Index

Editor:
Mike Saks
Publication Date:
23 Jul 2020
Pages:
225–231
DOI:
https://doi.org/10.51952/9781447352112.bm001
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This edited text is the second in the series entitled the Sociology of Health Professions: Future International Directions, published by Policy Press. It consists of eleven chapters covering several different aspects of support work and its relationship to the health professions, illustrated with reference to a wide range of different countries. Its importance is underlined by the relative lack of attention given to date to the diverse span of health support workers, in light of their growing significance in harness with the health professions in providing care to an increasingly ageing population in the modern world. The special significance of this collection, introduced by Mike Saks as editor, is that the various expert international contributions are brought together in the first social science book produced on the part played by support workers in conjunction with health professions in providing health care to users and their carers. This has crucial ramifications for well being in all modern societies. The support workforce and its place in the health care division of labour have too often been invisible in the past. However, this book, written from a neo-Weberian perspective, enhances our academic understanding of the role of support workers and helps to inform policy making in this critical field.

A

Abel Salazar’s Biomedical Sciences Institute (Porto, Portugal) 174
Accelerated Development Programme in Intermediate Care 111
Act Concerning Support and Services to Persons with Certain Functional Impairments (Sweden) 127
Activities of Daily Living (ADLs) 35 , 36 , 37
acupuncture 161 , 176
Brazil 168
Portugal 171 , 173 , 174
see also British Medical Acupuncture Society (BMAS)
ageing population 42 , 51–2 , 54 , 101 , 111 , 163 , 178 , 184 , 188 , 193
dementia 35 , 37 , 40 , 41 , 49 , 205
Japan see Japan’s ageing population
Agência de Avaliação e Acreditação do Ensino Superior (A3ES) 171 , 172
agencies, health support workers 84–5 , 214
allied health professions 103–5
career progression 115
definitions 104
delegation 115
generic vs. discipline specific division of labour 116
growth driver 117
regulation/identity 116
supervision 116–17
support workers and 4–5 , 101–24
training 114–15
workforce development 105–6
Allitt, Beverley 82
ARCH National Respite Network and Resource Center 44
aromatherapy, Portugal 175
Assistant Practitioner (AP) 67
auriculotherapy, Brazil 169
Australia
allied health professions 5 , 103
caregiver financial support 45
co-housing 48–9
health support workers 20 , 102 , 114–16
profession-driven model 107–9
auxiliary social workers 126 , 127 , 136
Ayurveda, Portugal 175

B

‘Baby P’ 82 , 91
Better Regulation Task Force 92
Brazil, complementary and alternative medicine 6–7 , 167–70 , 176–7
Brazilian Association of Holistic Therapists 170
Brexit 27
Bristol Royal Infirmary 81 , 91
British Acupuncture Council 161
British Dietetics Association 108
British Homeopathic Association 161
British Medical Acupuncture Society (BMAS) 165 , 166
Business Process Re-engineering 118

