in health among adults with care needs. In this study we examine the longitudinal associations between different types of home-care (informal, formal and mixed) and subsequent wellbeing (quality of life and depression) among physically-impaired individuals aged 50 and above. We propose a theoretical model of SES inequalities in the consequences of care for wellbeing, and empirically assess SES differences in the longitudinal associations using data from the SHARE survey. On average, we do not find evidence that informal, formal or mixed care are associated with changes in wellbeing. However, informal and formal care are linked with better outcomes among wealthier – relative to poorer – individuals.

Nekehia Quashie, Judith Kaschowitz, Christian Deindl & Martina Brandt – TU Dortmund University

We assess socioeconomic inequalities in informal care provision and its consequences for the wellbeing of informal caregivers. The literature states that a lower socio economic status (SES) is linked to a higher probability to give care (at higher intensities) which then leads to a higher caregiving burden. People with lower SES additionally have fewer resources to alleviate caregiving pressures. Thus, they are likely to experience decreased wellbeing compared to those with higher SES. Our analyses based on data from SHARE and ELSA confirm, that individuals with lower SES are indeed more likely to provide care all over Europe. They also report a lower wellbeing than people with higher SES, even if controlling for further important influences. In the next step we investigate longitudinally, if taking over care responsibilities leads to a wellbeing decline and if this decline is more pronounced for people with lower SES.

Jens Abbing, Bianca Suanet & Marjolein Broese van Groenou, Vrije Universiteit Amsterdam

This study aims at investigating to what extent inequalities in the use of formal, informal and privately paid care have changed over time. Data from the Longitudinal Aging Study Amsterdam (LASA) was used from three points in time (1995, 2005 and 2015) that capture distinct periods in the recent development of the Dutch long-term care system. In particular, the reforms of 2007 and 2015 might have impacted care uses. All participants (N = 1810) were living at home and between the age of 75 and 85 at measurement. The results indicate that, adjusted for health and partner status, formal, informal and privately paid care have decreased over time. Socioeconomic differences in informal care use have increased over time, but no change was found for privately paid or formal care use. These findings suggest that changes in the LTC system and long-term care resources in particular benefit lower socioeconomic groups.

Open Panel

This open session welcomes papers that strongly relate to the Conference theme Time and temporality in care policies and practices – but do not specifically match any thematic panel.

Paper should focus on one or more research areas at the core of the Transforming care Network – early child education and care, care for adults with disabilities and long-term care for older people – and tackle at least one key dimension:

    • Changes in the institutional setting of care systems and in care policy


    • Impact and dilemmas of social and policy innovation in care services


    • Changes in intergenerational care arrangements and informal care


    • Transformations affecting care workers and their working conditions


  • Care policies and practices during the Corona pandemic: difficulty in crisis management, social and political impacts, prospects for the future.

Thematic Panel 15: How to measure care? Innovative reflections and proposals with quantitative and qualitative approaches

Karina Batthyany and Natalia Genta, Universidad de la República

In direct connection with the theme of the 5th Transforming Care Conference, related to time, this symposium receives proposals that seek to analyze the different ways of measuring care, with time being one of the most frequent. Surveys of Time Use, a privileged instrument to quantify the time of unpaid work has been used for several decades around the world. These measurements allow the calculation of the overall unpaid workload, including specific care activities.
However, this instrument has limitations to measure care activities, questions already discussed in the literature.

In this thematic panel we focus on presentations on innovative methodologies to measure care, through quantitative and qualitative strategies that allow quantifying the time of care, its distribution between men and women, the differences in the types of care tasks performed, the uses that families do care in institutions and how they combine it with the time provided at home, among others.

In addition to this, there are key elements that allow understanding the time dedicated to care (such as care services in the country as well as family assessments and gender mandates related to care). The incidence of these elements in the time that families spend on care is also a central element, with which we invite proposals in this regard.

