Virtual care work in times of citizen empowerment and retrenchment

Description

New technologies, termed ‘welfare technologies’ in the Nordic Countries have become a new mantra for reforming Danish public health care. Following a long period dominated by New Public Management-inspired reforms aiming at rationalization and marketization, these new technologies are envisioned as leading to a new and smarter form of retrenchment, promising better quality, empowerment of clients and work that is smarter and more qualified (The Danish Government et al., 2016). In this paper, we present an ethnographic study of the introduction of one such technology - ‘virtual homecare’ - in Danish elderly care. Virtual homecare entails the performance of specific homecare services by care workers and community nurses through video conversations (telecare) instead of physical visits in the clients’ homes.
Previous studies of telecare primarily focus on how virtualization may imply transformations of care and care relationships (Pols, 2010). However, it is also important to acknowledge how new technologies like virtual homecare form part of broader political reform agendas. Both ambitions to enact so-called ‘person-centred care’ (Wilberforce et al., 2017), and broader ambitions concerning the withdrawal of the welfare state, and the need to change relationships between professionals and citizens (see e.g. Newman and Tonkens, 2011) are at stake. They form part of the arguments for implementing these technologies, and affect the way they are used.
In this paper, we show how this framing of the technology is critical for understanding its implications for working life. Furthermore, we highlight how different ways of organizing the labour process of virtual homecare affect care work. Our study comprises two forms of organization of virtual homecare, in two different municipalities: a) organized in a local specialized call centre, and b) integrated in normal out-going homecare services.
The analysis focusses on both formal and informal processes of care work (see e.g. Bolton and Wibberley, 2014) and show how conceptions of care, professionalism and professional ethics are negotiated in the ambiguous and conflictual work practices of virtual homecare. We explore how the framing and organization of virtual homecare impacts care workers and nurses’ possibilities to develop care relationships with clients, and create transparency through the very short virtual home-visits. Moreover, we discuss how the use of virtual homecare affects questions of meaning and identity in work in the two cases.

Period	25 Apr 2019
Event title	ILPC Conference: Fragmentation and solidarities
Event type	Conference
Location	Wien, Austria
Degree of Recognition	International