C

Canada
ageing population 42
allied health professions 103–4
caregiver financial support 45
co-housing 48–9
demographics 42
deprofessionalisation 17
health ratings 39–40
health support worker register 95
personal support workers 23–5 , 183–200
political heritage 20
profession-driven model 106
UK and 3 , 16 , 20 , 101
unpaid informal carers 36–7 , 38 , 41 , 43–4 , 45 , 46–7 , 48 , 51
see also Ontario (Canada)
Canadian Human Rights Commission 47–8
care
challenging realities of 39
clinical work vs. in nursing 64
community vs. hospital care 85
complex needs 39–40
costs 40–1
domiciliary settings in 86–7
Japan’s ageing population 206–8 , 215–17 , 219–21 , 219t
profession-led model 112–13
support workers 71–2 , 113
unpaid, informal see unpaid informal carers
Caregiver Action Network (United States) 44
Caregiver Advisory Committee (Manitoba, Canada) 43
Caregiver Recognition Act (2011, Manitoba) 43
Care Quality Commission (CQC) 68 , 90 , 91 , 95–6
Carer’s Allowance 45
Carers Australia 44–5
Carers Canada 43–4
Carers Trust 38
Carers UK 44
Cavendish Review 11 , 21 , 62–3 , 64 , 66 , 67 , 69 , 71 , 90–1 , 162 , 163
Central Administration of the Health System (ACSS, Portugal) 171–2
Certificate of Fundamental Care 90
Certified Care Workers (CCWs, Japan) 205 , 207 , 208–10 , 215 , 217 , 218–19
Changing Workforce Programme (NHS) 111
chiropractic 161 , 166 , 171
co-housing 48–9
Commisão Nacional de Práticas Integrativas e Complementare em Saúde (CNPICS, National Committee for Complementary and Integrative Health Practices) 169
Commission for Social Care Inspection 91
competence mechanism assessment 88
Competition and Markets Authority (2017) 67–8
complementary and alternative medicine (CAM) 6–7 , 161–82
Brazil 6–7 , 167–70 , 176–7
Portugal 6–7 , 171–5 , 176–7
see also acupuncture , aromatherapy , auriculotherapy , Ayurveda , chiropractic , homeopathy , lian gong , naturopathy , osteopathy , phytotherapy , reiki , tai chi chuan , traditional Chinese medicine , yoga
consumer-run drop-in and activity centres 144
Council for Health Regulatory Excellence (CHRE) 81
COVID-19 11
Credentialed Holistic Therapist Licence and Technical Norms (Brazil) 170

D

dementia 35 , 37 , 40 , 41 , 49 , 205
Dementia Friends (Japan) 49
Dementia Supporters (Japan) 49
Democracy Village 22
democratisation 144
Denmark 20 , 46
Dentist’s Act (Japan) 215
deprofessionalisation 15 , 16–18 , 25 , 108 , 110 , 137
dieticians 2 , 108
domiciliary care 86–7 , 125 , 126 , 130 , 133–6 , 138 , 139
Donaldson review of regulations 81
dual closure 16 , 164 , 165

E

Economic Partnership Agreement (EPA, Japan) 220
educational training programmes
allied health professions 114–15
Cavendish Review 90
complementary and alternative medicine 177
group homes (Sweden) 131–2
mental health personal support workers 147–8
occupational therapy assistants 101
personal assistants 134
support workers 23 , 102 , 194–5 , 219–20
elderly see ageing population
emancipation 144
Estratégia Saúde de Família (ESF, Family Health Strategy) 167
Eurocarers 44
exclusionary social closure 3 , 4 , 9 , 16 , 33 , 72 , 79 , 161
experiential knowledge 143 , 145
expert knowledge vs. 153–4

F

family
Canadian personal support workers 193–4
care in Japan’s ageing population 205–6 , 218–19
see also unpaid informal carers
Family Health Strategy (Estratégia Saúde de Família) 167
Finland 45
Flexible Active Community Treatment (FACT teams, The Netherlands) 146–7 , 149 , 150
foot hygienists 107
France 20 , 45 , 63 , 191
Francis Report 68 , 85 , 90

G

General Agreement Mental Health Care (2019, The Netherlands) 149
General Dental Council 83
General Medical Council 83 , 104
General Social Care Council 82
Germany
ageing population 42 , 51–2
caregivers 45
complex needs of caring 39–40
intergenerational housing 43
new community institutions 48
nursing 63
sickness fund 61
Greece 42 , 63–4
group homes (Sweden) 128–9
administrative competence 132
definitions 132–3
educational training programmes 131–2
routines 133
support workers 125

H

Health Academy Programme (Brazil) 168
Health and Care Professions Council (HCPC) 82–3
Health and Social Care Act (2008) 81–2
health care assistants (HCAs) 22 , 62
management 68
nurses/grading 67
work classification 65
Health Care Commission 91
Health Education England (HEE) 162–3
Health Insurance Law (The Netherlands) 149
health professions see medical profession , nursing and other health professional entries
Health Professions Council 82
Health Professions Regulatory Advisory Council (2006) 184
health support workers (HSWs) see support workers
heteronomous control 66
Higher Certificate of Fundamental Care 90
HIV infection/AIDS 42
homeopathy 161 , 165–6 , 171
Home Support Service Standards (New Brunswick, Canada) 187
Home Visiting Care Workers (HVCWs, Japan) 205 , 207 , 209–10 , 215 , 218–19
Hospital at Home services 113
Howie the HarpTM 147
human rights protection, unpaid informal carers 47–8
hybridisation 16

