Oral Presentation The 26th International Nursing Philosophy Conference 2023

Supply and Demand: Brokerage as the New Tango in Home Care (#36)

Jenny Mee 1
  1. Federation University Australia, BROWN HILL, VICTORIA, Australia

This research examined the experiences of home care business managers during a time of political change with the onset of the Commonwealth Home Support Programmes and the National Disability Insurance Scheme. The performance of Australian home care and how it is enacted has been significantly impacted by the economic and political challenges since the announcement of the Aged Care Reforms in July 2012 and the launch of the National Disability Insurance Scheme in July 2013. The home care arena in Australia’s marketplace has seen a shift to be more competitive, political and commercialised as a result. This PhD study involved a post-structural research approach examining the literature on home care and informing the interview processes for 10 home care service managers. The framework of governmentality as an epistemological lens was utilised in the creation of a genealogy that situates Australian home care globally. By valuing the inclusivity of the voices of home care business owners in the research, this study highlighted the inequities of traditional research and how certain viewpoints were not previously considered. What was discovered was that there are challenges to quality service delivery within the Australian social context. The supply and demand of nursing and allied healthcare workforce in the sphere of home care are fraught with the instability of economic rationalism and sovereignty of government over this industry. The use of “brokerage” by home care service providers is a means to continue to care for the most vulnerable in our communities. However, more so, it is also a means to create a political tango to push against economic constraints enforced by governing powers. Political agency by the participants meant that they could interpret and enact the rules in such a way as to compete in the market arena despite the challenges.