From bad to worse :The impact of austerity on social care in Ireland
Public provision of social services in Ireland has historically been quite limited in comparison to other modern developed welfare states in Europe (Daly and Clavero, 2002; Fanning, 2006; Lynch, 2007; OECD, 2008; Considine and Dukelow, 2009). Social care has primarily been provided by family members (usually female) with assistance from a system of means-tested welfare payments and the voluntary sector, where it exists. Notions of state responsibility for social care provided as of right, have been limited (O’Riordan et al, 2010). Policy decisions leading to a range of austerity measures since 2008 have led to further welfare state retrenchment and a much weaker public sector in general while the private market and families have been encouraged to fill the gap (Kirby, 2010, Considine and Dukelow, 2012, ).
The current paper is informed by ongoing IRC funded research (2015) on family carers in the Cork area of Ireland and follows on from earlier research carried out in 2007-08 (O’Riordan et al, 2010), and 2013/14 (O’Riordan and Ó hAdhmaill, 2014). It describes the experiences of family carers and access to support services in Ireland in the aftermath of budgetary cuts from 2008-15. It reveals a trend towards the marketization of care provision, with ‘care consumers’ reliant on individual income and means-tested benefits buying care in the market place. Home care packages have increasingly become cash payment based while cuts to both public sector provision such as home help support and the voluntary and community sector (Harvey 2012) have been accompanied by increased competitive tendering for service provision. While the marketization of care provision may appear to empower and increase choice, this paper argues that in fact, in the long term, it promotes further social exclusion, marginalisation and dependency. Choices provided become limited to the profitable, and the notion of supports linked to citizenship rights and need become replaced by provision based on ability to pay. This paper examines such trends in the light of a more general move towards privatisation in public service in Ireland, and in particular, in community health service supports. We question where the responsibility, in the end, lies, to ensure the development of holistic, person-centred care based on need to enable people to continue living in their own homes and communities.
Féilim Ó hAdhmaill and Jacqui O’Riordan, School of Applied Social Studies, University College Cork, Cork, Ireland.