I

Independent Living (Sweden) 128 , 135 , 136 , 137
Instrumental Activities of Daily Living (IADLs) 35 , 36 , 37
intergenerational housing 43 , 48–9
intermediate care 111 , 112 , 114 , 164
International Society of Therapists (SINTE, Sociedade Internacional de Terapia) 170
Ireland 45
Italy 42

J

Japan
Certified Care Workers see Certified Care Workers (CCWs, Japan)
insurance see Long-Term Care Insurance System (LTCIS, Japan) and Medical Insurance System (MIS, Japan)
intergenerational housing 43
mutual support programmes 49
new community institutions 48
Japan Medical Association (JMA) 207
Japan Nursing Association (JNA) 207–8
Japan’s ageing population 7–8 , 42 , 49 , 51–2 , 205–23
boundary issues 215–19
business plans 49–50
carers 206–8 , 215–17 , 219–21 , 219t
employer and family care 218–19
foreign caregivers 220
life support 217–18
medical practice 216t
response to 205–6
see also Certified Care Workers (CCWs, Japan) , Home Visiting Care Workers (HVCWs, Japan) , Tsukisoifu
Jointly app. 44

L

lesbian, gay, bisexual, transsexual (LGBT) communities 42 , 48
lian gong , Brazil 169–70
Licensed Practical Nurses (LPNs, Canada) 185 , 191–2
Local Centres of Information and Coordination (France) 44
Long-Term Care Accommodations Standards and Checklist (Alberta, Canada) 187
Long-Term Care Homes Act (Ontario, Canada) 187
Long-Term Care Insurance System (LTCIS, Japan) 205 , 206 , 207–8

M

market shelters 125
marketisation 66 , 144
Medical Insurance System (MIS, Japan) 206
Medical Practitioners Act (Japan) 215
medical profession
collective autonomy 71
deprofessionalisation 110
hierarchy and 2 , 7 , 66 , 104–5 , 109 , 112–14 , 118 , 206
jurisdiction 164 , 165
nurses and 66
policy change 9 , 20 , 80 , 81–2
mental health peer support workers 146–50
anxiety due to accountability 155–6
content 153–6
control 150–2
definitions 145
education and training 147–8
experiential vs. expert knowledge 153–4
mental health settings 143 , 144–6
professionalisation 148–50
professional vs. organising responsibilities 154–5
Mid Staffordshire NHS Foundation Trust 85–6 , 90
Minister Responsible to Seniors and Informal Caregivers (Canada) 43
Ministry of Health Care (The Netherlands) 146
Morecambe Bay midwifery services 82 , 90

