Madeleine Bunting brings into the public domain what researchers have known for decades: patriarchy underpins the gendered division of labour in care work (Covid shows why care is in crisis: we have crushed the humanity out of it, 15 October). But three critical elements of the story are missing. First, the vast bulk of care is “informal” (ie unpaid), provided in the family, and overwhelmingly by women. Second, such care is always a relationship and, while normative pressures to care are strong, reciprocity and affection are usually involved.
It was the failure to recognise the affective basis for care that led some feminists in the 1980s to argue that the state should provide residential facilities for the frail so that women would be freed from the obligation to care. In fact, common interests should unite carers and the cared for. Both are disadvantaged by a patriarchal and neoliberal state which, for ideological reasons, fails to ensure sufficient social support to enable unpaid carers freedom of choice about how much care work they do.
Hence the high levels of fatigue and breakdown among such carers, particularly those who try to sustain paid employment (often as carers). In the coming debate about social care funding, this common interest should take centre stage – but, sadly, it won’t.
Alan Walker
Professor of social policy, University of Sheffield
• I am so glad that Madeleine Bunting has highlighted the need to re-evaluate care. I have been saying the same thing for 30 years since becoming a nurse and have witnessed the gradual decline to what is now a completely unacceptable situation. Loyal carers have seen their work reduced to time slots that are completely unrealistic, where they have to give care to some of the most vulnerable people in our society. Paperwork takes more time than actual time given for physical care.
The stress this generates for carers is unacceptable. I still have a recurring nightmare that I can’t finish my work properly in the ward because there is too much to do, and I, like many others, went into nursing because I wanted to make a good job of looking after people. It is much worse today and the carers are pushed to the limit and carry on, but I am sure to the detriment of their health and the wellbeing of their patients. I am full of admiration for them.
Emily Norton
Hatford, Oxfordshire
• Madeleine Bunting’s article on re-evaluating care reminded me of my mantra when, as a hospice chaplain talking to medical students about our role in care, I reminded them of the French verb patienter, which means “hang on” when on the phone.
Calling those in our care “clients” or “service users” instead of patients shows just how far we have fallen, but it is that attitude that drives so much of healthcare management and strategy. Sometimes listening can be a more effective pain reliever than tablets or injections.
Trevor Smith
Plymouth
• It’s ironic that the party which effectively privatised local council care homes and for 10 years has drastically underfunded local government should now instruct councils to set up care homes for discharged Covid-19 patients (English councils told to set up hundreds of Covid-dedicated care homes, 14 October). What financial support will councils receive to undertake this duty?
Jeremy Beecham
Labour, House of Lords and Newcastle city council
