What can be done to make healthcare less gendered and more respected in Ireland?


We do not care? Well, women, especially.

As a child, I often woke up at night with growing pains. My father would get up and rub my legs until I could go back to sleep. He carried me on his shoulders during family vacations. In many ways, for as long as I needed it, it carried me. Later, he became my mother’s caregiver.

I was so lucky to be raised by a caring man. In Ireland we need more like him.

When my father suffered a stroke in 2019, he received his last rites, before reaching a milestone.

After months of rehabilitation, he was about to go home. We rushed to arrange his care. We knew that basic home help from HSC would not be enough.

Two people with disabilities living alone would need more support to ensure their safety.

We started by looking at private health care. I remember a woman who came to my house for tea to discuss the best plan. She wore an expensive perfume. She used the right words, like dignity and person-centered.

Then she shared her price list. At an hourly rate, including sleeping hours, the costs were exorbitant and probably beyond what most Irish families can afford.

It overwhelms me to think that there are other families out there, feeling as stressed and alone as we are in 2019.

We have found our rhythm now. A Brazilian woman takes wonderful care of our parents during the week. And my siblings and I take care of them on weekends. They also receive home help. We are also lucky on this front.

Exceptionally, against all expectations, my father’s home help is a man. They make fun of each other in a way that my dad loves. I am very grateful to Mick for choosing to be a caregiver.

Home care assistant Mick Carroll with Jennifer Horgan and her father Mick and who suffered a stroke three years ago. Photo: Dan Linehan

Because people like Mick, men who get paid to look after, are rare. Men are also less likely to perform unpaid care work.

According to a study by the Economic and Social Research Institute (ERSI) in 2019, on average, women in Ireland spend twice as much time on care and more than twice as much time on household chores.

The gendered nature of family care is evident in every doctor’s waiting room across Ireland, at every school entrance and outside every crèche.

At the heart of the problem in Ireland is the fact that we don’t value caring, because we don’t value the work traditionally done by women. We fail to recognize the essential nature of care, our interdependence, and so vulnerable families find themselves turning to private businesses they cannot afford.

The same cost crisis and kind of care is evident across childcare in Ireland.

I’m grateful to be past the baby stage, but my mom friends are struggling with the cost of early childhood child care. And yes, it is invariably the mothers who talk about it. The sector, mostly run by women, also receives very little support.

A friend living in the countryside informs me that mums-to-be register their baby’s name at nursery four weeks into pregnancy, even with no hope of securing a place until the child is at least six months, due to waiting lists. She tells me about places lost due to a backlog of children not going to primary school.

The same woman quit her corporate job after trying to make it work with two kids. After too many nights spent between excessive work demands and children in need of her care, she accepted a less demanding job in her field.

    Jennifer Horgan with her father Mick.  Photo: Dan Linehan
Jennifer Horgan with her father Mick. Photo: Dan Linehan

Today, soon to be back at work after maternity leave with her third child, she wonders if it makes sense to return to a 38-hour week when her salary will be below the minimum wage once she has deducted 2 €100 custody fee.

She feels disappointed with the subsidies put in place through the National Childcare Subsidy Scheme (NCSS), which is a separate administrative burden and can be reduced if her children miss too many childcare days. She is grateful that her employer signed up for the NCSS, which is not mandatory. His story is trivial.

According to a recent report by the Organization for Economic Co-operation and Development (OECD), based on the percentage of income spent on childcare, Ireland is the third most expensive country in the European Union. Politicians promise cost reductions, but they will also have to support and adequately fund workers in the sector. The ripple effect of our low regard for care and for women is proving significant.

Unfortunately, we are doing little in Ireland to reconfigure the gendered nature of care work.

It’s difficult when even our classrooms are mostly populated by women. And, boys don’t gravitate towards professions that their fathers continue to neglect. The ERSI study concludes that “the Irish welfare state has been characterized as a liberal ‘modified male breadwinner’ system”. In that sense, there may be more women in the workplace, but they still do the lion’s share of care work.

“These trends,” the study concludes, “open up new contradictions and pressures on work and family life, especially for women.” Interestingly, my friend reports child care expenses against her income, not her husband’s. She talks about her career being the most dispensable, if they choose not to participate in soaring childcare costs.

So what can be done to make care less gendered and more respected in Ireland? Should Irish women replicate what happened in Iceland on October 24, 1975, when 90% of women in the country went on strike?

    Jennifer Horgan with her father Mick.  Photo: Dan Linehan
Jennifer Horgan with her father Mick. Photo: Dan Linehan

At the very least, we finally need to change section 41.2 of the constitution, which reads:

“In particular, the state recognizes that through her life in the home, women provide the state with support without which the common good cannot be achieved.

Orla O’Connor of the National Council of Women points out that we need to rephrase, not delete the article. To delete it would be to miss “this unique opportunity to express the positive contribution of equality in the home, care and work of all kinds”.

Care work must take place. Our interdependence is something to celebrate, not ignore. Care work is both rewarding and meaningful, even more so when shared equally between men and women.

Work must also be done at the institutional level to normalize part-time work among men and to increase their paid parental leave.

The work must also be done at the cultural level. Men can join moms WhatsApp groups or take responsibility for remembering birthdays, choosing gifts. Fathers need to model care for their sons, taking on more paid and unpaid care work.

What is imperative in all of this is that this work of change be done by men, not pushed by women. Women are tired of pushing.

As things stand, it is the people at the center of the crisis who are trying to change it. In my work as an education columnist, I meet with advocacy groups for children with additional needs. The members are women. I attend classes on social justice and creative activism; the facilitators and participants are mostly women.

My real fear is that we will be left as we are, stuck in a loop, with only women bothering to read until the end of this article, with only women bothering to fight for change.


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