N

National Alliance for Caregiving (USA) 44
National Care Standards Commission 82
National Committee for Complementary and Integrative Health Practices (CNPICS, Commisão Nacional de Práticas Integrativas e Complementare em Saúde) 169
National Health Service (NHS) 17 , 21 , 28 , 38 , 64 , 67 , 70 , 85 , 106
allied health professions 103
Changing Workforce Programme 111
complementary and alternative medicine 164
homeopathy decline 165
Modernisation Agenda 110
National Institute for Health and Care Excellence (NICE) 165
National Policy for Integrative and Complementary Practices (PNPIC, Brazil) 168
National Resource Center on Lifespan Respite Care 47
National Service Framework 110
National Vocational Qualifications 111
naturopathy 171
Neighbourhood Network 48
neo-Marxism 15 , 17–19 , 22 , 24 , 26 , 65
neo-Weberianism 1 , 3–7 , 12 , 33 , 59 , 79 , 90 , 125 , 157 , 183 , 207
complementary and alternative medicine 161 , 164
health support workers 15–16
mental health settings 143
nursing 62 , 65
precariat 19 , 21 , 24 , 25
profession-driven model 108–9
see also dual closure , exclusionary social closure
New Labour 110
New Orange Plan (2015, Japan) 49
New Public Governance (NPG) 60 , 68–71 , 73
New Public Management (NPM) 4 , 19 , 59 , 60–2 , 72–3 , 137
professionalism and 66
rise of 17
New Zealand 45 , 103–4
NHS and Community Care Act (1990) 62–3
Nurse Registration Act (1919) 66
nursing
assistants and auxiliaries 19 , 22 , 63
care work vs. clinical work 64
clinical and other responsibilities 67 , 206–8
earnings 24 , 188 , 209
health care assistants and 67
hierarchy, place in 2 , 63–4
higher education 63
immigration and 195 , 220
New Public Governance 73
New Public Management 4 , 72
numbers of 88 , 185
professional expertise 63
professionalisation 62 , 64–8
professional upgrading/reorientation 59
semi-profession 64–5
unionisation 197
see also dual closure , hybridisation , Registered Nurses (RNs) and Registered Practical Nurses (RPNs)
Nursing and Midwifery Council 83

O

occupational therapy assistants 101 , 113
Occupy 26
Ontario (Canada)
market deficiencies 27
personal support workers 23 , 33 , 95 , 190 , 192
unpaid informal carer recognition 43
Ontario Personal Support Workers Association 25
operating department practitioners 21 , 83 , 103
Organization for Economic Cooperation and Development (OECD) 36 , 39 , 46 , 51
osteopathy 161 , 166 , 171 , 173 , 176
Overseas Domestic Workers (ODW) visa regime 27

P

paediatric surgery, mortality 81
palliative care 6 , 164
peer support workers 6 , 143–57
performance targets 60 , 69
personal support workers (PSWs) 7 , 20–1 , 23–5 , 33 , 183–204
benefits and pensions 198–9
community care 188
definition of 184–5
domestic regulations 187–8
education 23 , 194–5
family and household characteristics 193–4
health status 24 , 194
hours of work 190 , 196–7
immigration 192
institutional long-term sector 188
socio-demography 191–3
supply and demand 185–7
union status 24 , 180 , 197–8
wages 24 , 189–90
work situation 24
see also Canada, support workers
physiotherapy 2 , 109 , 113 , 173
physiotherapy assistants 87 , 104 , 116
phytotherapy 171
podiatry 106 , 107–8
podiatry assistants 106 , 107–8 , 116
Portugal, complementary and alternative medicine 6–7 , 171–5 , 176–7
Portuguese Association for Ayurvedic Medicine 175
Portuguese Association for Reiki 175
Portuguese Medical Society of Acupuncture (SPMA, Sociedade Portuguesa Médica de Acupunctura) 174
Portuguese Society of Aromatherapy 175
precarity 3 , 6 , 15–16 , 18–27
Professional Standards Authority for Health and Social Care (PSA) 68 , 70 , 82–3 , 84 , 90–1 , 95
establishment of 83
health and care occupational accreditation 84
Programme for Improving Primary Care Access and Quality (PMAQ, Brazil) 168
Project 2000 62 , 66
proletarianisation 15 , 16–18 , 19 , 25
proto-professionalism 72–3
psychiatrists 6
psychologists 6
Public Health England 91 , 94
Public Health Nurse, Midwives and Nurses Act (Japan) 215

R

Registered Nurses (RNs) 24 , 65 , 90 , 162 , 185 , 191–2 , 216
Registered Practical Nurses (RPNs) 185
reiki 175
residential care 5–6 , 38 , 127 , 129–33 , 136 , 138

