Faced with ageing populations and the growing participation of women in the conventional labour market, welfare states in recent years have developed innovations that are designed to resolve the problem of the ‘care deficit’. In so doing, they have tried to find ways to bolster informal care through the payment of informal carers, and, sometimes, the introduction of a formalised contractual relationship between the care receiver and the caregiver such that the informal carer is obligated to care through a stronger system of obligation than that arising out of affect alone. The methods of bolstering the conditional incomes of informal carers are variable and have been classified by this author in previous work and named as the ‘commodification of care’ (Ungerson, 1997). This chapter explores the particular form of commodification previously identified as ‘routed wages’. This is the method whereby people in need of care are given cash rather than (or in addition to) formal care services, and then encouraged to employ their own caring labour directly with these cash payments. Many (but not all) of these systems are specifically designed to deal with issues of elderly care, and it is the shifting and increasing permeability of the boundary between formal and informal care in relation to elder care that this chapter examines.

Origins

The fact that ‘routed wages’ have developed so commonly, and, for most of the European countries, within a rather similar time period (the late 1990s), indicates that similar trends may be driving them. We know quite a lot about the way these policies work (Evers et al, 1994; Weekers and Pijl, 1998), but the history of their various origins remains unwritten. Nevertheless, one can speculate as to the general impulses that underlie these developments. Interestingly, some of these impulses seem contradictory, at least at first sight. For example, one can argue that these policies emerge out of a critique of the welfare state that developed in the 1980s and 1990s: that the welfare state is an unwieldy and clumsy responder to ‘need’ and that ‘need’ is all too often defined by professionals intent on self-aggrandisement and hegemony.