Coercive Care: Control and Coercion in the Restructured Care Workplace

Abstract This article re-analyses 105 interviews from four qualitative research studies of different kinds of care workers in Canada and Australia, in light of deepening workplace rationalisation and austerity. The sample included: two studies of voluntary sector social service and social workers—one study of nineteen and one of twenty social workers, twenty-two telenurses and forty-four nursing home care workers. Themes that emerged from the data included: restructured and rationalised workplaces, managerialism, reshaped practice, unintended neglect and control of service users, coercion of workers and resistance strategies. Significant similarities were apparent across these similar and yet different care workers, suggesting a strong convergence of working conditions and the policies shaping them. The article used Labour Process Theory and returned to state theory debates in order to re-assess how rationalised care workplaces shape relations between care workers and the individuals they care for. The article contributes to state theory by suggesting a control-coercion care continuum and to Labour Process Theory by suggesting three kinds of workplace control/coercion: control through compliance, cutbacks coercion and contextual coercion. The findings draw attention to deep tensions within increasingly managerialised, austere state-run and state-funded care services in which control and coercion intermingle with resistance and care.