Caring as a citizenship practice

Within citizenship studies, the concept of care has come into recent focus. Literature presents broader and narrower views of citizenship in different contexts, but generally builds upon a Marshallian perspective of ‘citizenship as social rights’ (Isin and Turner, Reference Isin and Turner2007: 5). Within this context, commentators have focused on the relationship between citizenship and the state, struggles for redistribution and citizenship, struggles for recognition and citizenship, multiple citizenships and the relationship between citizenship and human rights (Isin and Turner, Reference Isin and Turner2007). Writers on care and citizenship have drawn from all these approaches; the majority are located within studies of struggles for recognition and citizenship, where social rights are seen as ‘resulting from the contributions of individuals to the state in the form of work, military service (or similar public duty) and parenting. Contributory and redistributive entitlements presuppose a necessary relationship between right and duty’ (Isin and Turner, Reference Isin and Turner2007: 9). Conceptualisations of citizenship also have a moral dimension, and define ‘the boundaries between public and private life and determine which activities, attitudes, possessions, and so on are to be considered worthy in any given state’ (Tronto, Reference Tronto and Friedman2005: 139). They play an important role in shaping values of justice, fairness and ‘good’ behaviour as ‘[s]ocieties conceive of citizens in terms of contributions that they make to society’ (Tronto, Reference Tronto and Friedman2005: 139). The assumption of rights is related to the recognition of individuals’ existence in, and the value of their contributions to, society (Lister, Reference Lister2007). It is within this tradition that discussion about the relationship between care and citizenship has taken place.

Several studies have focused upon how care is recognised (or not) within different citizenship models (Knijn and Kremer, Reference Knijn and Kremer1997; Sevenhuijsen, Reference Sevenhuijsen2000; Herd and Harrington Meyer, Reference Herd and Harrington Meyer2002; Barnes, Reference Barnes, Balloch and Hill2007; Lister, Reference Lister2007). Commentators have argued that many normative conceptualisations of citizenship assume that certain activities provide greater contributions to society, thereby suggesting an explicit or implicit model of who is a full citizen. Such conceptualisations view some forms of (largely paid and formal) labour as granting access to the benefits of full citizenship (Tronto, Reference Tronto and Friedman2005; Lister, Reference Lister2007). In some countries, to enable access to social security benefits, an individual must have been employed and paid taxes to qualify after becoming unemployed. In this conceptualisation, care can be argued to be an undervalued form of labour (Erel, Reference Erel2012). Nevertheless, critiques of this approach focus on the importance of care as ‘a fundamental aspect of human life’ (Tronto, Reference Tronto and Friedman2005: 130) and highlight how, in many societies, care is associated with women's labour (Sevenhuijsen, Reference Sevenhuijsen2000; Tronto, Reference Tronto and Friedman2005). Normative conceptualisations of citizenship are related to the processes by which women's (and other caregivers’) contributions to society have been hidden, marginalised or undervalued in comparison to other forms of (often paid) labour. Enacting citizenship models through social security institutions can therefore be an exclusionary practice, with particular individuals and groups unable to access full rights because their particular societal contributions remain ignored. Critics have argued that what is desirable is a reframed citizenship, which acknowledges human interdependence. In this formulation, ‘[t]he notion of intergenerational reciprocity underwrites notions of citizenly solidarity. Citizens’ contributions, through paid work or childrearing, are seen as legitimizing their claims to health care, benefits, pensions, and public services more generally’ (Erel, Reference Erel2012: 4).

Advocates of alternative conceptualisations report that care work can be seen as a catalyst for positive change (Herd and Harrington Meyer, Reference Herd and Harrington Meyer2002). They argue that dominant framings of citizenship fail to appreciate the interdependency of human life, asserting that people at different stages of their lives will need to provide care and need to be cared for. There is also too much focus upon labour-market behaviour by ‘independent’ individuals, while ‘dependency’ is to be avoided if possible (Sevenhuijsen, Reference Sevenhuijsen2000). In this conceptualisation, citizenship behaviour revolves around public contributions to society rather than private activities (Barnes, Reference Barnes, Balloch and Hill2007), with the contributions of carers remaining unacknowledged. Critics of such notions argue for a ‘care framework . . . inherently characterized by a relational ontology: individuals can only exist because they are members of various networks of care and responsibility, for good or for bad. The self can only exist through and with others and vice versa’ (Sevenhuijsen, Reference Sevenhuijsen2000: 9). Within this reframed citizenship, citizens are defined as ‘people engaged in relationships of care with one another’ (Tronto, Reference Tronto and Friedman2005: 131). Care work is not hidden but rather embraced as the behaviour of good citizens. Citizens are in possession of two rights: to care for someone and to be cared for by somebody (Knijn and Kremer, Reference Knijn and Kremer1997). To citizens, neither is considered more positive or negative. Different countries have different institutional frameworks which tend to support or undermine notions of care as productive civic engagement (Herd and Harrington Meyer, Reference Herd and Harrington Meyer2002; see also Knijn and Kremer, Reference Knijn and Kremer1997 for a comparison between Denmark, the Netherlands and the UK in the 1990s).

