This edited collection provides a comprehensive insight into the relationship between support workers and the health professions that their work tends to supplement. The collection is particularly relevant for those interested in ageing owing to the impact of ageing societies on the demand for health and social care support work. Indeed, the collection is set against this backdrop and all 11 chapters highlight this issue in some way.
The collection is positioned as ‘the inaugural social science book on support workers operating in conjunction with health professions in health care’ (Saks, p. ix), highlighting health support workers as an underresearched element of the health and social care professions hierarchy. To explore this underresearched group of essential workers the book approaches support work from an international perspective, including insights from modern neo-liberal countries (concurrently, countries with ageing populations) including the United Kingdom, Canada, Sweden, The Netherlands, Australia, Japan, Brazil and Portugal.
The book aims to: contribute to the sociology of health professions and the sociology of health and illness more broadly; to have an impact on policy and practice; and to illustrate high-quality international work. To do this, the collection explicitly adopts a neo-Weberian perspective. Each of the 11 chapters applies this perspective to explore a broad range of issues concerning support work, including the relationship between support workers and health professionals, the precarious nature of support work, unpaid support work, management and leadership, regulation and risk, allied health professionals, social care, peer support in mental health, complementary and alternative medicine, the labour market and ageing populations. Consequently, as the editor points out, the collection is aimed at a broad audience, including postgraduate students, academics, health and social care practitioners including support workers themselves, and policy makers.
Throughout the collection, support workers are generally defined as a ‘disparate, but very large, group of workers … defined by providing face-to-face care and other support of a personal or confidential nature to service users in a variety of settings’ (Saks, p. 1). The collection does an excellent job of highlighting the heterogeneous and precarious nature of support work. Indeed, Chapter 2 explicitly links support work to the concept of precarity. The lack of clearly defined roles and responsibilities and the risks associated with this is reflected on throughout the collection, particularly in Chapters 2, 3, 5, 7, 10 and 11. The root causes of the increasing demand for support work is also highlighted throughout. Chapter 4 explores the role of New Public Management and New Public Governance in the creation of demand for support work; Chapter 11 focuses on the trend towards ageing populations and the consequent demand for support work; and Chapter 9 considers the professionalisation of health-care work and the impact of this on support work. What is clear from the book is that support work, regardless of the health-care discipline it supports, is a precarious mode of employment that tends to mop up the unwanted yet essential work in the provision of health and social care.
While the collection covers a diverse array of issues concerning support workers, there is no chapter dedicated to intersectionality. All chapters note that support work is predominantly carried out by women and some of the chapters note that these women are often older (Chapters 2, 10 and 11), black, Asian and minority ethnic (Chapter 2), economic migrants (Chapters 2 and 11), less educated/skilled (Chapter 4) and often have family dependants to care for (Chapter 10). As these issues underpin support work and the lived experience of those doing the work, it would have been useful to recognise explicitly this with, at the least, a chapter dedicated to intersectionality or gender.
In addition to this, another element that is lacking in the collection is an introduction to the neo-Weberian perspective. As it stands, prior knowledge of this perspective is very much assumed and needed. While there is some brief explanation in the introduction and throughout the chapters, Chapter 9 in particular, there is no explicit overview of this perspective. Neo-Weberian concepts such as social closure, exclusionary social closure and the professional project are used throughout the chapters but are not clearly defined. It was also unclear what a neo-Weberian perspective adds to the understanding of support work. All of the chapters applied this perspective but none reflected on its benefit. The lack of an overview of the neo-Weberian perspective is a fundamental failing of the collection. Without it the full impact of the collection is limited to those who have prior knowledge. Specifically, it is unlikely that many support workers, health-care practitioners and policy makers, for whom the book is aimed, will hold this prior knowledge.
In short, this collection provides an overview of a range of issues facing support workers and the health and social care systems that need them. As the editor outlines, this is the first social scientific book to explore this relationship. The collection makes an excellent first contribution. As the editor suggests, further qualitative enquiry exploring the lived experience of support work would facilitate further understanding of this diverse group of workers.
