Book Review: Mike Saks (ed.), Support Workers and the Health Professions in International Perspective: The Invisible Providers of Health Care

Second, Shibata argues that this contestation of precarity has managed to blunt the impact of or cause the abandonment of many specific aspects of the neoliberalization project. The impression I get is that from the point of view of Regulation Theory, this means that Japan is in kind of a political-economic stalemate. The stalemate favors the neoliberalization regime, but labor resistance continues to win important victories, such that the Japanese society remains unsettled. Thus, the Japanese political-economy has not been able to successfully coalesce around a new capital-labor accord that could allow it to reignite a growing economy. And there really is no end in sight for this. To me, Contesting Precarity bookends a work that was published at the tail-end of the Japanese boom – Dorinne Kondo’s Crafting Selves (1990) – which, among other things, undermined the Western notion of Japanese workers as ‘docile’ in the face of capital aggression. A lot more aggression has taken place since then, and Contesting Precarity captures that and resistance to it such that scholars in areas like political science, economics and organization theory can glean insights about Japan’s contemporary laborcapital situation. It was also an ‘easy’ read, in the sense that Shibata lays out her argument logically, and the book is largely free of theoretical jargon. Regulation Theory does provide a framework for the analysis, but there are no heavy-handed attempts to bend the data to fit in to a prescribed theoretical lens. That said, the introduction is in my view overly long, and tells too much of the rest of the story. Also, while Shibata is careful about the knowledge claims made, I was left wondering how much conflict over the growing precarity of Japanese work is responsible for the ongoing economic malaise compared with other possible causes, such as global market conditions. Nevertheless, I enjoyed reading this book and learned quite a bit about the struggles of workers to resist neoliberalization on the Japanese front of what is a 40-year global world war of capitallabor relations.

Second, Shibata argues that this contestation of precarity has managed to blunt the impact of or cause the abandonment of many specific aspects of the neoliberalization project. The impression I get is that from the point of view of Regulation Theory, this means that Japan is in kind of a political-economic stalemate. The stalemate favors the neoliberalization regime, but labor resistance continues to win important victories, such that the Japanese society remains unsettled. Thus, the Japanese political-economy has not been able to successfully coalesce around a new capital-labor accord that could allow it to reignite a growing economy. And there really is no end in sight for this.
To me, Contesting Precarity bookends a work that was published at the tail-end of the Japanese boom -Dorinne Kondo's Crafting Selves (1990) -which, among other things, undermined the Western notion of Japanese workers as 'docile' in the face of capital aggression. A lot more aggression has taken place since then, and Contesting Precarity captures that and resistance to it such that scholars in areas like political science, economics and organization theory can glean insights about Japan's contemporary laborcapital situation. It was also an 'easy' read, in the sense that Shibata lays out her argument logically, and the book is largely free of theoretical jargon. Regulation Theory does provide a framework for the analysis, but there are no heavy-handed attempts to bend the data to fit in to a prescribed theoretical lens. That said, the introduction is in my view overly long, and tells too much of the rest of the story. Also, while Shibata is careful about the knowledge claims made, I was left wondering how much conflict over the growing precarity of Japanese work is responsible for the ongoing economic malaise compared with other possible causes, such as global market conditions. Nevertheless, I enjoyed reading this book and learned quite a bit about the struggles of workers to resist neoliberalization on the Japanese front of what is a 40-year global world war of capitallabor relations. Kondo DK (1990)