Care in the UK

Much of the foregoing literature draws upon a broad definition of care, including care behaviour in parenthood, medical treatment and private care purchased by individuals. However, this article focuses on people who provide (unpaid) care for a sick or disabled relative or friend in the UK. More specifically, it is based on the perspectives of carers in receipt of the welfare benefit Carer's Allowance (CA). As the following section reveals, this group have caring responsibilities that involve large amounts of their time and resources.Footnote ²

Carers are a complex group to define, highly diverse and located in all parts of the UK. In 2011, approximately 10 per cent of the population provided care on an unpaid basis in England and Wales, amounting to 5.8 million people (ONS, 2013). Carers are a very ‘fluid’ group, with new people regularly becoming carers while others’ caring responsibilities come to an end (NAO, 2009). The responsibilities of carers vary according to the needs of those cared for. Some ‘juggle’ their responsibilities (for example, paid employment, other family commitments and recreational activities), while others struggle to do so (for example, feeling they have to give up paid work) (Phillips et al., Reference Phillips, Bernard and Chittenden2002). Carers’ needs and experiences also vary, depending upon gender, age, and social status (for example, younger carers tend to suffer more financial difficulties, while older carers tend to be in poorer health – Dahlberg et al., Reference Dahlberg, Demack and Bambra2007).

Carers have become increasingly prominent in UK public discourse, partly because of the activities of care lobbying organisations (for example, Carers UK), which have helped to draw attention to the important role of carers. The changing demographic situation has also been a crucial factor, as people are enjoying longer lives, resulting in significant increases in people over the age of seventy-five (Arksey and Morée, Reference Arksey and Morée2008). Other factors include increasing numbers of women entering paid work, and children suffering illnesses that, in the past, would have resulted in early mortality. As demand for paid care already outstrips supply, reliance on contributions made by unpaid carers is likely to increase (Buckner and Yeandle, Reference Buckner and Yeandle2005). However, these changes have resulted in the numbers of informal carers decreasing relative to demands for care for sick and elderly people (Dahlberg et al., Reference Dahlberg, Demack and Bambra2007).

Many have pointed out the important role of carers in the UK health and social care system, focusing on the financial benefits they confer on society (Buckner and Yeandle, Reference Buckner and Yeandle2007; Buckner and Yeandle, Reference Buckner and Yeandle2011). As the UK government responds to demographic pressures, which are set to continue in the medium-term, legislation has been put in place to provide carers with legal rights and welfare benefits.Footnote ³ CA is the welfare benefit available to carers, while other initiatives have been implemented to support them, including the right (in certain circumstances) to request flexible working and a range of carer-support programmes focusing on training, breaks and health checks (Yeandle et al., Reference Yeandle, Buse, Joynes, Yeandle and Wigfield2011; Arksey et al., Reference Arksey, Wigfield, Yeandle, Yeandle and Wigfield2011).

With a greater focus on the role of carers, more attention has been paid to the impact of caring, with the aim of supporting carers to continue caring and avoid crises where they experience a ‘breakdown’. Many carers suffer ill health due to caring responsibilities (HM Government, Reference Government2008), as a result of which the health and social care system is required to assume the care of sick or disabled people. Preventing a situation in which either (or both) the carer and the cared-for person need to be supported by the state has led to a focus on supporting carers in their daily roles.

Carer's Allowance

CA is a welfare benefit intended to acknowledge the role of carers whose incomes have been affected by significant caring responsibilities and to contribute to their financial support.Footnote ⁴ Until April 2003, CA was known as Invalid Care Allowance (ICA), an initiative introduced in November 1975. ICA (CA) was (and still is) the main social security benefit for people looking after sick, disabled and older people in England, Scotland and Wales. It was intended as an income replacement benefit, reflecting that it is important that those providing care should have an income rather than be financially dependent on the cared-for person. CA is not available to all carers, because it has several qualifying rules; at the time of writing, the eligibility requirements meant that carers must be:

• • sixteen years old or over;

• • caring for thirty-five or more hours per week;

• • caring for a person in receipt of Disability Living Allowance (higher or middle rate), Attendance Allowance, Constant Attendance Allowance, the daily living component of Personal Independence Payment or Armed Forces Independence Payment.

