Changing priorities: The making of care policy and practices

24-26 June 2019, Eigtveds Pakhus, Copenhagen, Denmark

2019 conference theme

Care policy approaches are guided by priorities which decide who gets what kind of care, how much and of what quality. However, unlike in health care, the priority setting in social care is often more implicit. The Transforming Care Conference series will in 2019 put focus on how priorities are made and on various levels influence the structuring and distribution of social care for children, frail older people and adults with disability.

Care for these operate in a context of continuous priority making where policy makers must balance budget limits, pressures from different user groups and decisions on whether to invest in the short or long run. In essence, policymaking involves the specification and prioritization of ends and means and the relationship between competing ends and means. However, it is not always clear how and on what basis priorities are made. Often, priority setting is seen as a mere technical activity and not as an active policy decision. This conference wants to contribute changing this idea and make it clear what are the policy implications of setting and changing priorities in care, as these have great impact on the distribution of care as well as for the value of formal and informal care work.

How priorities are made becomes especially clear in times of austerity and retrenchment, and often leading to higher selectivity and trade-offs. However, also in more affluent times, priority decisions are constantly framing the distribution of care services and benefits as well as the conditions for formal and informal care work. Priority decisions may be made on explicit risk perceptions and assessments as part of evidence-based policymaking and the pragmatic identification of ‘what works’ in care. Or decisions may be influenced by long established policy and cultural tradition where ideology and interest-based politics decide who and what should be prioritized. Popular values may for instance favour some needs over others based on notions of deservedness, which again affect policy makers in their priorities. On the other hand, politicians may be swayed by ‘investing in the future’ and the coming generations or – in times of ageing societies – instead prioritize the aging electorate, in both cases at the risk of stimulating generational conflicts. Specific policy approaches may be prioritized and for various reasons, such as community care over institutional care, parental leave over day care, or a social investment instead of a repair approach etc. Likewise, some care work may be prioritized higher than other; as an example, working conditions and salaries for formal care providers providing care for young children and frail older people often differs as these kinds of care is differently valued. Policy priorities also decide whether to favour services over cash benefits, public over private providers, formal over informal/migrant/voluntary care or whether to replace conventional approaches with what is considered more innovative approaches, such as welfare technology or reablement for frail older people. Prioritization is also about the social objectives and outcomes, which may favour gender equality, empowerment, diversity or freedom of choice and perhaps higher than justice and social equality.

Priority setting may in this way create hierarchies as well as competition between policy fields, user groups, policy instruments, formal and informal providers, objectives and outcomes. There is a need for empirical and theoretical investigation and understanding of how priorities structure care and care work and the Transforming Care Conference 2019 will investigate in a global setting:

• What and how priorities are made?
• Which priorities are maintained and which are changing?
• How do priorities (re-)design the care approaches?
• What are the prioritizing dilemmas, solutions and conflicts?
• How do priorities impact the distribution of care and conditions for informal and formal care work?

We encourage contributions that investigate these themes in regards to early childhood education and care for children, care for adults with disabilities and long-term care for frail older people. Papers may address priority-setting on a macro-, meso- as well as micro-level, and therefore involving the politics and policy level, but also organizational/provider and individual level decisions. We encourage contributions from different continents in order to exemplify how priority setting is made and perhaps differ in e.g. European, Asian and South-American countries.

We specifically welcome papers that deal with the over-arching theme of changing priorities, but also papers that look into care from other theoretical and empirical perspectives. In addition to one or more open streams, the Transforming care conference series is therefore structured around four main dimensions, which allows for papers that do not directly address the overall conference theme :

• The institutional setting of care systems and care policy (in terms of social rights to care, public regulation, public/private arrangements involving non-profit and/or for-profit organizations, marketization trends, inclusion/selection criteria, affordability, quality, etc..)
• Care arrangements and practices, organized through formal and/or informal channels (caregiving and distribution of paid and unpaid care work, organization and adequacy of care services and cash for care programs, etc.)
• Social and policy innovation on care services and care arrangements, and its impact and dilemmas
• Formal and informal care work, including involvement of informal carers as well as working conditions of formal care providers.

Keynotes

Professor Bent Greve, Roskilde University, Denmark: Social investment: Good for all in need of care?
Professor Martin Knapp, London School of Economics: Economics and priority-setting
Professor Mary Daly, Oxford University: Changing Care Provision in Europe: Conceptual and Other Challenges

Organized by

Prof. Tine Rostgaard, VIVE – The Danish Center for Social Science Research, Denmark
Prof. Costanzo Ranci, Social Policy Lab, Polytechnic of Milan, Italy