Finally, we especially celebrate comparative studies between countries, especially those that compare countries from different regions of the world. In the Latin American region, it is especially important to deepen the comparative view, more present in other regions.

Thematic Panel 14: Negotiating and arranging care during the COVID-19 pandemic and shifting grounds: the effectiveness of policies in shaping a responsive and resilient care system

Shereen Hussein, London School of Hygiene and Tropical Medicine, United Kingdom

The COVID-19 pandemic and associated policy and practice responses have profoundly impacted care and time to care across the world. The policy measures taken to control the infection spread have further affected care disproportionately. Evidence is mounting of higher infection and death rates in care settings, and the workforce is at the forefront of negotiating a complex set of challenges. COVID19 pandemic, and measures taken to contain the disease, are having a profound impact on the individuals and health and care systems calling for a consorted recovery policy response. At the individual level, there are significant effects on care recipients, their family and the care workers’ physical, mental and social wellbeing. The care systems have experienced enormous pressures on the organisation and delivery of care, including the workforce. Furthermore, the pandemic has clearly shown the effect of profoundly rooted health inequalities with disproportionate mortality rates among ethnic and less socio-economically advantaged groups.

The response to the pandemic, especially at the early stages, illustrated the impact of the disparities between health and care systems where discharge, isolation and infection containment guidelines simply did not account for the spill-over across the two systems nor the specific dynamics of each. Furthermore, the UK and Europe are experiencing other forces of change at different policy levels, including Brexit and economic downturn exacerbated by the response to COVID-19, adding immense pressures to existing policy challenges. The full impact of Brexit on the care systems is yet to be realised. However, there are significant implications expected on the workforce, care regulation and supply and cross-border care arrangements, among others.

This session is calling for papers addressing some of the following questions, utilising appropriate policy, qualitative or qualitative research methods and analyses:

How do current policies consider and shape time for care in response to system shocks across the globe?
Comparative analyses of the policy response to COVID-19 and their implications on care arrangements and outcomes?
How Brexit and end of free labour mobility affect different care actors, care professionals, caregivers and care receivers across Europe?
What role, if any, of innovations and technology in responding to long-standing and emerging challenges in arranging and delivering care?
How care delivery and arrangements, especially in low and middle-income countries, have been impacted by the pandemic?

Thematic Panel 16: Comparing long-term care policies in time and space: Historical developments and cross-country variations

Panel convenors:
Johanna Fischer, University of Bremen
Heinz Rothgang, University of Bremen
Lorraine Frisina Doetter, University of Bremen

The extent of state involvement in the field of long-term care (LTC) differs between countries and has changed considerably over time. The historical inception of public programmes concerned with LTC often was rudimentary, fragmented and focused at the most vulnerable population groups. In the last decades, LTC for the old-age population has increasingly become a salient issue in many parts of the world, calling to be politically addressed. For instance, many countries in Europe have established (limited) social protection for LTC rather early and experienced different kinds of reforms since the 1990s. More recently, countries in the Global South like China or Uruguay are increasingly discussing and introducing public policies for LTC as well.

This thematic panel focuses on the varieties of public LTC schemes in different time periods and countries. We aim to address the following questions. In which contexts did first – often rudimentary – LTC policies emerge, which form did they take and how did they develop subsequently? How do past and present LTC arrangements compare across countries and regions? Do we see similarities between early adopters of social protection for LTC in the Global North and recent undertakings in the Global South?

We invite papers addressing one or several of the above questions which focus on long-term care for the elderly and/or adults with disability. Papers should take a macro-perspective on LTC policies, looking at historical developments and/or cross-country variations. We welcome papers dealing with any region of the world and especially encourage submissions that explore more embryonic developments unfolding in recent years in countries of the Global South. Contributions may focus on individual countries or cover a wider set of cases comparatively.