CA claimants’ earnings and educational opportunities are also constrained. As of 2014, claimants can earn up to a maximum of £102 per week from paid employment (after tax, national insurance and allowable expenses) and cannot be in full-time education (over twenty-one hours supervised study per week) (Government Digital Service, 2014). If a carer has an ‘underlying entitlement’ (for example, receives State Pension or another income-replacement benefit), they are not eligible to receive CA. These rules mean that it is not possible for a carer in full-time work (if receiving at least the national minimum wage) to claim CA. The thirty-five-hour caring rule additionally means that CA recipients are among those dedicating the largest amount of time to caring roles. In August 2013 (the latest figures available at the time of writing), there were 651,000 people receiving CA (DWP, 2014). As of May 2014, CA was worth £61.35 per week (Government Digital Service, 2014).Footnote ⁵

The value of Carer's Allowance

While exploring how welfare benefits contribute to societal discourses on citizenship, it is important to understand the role they play in the lives of claimants. During the CA study, almost all focus group respondents considered the sum of money they received too low, and, in many cases, even ‘insulting’. One male carer said:

Many respondents reported that this inadequate sum contributed to difficulties, with several describing the stress involved in having to calculate expenditure while shopping. Others expressed disappointment at being unable to buy people gifts. One female carer said:

Most respondents explained that CA had become a part of household income or, in some cases, was used to pay for care costs. Some reported that CA was paid along with other welfare benefits and that separating it from household income had never occurred to them. One female carer said, ‘It just goes into everyday household things really. It's not enough for anything else, is it?’

Only one respondent claimed she was able to set aside the money for non-care purposes, using it for an annual holiday for herself, her husband and the daughter they cared for. This carer claimed to feel ‘lucky’ because her husband had a full-time job, allowing her to use CA for this purpose. This becomes significant when compared to other respondents’ views on what CA should be used for. Some saw it as funds they prefered to spend on the person cared for, while others wished to spend it on themselves. Examples of the latter included using CA to pay for restaurant/pub meals (‘[o]nce a month so you can feel like you’re alive!’, as one male carer put it) and buying clothing or cosmetics. However, for CA claimants, such usage was not always possible.

Some felt that daily household costs should be covered by other welfare benefits, leaving CA as a ‘reward’ for/acknowledgement of the contributions they make to society. In contrast, other respondents claimed that CA was a ‘wage’ benefit and should provide a liveable income, covering all household costs and helping families to cope with unexpected outgoings (for example, household repairs). These two different views on the purpose of CA were common, with some carers viewing it as a ‘reward’ and others claiming it was a ‘wage’. Proponents of the former view felt that household needs should be met by other sources of income, while advocates of the latter had fewer concerns about household expenses being covered by CA.

Having discussed varying views on CA's purpose, carers in the study struggled to articulate a common understanding of its official purpose.Footnote ⁷ The money received was considered too low for a wage replacement, even though some believed this was what the government intended it to be. As two female carers explained:

Other carers argued that CA was a ‘token gesture’ from the government, intended to (inadequately) reward carers for their contribution to society. One female carer said:

Many respondents considered CA an inadequate ‘token gesture’ which they regarded as a poor reward for the care they provided. Some claimed that CA was used by ‘the government’ to avoid paying for the care of people in need of it and that if all carers opted out of caring responsibilities, even for a short period, the country would suffer in terms of higher taxation. One male carer said:

This attitude exacerbated carers’ bitterness about their situations and the role CA played in acknowledging their roles. One female carer said:

Awareness of carers’ importance in terms of social and financial benefits was common across discussion groups. Not every carer in the study had considered the roles carers played in society, but one carer would frequently point out that the low amount of money available to CA claimants was disproportionate to their contribution. Many carers reported suffering a lack of dignity from this situation, contributing to feelings of low self-esteem. One female carer said:

Several CA claimants pointed out that the amount of money they received for over 35 hours’ caring was less than the national minimum wage. Some suggested this comparative observation demonstrated the government's lack of sympathy for, and empathy with, carers. Indeed, carers in the forums discussed the high cost of hiring professional staff to provide care as an example of how CA claimants’ contributions to care on a national level were not adequately compensated.

