Abstract

Objectives and background: The aim of this paper is to discuss historical changes in care work in Norway from a perspective that has a focus on tacit practices related to this work. Theoretically, the discussion is inspired by ideas about ‘tacit knowledge’ as including both embodied knowledge, difficult to articulate, but also silenced knowledge, which is knowledge restricted from having a voice in society (Molander, 1992; Synnes, Øye, Christensen and Dewing, 2017). The paper takes its point of departure in three care work features relevant for a discussion of tacit practices: care work as gendered and often viewed as ‘women’s work’; care work as having a marginalised position in society, closely related to the informal sector; and care work as help and support to dependent and marginalised people in society. ‘Care work’ is in this context defined in a broad way, in order to grasp the different types of care work over time: from informal care work in the family to different kinds of formal care work, including both unpaid formal care work in e.g. non-government organisations and paid formal/professional care work (social care work) organised by the welfare state. The discussion is mainly limited to long-term care work for older and disabled people, although important historical roots of care work roles include childcare.

Methods: Using a historical sociological approach, the paper first presents structural and institutional changes facilitating different kinds of tacit practices, and then uses two empirically based case studies to discuss important changes.

Results: The paper points out three historical phases: A first phase where tacit practices are about care work as private in the sense that it is carried out by families/local networks or in non-government organisations by volunteers. A second phase, which is related to the post war expansion of long-term care services, where care work becomes public, organised by the welfare state; at this point care work is paid work, but still inspired largely by informal unpaid care work in families. Finally, in a current third phase, care work is established as publicly organised and paid work, but now – due to consequences of New Public Management ideas and models – bureaucratically governed, with controlled and restricted time and content directions, as well as affected by changed working conditions due to the social care sector’s inclusion of private for-profit actors as well as new ideas about user controlled services.

The discussion is then based on two Norwegian cases. One is about home based care services in the late 1980s/beginning of 1990s and one is about user controlled personal assistance (with the user as employer/manager of the care worker) from the 2010s.

Conclusion: The paper concludes that both an empowerment (e.g. from informal to formal/paid work) as well as a dis-empowerment (e.g. loss of control over the work) of care work and care workers has taken place. In this sense, tacit practices, but with new content, still represent one main challenge of (gendered) care work today._