S

Science and Technology Committee 165–6
Scotland 95
self-help 144 , 161
Serviço Nacional de Saúde (SNS, Portugal) 171
Shipman, Harold 81
sickness funds 61
Silver Human Resources Centre (Japan) 219
Skills for Care (2018) 64 , 94
Skills for Health 94
Social Care Register 82
Social Democratic Party (Sweden) 139
social isolation 37–8 , 145–6
social prescribing 38
Social Services Council (Scotland) 95
Social Services Inspectorate 82
Social Worker and Certified Care Worker Act (1987, Japan) 208–9
social workers 2 , 5–6 , 64 , 125–42 , 151 , 152 , 154 , 219
Sociedade Internacional de Terapia (SINTE, International Society of Therapists) 170
Sociedade Portuguesa Médica de Acupunctura (SPMA, Portuguese Medical Society of Acupuncture) 174
South Korea 36
Spain 36 , 45
Support and Services to Persons with Certain Functional Impairments (Sweden) 128–9
support workers
ageing crisis 205–21
allied health professionals and 101–18
complementary and alternative medicine and 161–78
health professionals and 1–12
informal carers and 33–52
labour market and 183–200
management and leadership 59–73
mental health and 143–57
precariat and 15–27
regulation and risk 79–96
social care 125–39
see also personal support workers
Sweden
caregivers 45 , 46
complex needs of caring 39–40
cost containment 61
domiciliary care 5–6 , 130 , 133–6
financial support 45–6
labour unions 139
nursing homes 63
personal assistants 5–6 , 130 , 133–6
professional vs. user controlled services 128–9
professonalisation 137–8
residential care 5–6 , 130–3
social support worker 5–6 , 129 , 130–3
welfare policies 126–8
Swedish Social Insurance Agency (SSIA) 127
Systemic Único de Saúde (SUS, Unified Health System, Brazil) 167–70 , 176

T

tai chi chuan , Brazil 169
The Netherlands 6 , 20 , 45 , 191 see also peer support workers
traditional Chinese medicine (TCM) 169–70 , 173–4
Tsukisoifu 210–15 , 218–19
abolition of 211
brief history 210–12
case study 211–14 , 213t
narratives of 212–14
operation of 214–15
standardised nursing system and 211

U

Unified Health System (SUS, Systemic Único de Saúde, Brazil) 167–70 , 176
Unison 22
United Kingdom (UK)
ageing population 42
allied health 5 , 106 , 107 , 108 , 111 , 113 , 114 , 116 , 117
Canada and 3 , 16 , 20 , 101
caregivers 38 , 41 , 45
co-housing 48–9
complaints procedures 93
complementary and alternative medicine 161 , 164 , 166 , 172
complex needs of caring 39–40
health support workers 21–3
intergenerational housing 43
management and leadership 4 , 61–2 , 67 , 68–70 , 110
new community institutions 48
political heritage 20
professionalisation 62 , 63 , 64 , 67 , 106
regulation of health and social care 4 , 17 , 79–96
social isolation as health concern 38
support workers 18 , 19–20 , 21–7 , 64 , 79 , 84–96 , 101 , 102
unpaid informal carers 37 , 47
see also other entries relating to the UK
United States
allied health professions 103–4
complex needs of caring 40
deprofessionalisation 17
dietetic support workers 108
health system 61
occupational therapy assistants 101
precarity 2
social isolation as health concern 37–8
support workers 186 , 191 , 192 , 195 , 198
unpaid carers 38 , 41 , 44 , 46 , 47
unpaid informal carers 33–57 , 80 , 219 , 221
advocacy networks 43–5
boundaries between paid workers 34–5
characteristics of 35–8
concerns of 34
costs and consequences 40–1 , 50–1
decline in 41–2
economics of 38
emotional strain 40
financial support 45
human rights protection 47–8
paid work and 36–7
policy on 34 , 42–50
recognition of 43
respite 46–7
routine medical procedures 51
social structures 48–50
support for 43–5
work leave 45–6

V

Vereniging voor Ervaringsdeskundigen (VvED, The Netherlands) 146 , 148
Volunteer Centre (Japan) 219

W

Welfare Human Resources Centre (Japan) 219
Wellness Recovery Action Plan (WRAP) 147
World Health Assembly 205
World Health Organization (WHO) 7 , 36 , 161 , 205

Y

yoga 169 , 175

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