4.2 Negative outcomes
The marketisation processes in the field of care for older people cannot achieve ideal model (Forder, et al., 1996). ‘Failures’ (Forder, et al., 1996) and ‘limits’ (Lewis and West, 2014) exist in the market and market mechanism. The limitations of marketisation mainly focus in the areas of inequalities (Brennan et al, 2012), limited competition (Nyssens et al., 2012), quality of care (Glendinning, 2012; Lewis and West, 2014), care relationship (Lewis and West, 2014), ability and information for decision-making, scope of care recipients, and processes of care in practice.
First, inequalities are embedded in marketisation of care due to ‘contracting out’ public provision to the market, limited financial support for purchasing…show more content… As Glendinning (2012) illustrated with the case in England, even though both public home care services and private funding supply have grown, care quality is potentially harmed in both public and private home care sector. Lewis and West (2014) critique social care policies in recent thirty years in the UK, which exclusively aiming to improve quality via competition among providers and empower recipients in the market, while ignoring the care relationship between care workers and recipients. They emphasized the importance of care relationship and quality of social care. In practice, the interpersonal relationship and quality of care work have direct impacts on living standards of older people. However, the process and quality of care has been neglected when the care worker only care about the result of whether the consumers have been fed rather than being friendly treated in the process. In the field of home care, Lewis and West (2014) discuss about the case in the UK, where home-care workers undertake personal care tasks on a ‘task and time’ basis. As they criticized, this model easily leads to rush working pattern of care workers in a very limited time, which cannot guarantee the quality and interpersonal relationship and even might deteriorate the service…show more content… For example, marketisation also promotes increasing informal care, which would enhance the burden of the family (Daly and Lewis, 2000; Lewis and West, 2014). As Daly and Lewis (2000) emphasized, these negative outcomes of marketisation might give greater individual choice for older people and their families might, but it may also be prompting more ‘compulsory altruism’ (Land and Rose 1985) on the part of family carers. In this case, it is the formal care workers who must pick up the slack. However, the encouragement to informal care is still restricted. Powell (2007) points out the ‘do-it-yourself’ social policy, where individuals and families would construct their welfare mix combining the state and market sectors. For example, as Arksey and Glendinning (2007) argued, local governments in the UK have given additional responsibilities to informal carers without additional supports. Besides, the support level among different local governments is diverse: some authorities in Britain managed to improve support to informal carers but these supports are not consistent over space (Arksey and Glendinning,