For many, the low amount of money in CA, while causing difficulties, was not the biggest problem; it was rather the undervaluing of a carer's perceived contribution to society. One male carer said:

In summary, carers in the study were unsure about the purpose of CA, and in agreement that the sum paid was too low. But, in addition to its utility value, it was the welfare benefit's symbolic role that dismayed claimants, as it was felt it failed to provide acknowledgment of the care they provided in society. Those considering it a ‘wage’ or a ‘token gesture’Footnote ⁸ said that CA's role in constructing carers’ identities was important. The low sum offered through CA made many claimants feel less worthy than ‘normal’ UK citizens.

Carer's Allowance and other benefits

The perceived value of CA among claimants in this study may be connected to how welfare benefits are regarded in the UK. Some respondents discussed what they considered two problematic aspects of claiming financial support. The first related to stigmatisation arising from receiving welfare benefits, the second to problems people had experienced while claiming money for a task some considered a familial or communal duty.

Several respondents discussed feelings of stigma, even though this was felt to be inappropriate for carers. CA claimants occasionally suggested that other people did not understand what caring entailed. As one female carer put it:

Stigma was sometimes internalised. One female carer admitted to feeling ‘a bit guilty’, while another claimed her pride had been ‘chucked out the window’; a third suggested that she felt like a ‘scrounger’. Another female respondent reported that some carers had a reputation as ‘blue badgeFootnote ⁹ abusers’, as if they took advantage of state provisions to support disabled people. A few respondents felt the welfare benefit system was ‘topsy-turvy’, with carers’ contributions less adequately rewarded than (what they perceived to be) others’ more negative activities. Certainly those in receipt of Jobseekers’ AllowanceFootnote ¹⁰ or Income Support were perceived by some in the study to receive money for ‘doing nothing’ while carers worked.

The second source of negativity concerning CA related to the role of caring. Several respondents argued that caring was something done as familial duty. Many respondents stated that claiming money for caring could be a source of shame. Some reported difficulties in filling in the CA application form, especially detailing one's income, which could be a stressful process. One respondent admitted to feeling guilty about documenting financial problems and had worried she had overstated them.

Many carers in the study suggested that relatives sometimes failed to appreciate how challenging caring was, reporting that some had said it was right that those not in work should provide care. In this sense, caring was perceived as being ‘easier’ than paid employment and less valuable in terms of family contributions. As one female carer said:

Many carers reported that caring for a sick or disabled person involved excessive commitment, going beyond normal levels of care provided by a family member for healthy others. For example, one respondent in the study, caring for her sick husband, claimed she was now a carer first and a wife second. Going beyond the limits of ‘normal’ caring relationships had placed many CA claimants in difficult situations, having to struggle without help or experiencing shame over being paid for their role. In summary, while expressing feelings about CA, carers expressed ambivalence, enacting normative dimensions of UK citizenship, including the view that full citizens should not receive state support and not require assistance to care for friends or family in need.

CA and paid employment

Respondents in the study reflected several normative positions concerning paid employment. Many expressed a desire to participate in paid employment, and if caring had resulted in quitting work, this could be a source of resentment. One female carer explained that to earn less than the CA rules allowed (see Study Method), she had given up two jobs. Others discussed cutting back working hours until they gave up paid employment entirely.

Being forced to leave work was upsetting for some respondents, because reduced earnings had limited their capacity to engage in limited recreational time. One female carer said:

The CA restrictive earnings rules appeared to have affected carers’ decisions to quit or remain out of paid work. Respondents claimed the CA rules meant that financial rewards from working were too slight to motivate the maintenance of employment. The complicated nature of CA's rules was also considered a reason why several respondents had been cautious before taking on part-time work.

Alternatively, some respondents highlighted the benefits of work, particularly how it helped them remain connected to society and provided an identity away from their caring role. Although some respondents envisaged a future in which their caring responsibilities prevented them from working again (even part-time), it was common for at least one carer in each discussion group to express a preference for work over care. This had a notable difference in terms of gender. One respondent, speaking on behalf of her husband, claimed it was harder for men to be out of work as the caring role was commonly seen by respondents as easier for women to assume.

In summary, many respondents demonstrated awareness of normative positions concerning paid employment in UK society. In many cases, these contributed to negative feelings about their caring role, and several expressed an aspiration to gain (or regain) work-based identities, rather than becoming ‘lost’ within caring roles.