Thematic Panel 17: The changing meaning of informal care

Barbara Da Roit, Ca’ Foscari University of Venice

The balance between public and private care responsibilities in the provision and funding of care for older people is high in the political agenda across Western countries. A long-standing debate exists on the effects of the expansion of formal care on the provision of informal care. More recently, policy makers attempted to “refamilialize” care or to reinforce informal care, while research has started to look at the effects of such policies.
Notwithstanding differences in cross-country policy trajectories, we can detect a number of shared assumptions in these debates: (a) care is seen as a fixed/given set of responsibilities and tasks that can be allocated to different actors; (b) family and community care belong to a common past of Western societies; (c) the welfare state, when able to provide universally accessible care services, reduced or changed the role of family care; (c) family care in weaker welfare states is endangered by socio-demographic developments and is turning to an unprecedented crisis that reverses its traditional strength.
Yet, our knowledge of the extent, nature and forms of informal care and its relationship with formal and market care is more based on comparative research than on historical accounts. Little is known of the practices and experiences of informal caregiving in the past.
This thematic panel welcomes papers with a socio-historical approach to the study of informal care (and of the relationship to other forms of care). It focuses on changes in (elder)care practices, visions, understanding, framing in relation to economic, political, demographic and technological change.
Relevant papers tackle:

  • The changing organization of informal care and its relationship to formal care provision
    The changing visions of care by formal care professions and professionals
    The changing narratives of informal care and intergenerational support by caregivers and people cared
    The changing media accounts and representations of informal care and intergenerational support
    The changing representations of care in the arts

Research should preferably consider eldercare, but contributions on intergenerational relations and care at large will be considered.
The historical time(s) taken into account may vary according to the specific research question/hypothesis and the social, political, economic development of the context considered.
Cross-disciplinary approaches (history, sociology, literature, art and media studies) are welcome. Historical accounts of western and non-western contexts are of interest for the thematic panel.

Thematic Panel 13: Time to care: critical perspectives on “fast policy regimes” and anticipatory techniques in care policy

Carlotta Mozzana, Università degli Studi di Milano-Bicocca
Davide Caselli, Università degli Studi di Torino

The session aims to tackle the issue of time in care by focusing on two trends: a) the increasing speed by which policy frames and policy tools are elaborated and circulate globally; b) the policy-makers’ ambition to shape and control the future through the use of anticipative tools based on quantitative data and knowledge (e.g. social impact metrics).
Contemporary public action is embedded into a complex global fast policy regime (Theodore, Peck 2015), based on increasingly globally interconnected policy communities that create a complex temporality of policy transfer. This regime is made on the one hand of fast circulation and adoption of policy frames and tools through the widespread reference to international best practices and benchmarking; and on the other of slow, gradual and path-dependent adaptations to the local socio- institutional context. This is true also for care policies and services, where new actors (with their policy frames and the informational bases upon which they rely) have emerged and contribute to reshape policies and practices.
But time is important here not only for qualifying the speed of such circulation but also as a specific dimension embedded into the policies and practices themselves. In order to reduce uncertainty and to justify public spending in the field of welfare, care policies are increasingly based on predictive and anticipative techniques such as assessment and evaluation metrics that project actual actions in the future.
The session invites empirical and theoretical papers dealing with these two specific problems of temporality in the field of care policies. Interesting contributions may include (but are not limited to):
• Analysis of the elaboration and circulation of policy frames and policy tools in specific policy areas (e.g. active ageing; home care; social impact assessment): who are the actors involved in the process and what kind of temporality does this circulation involve?
• the making of a global Fast Policy Regime in the field of care (e.g. analysis of specific policy and epistemic communities operating at the global level; analysis of local and national networks of expertise mediating global trends, etc);
• the analysis of the logics of care that are promoted through the use of anticipatory, pre- visional, impact-oriented tools in the realm of care policy. How do such tools promote specific logics of action? How do they modify existing logics and practices of care?
• Analysis of the conflicts taking place into the Fast (care) policy regime: emerging forms resistance and elaboration of alternative/new/different paradigms and informational bases for care policies and services.