Reviewed by Caroline Murphy , University of Limerick, Ireland
From a sociology of work standpoint, one of the noteworthy outcomes of the COVID-19 pandemic has been the extent to which it has increased the visibility of what heretofore was a largely overlooked frontline workforce -support workers in health and social care (Rossiter and Godderis, 2020). This important contribution edited by Mike Saks provides an enlightening insight into the features, structures and challenges facing this diverse and growing cohort of workers. Through a collection of chapters, the book contributes to ongoing debates on the future of healthcare delivery, focusing on the role played by support and nonprofessional staff in different national settings. The central premise of the book is to both fill a major gap in the literature on the role of support workers and their interface with other health professions, and to influence policy and practice in healthcare delivery. The book delivers a varied and balanced mix of theoretical discussion, and empirical case studies. Chapter contributions range from an examination of support and allied health professionals (Nancarrow); to an exploration of the work performed by those in complementary and alternative medicine (Almeida and Barros); to a critical assessment of the role of health support workers in the ageing crisis where Hosoda's review of the Japanese context gives insight into challenges that will likely become more apparent in western societies in the coming years.
While it is stated that the book is aimed at 'final year and postgraduate students, academic lecturers/researchers, practitioners and policy makers' (p. ix), the fields from which that audience might be drawn is diverse. Although the focus of the book is healthcare related, it draws on a variety of themes that would be of interest to researchers in a multitude of fields. For example, Chapter 2 would likely be of particular interest to labour process scholars, depicting as it does the precarious employment status of support workers in both Canada and the UK. Similarly, Chapter 4 discusses the management of support workers, considering the impact that New Public Management (NPM) practices have had on the occupation. The chapter holds a critical lens to the managerialised systems at play in health and social care settings, and the drives for efficiencies that impact workers. The chapter draws on theoretical insights from Foucault's 'governmentality' approach, presenting an alternative model to NPM. NPM is a theme revisited at several junctures throughout the book, as is the issue of professionalisation, a common theme running through many of the chapters. Chapter 3 may be particularly valuable for those interested in gender equality or work-life balance research, because it focuses on informal carers, a group referred to as the 'shadow workforce' in healthcare. Intentionally or otherwise, in that chapter, Williams and Lum touch on the fundamental issue of how work is defined. Many of the themes from that chapter are later re-examined in Chapter 10 where the authors examine labour market conditions for personal support workers in Canada. The importance of regulation emerges throughout the book; however, in contrast to more general texts on healthcare, the focus moves beyond the role of regulation from a patient viewpoint, instead bringing to the fore its importance from a labour perspective.
A particularly strong feature of the book is the wealth of empirical data presented. Chapter 7 (Liljegren, Dunér and Olin) tackles a persistent debate on the role of support workers in social care, namely whether they should form part of a service that is managed by staff or by service users themselves. Through two detailed case studies conducted in the Swedish social care system, the chapter illustrates challenges that exist for support workers in residential and domiciliary care settings. It also captures the voices of both support workers and the service users they support. This is an approach that in my view the book would have benefitted more from, since the voices of those deemed to be at the bottom of the professional hierarchy in healthcare are rarely captured and documented.
Taken together, the contributions cover an extensive amount of content. The editor concludes that it is their hope to contribute to driving forward beneficial policy change in health support work. Given recent experience amid the global pandemic that has placed health and social care systems under added pressure, the insight and critical academic thinking contained within this book has the potential to really contribute to policy changes that seek to create a more equal and rewarding working environment for support workers.

Reviewed by Tim Butcher , University of Tasmania, Australia
Digital nomadism is popular, problematic and therefore worthy of critical inquiry. I first encountered it when researching coworking spaces in the mid-2010s. Coworking spaces are key nodes in global networks of digital workers. Woldoff and Litchfield show why and how some digital nomads relocate from the global North to cowork in the global South -specifically Bali, to 'search for a new path to more freedom, more meaningful work, and a better quality of life' (p. 3). Such utopian ideals go hand-in-hand with colonialism. Unsurprisingly, when research participants were asked, notions of neo-colonialism were rejected. So, the authors instead define this new category of worker based on the values and work ethics participants exhibited. The central problem is established as prohibitively expensive lifestyles in the global North. Specifically, the authors identify: In creative class cities, the cost of living has outpaced wage growth. Although creative class professionals earn good wages by societal standards, many find that their wages do not go very far in the top-tier cities where their jobs are located. (p. 3) Creative class ideals took root in the public imagination in the mid-1990s as the panacea for economic and social decline (Gerosa, 2021), empowering enterprising individuals to reimagine themselves as free to forge careers unbound from conventional notions of work. Interestingly, the authors also identify 'how some individuals have responded to the transformation of creative class work into a routine commodity' (p. 2). Hence, it might be inferred that digital nomadism is a consequence of a growing malaise.
Rachael Woldoff first encountered digital nomads in Bali while there for two and a half weeks. Returning together for three months, Woldoff and Litchfield coworked with digital nomads in Bali, interviewing 70 participants -mostly white North Americans and Europeans. The authors identify five core values -freedom, personal development, sharing, positivity and minimalism -underpinning participants' narratives of why they are in