ILPC 2027

the study intends to understand workplace structures and dynamics of workplace relations of informal care workers (or ayahs) in private nursing homes in a city in Bengal (India). the control and subordination of work in the gendered labour process in care services in particular workplace settings are being explored. The employment of ayahs can be traced to the starting of maternity homes in the city 35-40 years ago when doctor-entrepreneur led private healthcare development took place. Ayahs fall the lowest ladder in the work organisation of nursing care work in nursing home or hospital setting. The work consists of nursing the sick, maternity patients, in wards (male and female), or assisting surgeons in Operation Theatres in nursing homes. Based on personal interviews with 60 ayahs working in three nursing homes using semi-structured questionnaires, the study tries to show despite working for a considerable period of time (20 to 40 years), they have not been recognised as employees of the nursing homes. The ayahs are paid by patients' families in exchange of care work. the nursing home claims to act just as a facilitator mediating their employment.

In view of management, the ayahs are allowed to use the nursing home premises and derive their livelihood therein, they need to be controlled to maintain quality of care delivery at minimum costs to patients. Although ayahs are not considered their employees, the management subjects them to various forms of job control and domination. Management fixes their wage rates for each duty (varies between Rs.120 and Rs. 150 for 12 hour shift). the number of duties are controlled by the management and normally each ayah does not get to work for more than 22 days a month. Ayahs do not receive any form of monetary rewards or support from the nursing home. In the presence of elaborate hierarchies of nursing and care workers, the dynamics in the relation of nurses and ayahs forms important part of labour process as it helps to understand the processes of control in the care hierarchy. The relation of ayahs with the management have undergone further deterioration with the change in the structure of the management (from being doctor-entrepreneur led to now private limited companies and corporate chain hospitals) as well as their participation in the union activities. With the development of superspeciality hospitals, ayah work has undergone changes in status and conditions of work. Workplace relations have become more impersonal and nursing homes are currently employing various strategies to eradicate them, in their place employing low cost alternatives (informal trainee nurses).

Labour process debates of Braverman (1974)and Burawoy (1979) and Edwards (1978) processes of control and coordination of work at the shopfloor, as well as Hochschild's (1983) control over gendered emotional care work have guided the present study to understand labour process in ayah work. However in the above works, labour process analysis helped to understand the workplace the work relationships being clearly outlined and defined between workers and employers. the study seeks to explore the work and employment situation of these workers who are currently at the margins of service industries. Employment relationships being illdefined and ambiguous, these workers continue to remain invisible at their workplaces. It would thus be interesting to explore how with rapid development of service industries, traditional forms of care work are fast eroding posing livelihood challenges for a distinct category of workers in this gendered work category.