New Sciences of Protection: Designing Safe Living

1. New Sciences of Protection: Designing Safe Living Workshop: Codes and Conduct Mediating care:reading, interpreting and diagnosing code the ‘new’ skills of ‘caring’? Norman Crump Department of Organisation, Work and Technology, Lancaster University

2. Overview • What is Telecare? • Telecare as a ‘science of protection’ • Telecare as a service • Telecare as informated work • The story of the call-centre workers • Tensions in ‘care’ work • The disappearing ‘object’ of care • Client-centred approaches • Telecare as gentrification of work • Telecare as mediation • Telecare works too well • Telecare doesn’t care

3. Telecareas a ‘science of protection’ • CCTV in public • Watching over us (them) in private • Security systems – telecare as a process of commodification • ‘looking after’ or caring for the ‘family silver’ = ‘looking after’ or caring for granny • “Telecare is as much about the philosophy of dignity and independence as it is about equipment and services.” (DoH, 2007) • Protection is not care – as in care work

4. Telecare as a service • “… common experience in the current pilots and programmes has been poor take-up of telecare services … significant progress has been made towards the additional user target during 2006/7, it has often proved difficult to convince commissioners and NHS trusts' finance directors that telecare can pay its way, even if they are aware of it at all.” • “… the economics are nowhere near cut-and-dried. To deliver new services, significant new capacity will need to be created within the community care sector … payback is likely to take several years: in fact, some speakers at Telecare 2007 — including the eminent scientist and TV personality Professor Heinz Wolff — rejected the idea of payback, claiming that telecare would not reduce costs, only improve quality of life for its users.” • "This tool, though, only works when the supporting infrastructure enables effective sharing of health information“. Mitchell (2007) available at: http://www.telecare-events.co.uk/index.htm (accessed 16th November)

5. Telecare as informated workThe story of the call-centre workers • Introduction of Information Technology (IT) into work leads to automated work or informated work (many examples from manufacturing and service work, i.e. call centres). • Call centre workers dealing with the Telecare service identified themselves as care workers – but they work on code not bodies

6. Tensions in ‘care’ work • The disappearing ‘object’ of care • The object of care and the body of the other • Personal Care work is in large ‘bodywork’ • Culturally ‘bodywork’ is about improvement • It is also differentiated via gender, sexualities, race, class – it is complex • Culturally and historically work in the last 30 years or so has seen a turn away from working on ‘objects’ or ‘things’ to work upon, representations and also subjectivity on ‘self’

7. Telecare as gentrification work • Telecare as a taken for granted good • Work in contemporary industrial society is individualised and governed via a ‘turn to life’ and a ‘turn to the self’ • Desirable work is predicated on ‘soft-skills’ (creativity, knowledge and innovation) • The development of Informated work leaves a residue (as always)

8. Client-centred approaches to care • Care receiver as ‘expert’ • Requirement for ‘carers’ to be unskilled, untainted by expertise • “Taking the place of my hands” • Care givers are being asked to work against the flow of contemporary work culture – to work on ‘self’

9. Telecare as mediation • "This tool, though, only works when the supporting infrastructure enables effective sharing of health information”. • Telecare as mediation of care work, works very well – too well, as it will alert services to needs that they cannot meet, i.e. use of emergency services

10. Conclusions • Telecare should not be read as care work • Telecare (as reading, interpreting and diagnosing code, may well be a new skill but it will not replace care work) • Telecare is an sign of the continuing dispersion of informating work • Telecare is being cast as the answer to the demographic problem of an aging population – but Telecare can not care • Telecare is a tool, a technology, a mediating concept • Telecare can be seen as a ‘science of protection’ – but it does not care

11. The System of Activity (after Engestrom, 1994)

12. Defining ‘care’ • Being problematised via managerialised views of what care means • Wellness programmes as part of the employment contract – need to ‘look after’ or ‘care for’ employees • Health and Social Care • What does it mean to care – health or social

13. Does technology care? • Knowledge Workers • Zuboff and others Sentient Work the skills of ‘being there’ • Removal of the ‘body’ from the work of care

14. Activity Theory • The system of activity • Culturally and historically located – containing, a subject, object relationship mediated via • An attempt to conceptualise distributed agency’ (Blackler, 2007) • The object of activity • The care of elderly and vulnerable people living in their own homes • Telecare as an attempt to create a vision of ‘joined up services’ • Contradiction and paradox over the sharing of the object of activity • The system of activity • There would appear to be at least two very different systems of activity at play here • Technology may mediate, but it increases tension • The role of mediation

15. Code and Conduct • Working on ‘code’ as caring work • Care work as ‘knowledge work’ • Knowledge work as the work of ‘symbolic analysts’ (Reich, xxxx) • What is the link between code and conduct? • A retreat from work as having a clearly defined ‘object’ – from work on things to work on ‘subjects’ • For care-workers in the Knowledge Economy managerialism as the dominant discourse has opened up the v