The emerging sociology of care
Although the notion of 'care' has a long history in Western philosophy and culture (Reich, 1995) the social phenomenon of care has only recently begun to receive the serious attention it deserves from social researchers. This neglect appears to be the result of care being understood primarily as a family responsibility, the tasks routinely falling to women for whom it was seen as a natural, taken-for-granted behaviour (Graham, 1983). Care seems to have been subsumed under the general topic of social support, with the personal devotion and duty involved being implicitly attributed to gender, operating through the primacy of kinship and marriage. Under these conditions, the fundamental importance of care for social life was easily ignored. But in the latter part of the 20th century care was brought into the public domain as the cumulative effect of a series of fundamental changes reached a point where the availability and provision of care became an ever more contentious aspect of modern life. I argue in this article that the move of care from what C. Wright Mills termed a 'private concern' to 'a public issue' (Mills, 1959), has significance for social theory just as it does for social life.
The rise in care as a public issue seems to be the inevitable result of historic processes of social and cultural change. Foremost is the rise of feminism and the associated social and economic changes, of which the large-scale entry of married women into the paid workforce and the changing domestic forms of late modernity are perhaps the most significant. Demographic developments, especially population ageing and the decline in fertility, as well as a variety of medical and bio-technological developments, have served to accentuate the attention given to care, raising political, financial and ethical issues and dilemmas that seem to reach into every corner of modern life. These changes are not simply questions of perception or cultural meaning. The provision and availability of care has become a practical problem as existing responses prove inadequate or unsustainable and new solutions are sought. Whatever the underlying cause might be, demand for formal care in recent years has been increasing just as the sources of supply of unpaid care at home have been most under pressure.
As concerns about what is commonly termed the 'work-life' or 'work-care' balance suggest (Hakim, 2000, 2001; Pocock, 2003; Watson, 2003), recognition of the significance of care is vital, not just for understanding women's lives but for social life in its entirety, and has the potential to be the most telling of all public issues in the 21st century. This is heightened by the impact and anxiety surrounding developments in medicine and bio-technology, by the effects of demographic changes such as population ageing and fertility decline, and by changing patterns of social policy that are continually redefining the boundary between personal and social responsibility. Care is no longer simply a question of private household preferences. It has become instead an arena for social conflict, both implicit and explicit, marking out important new social divisions and underlying tensions.
Until the mid-20th century, formal and informal forms of care were relatively clearly separated. For example, informal care, provided at home, was quite distinct from the formal care provided in institutions. Families relinquished their claims to provide care only when they were no longer able to manage, and institutional care took over. In this form of care family members had no real place and their involvement was discouraged. De-institutionalization, the new technologies of care and the emergence of community care approaches have broken down these divisions, with the result that formal and informal have gone from being alternatives (either/or) to partnerships, hybrids, new forms of mixed care.