Tag Archives care work

From Hands-On to High-Tech: How Dutch Care Workers Navigate Digitalization and Robotization

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Whether we embrace it or not, digital technologies and AI are here to stay, and they are fundamentally changing the human world of labour. As new technologies revolutionize the healthcare landscape, these changes are reshaping the lives and work of care workers. In this blog, Sreerekha Sathi shares insights from her research, which explores important questions about how digital technologies are reshaping care work in the Netherlands specifically: how these innovations are affecting care workers and how care homes are adapting to digital solutions and AI-assisted robotics. What specific forms of AI-assisted robotics are currently being utilized in Dutch care homes and how can we evaluate the benefits, challenges and risks associated with their implementation?

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Digitalization, robotization and the care worker

The Dutch healthcare sector faces increasing inequality in access to care, staff shortages, increasing workloads and a high percentage of aging populations. Around two thousand government-funded care homes serve the elderly, those with dementia, disabilities and other care needs.

Like other countries in Europe, the Netherlands has been experimenting with digitization and robotization in health care. Over the past two decades, AI-assisted digital tools and Socially Assistive Robots (SARS) have become more common in surgeries, patient monitoring, consultations, diagnostics, rehabilitation, telemedicine, cognitive and emotional care, especially in the post-pandemic period (Getson, C., & Nejat, G. 2021, Kang et al. 2023). Beyond Europe, countries like China and Japan lead these developments, with Sweden and the Netherlands close behind.

The use of digital solutions and AI-assisted robotics have moved beyond the experimental phase into early adoption. Current discussion focuses on opportunities for collaboration between private companies, academic institutions and healthcare providers. This pilot study involved conversations with few care workers in the care homes, innovation managers, company officials and academic scholars in the Netherlands.

Conversations with care workers show that most technologies in use are still relatively simple – medication dispensers, sensor systems and communication tablets – selected for their affordability and ease. Once prescribed, digital care tools like Compaan, Freestyle Libre, MelioTherm, Medido, Sansara or Mono Medical are introduced to clients by neighbourhood digital teams, usually via smartphone apps connected through WIFI as part of online digital care.

The introduction of robots is slowly gaining ground. Many universities, including Erasmus University, are collaborating with private companies on new projects in robotization and digitalization in health care. Some of the robots which are popular in use currently in Europe include TinyBots (Tessa), Zorabots (NAO), Pepper, Paro and other robotic pets, and SARA, which supports dementia patients. Some care workers believe that the robots promote social contact and enhance patients’ independence, while others appreciate that robots taking over peripheral tasks can make their own work easier.

Care workers are required to learn and engage with new technologies, which directly affect their everyday lives. Although they are relatively well paid by normal standards, their workload and stress often exceed what their pay reflects. Larger, well-funded care homes have support staff who assist care workers for indirect or non-medical support at lower pay. When new technologies are introduced without sufficient involvement and inputs from the workers, they can lead to more burden on workers in terms of time and labour costs. For them, new technologies are often ‘thrown over the fence’, with insufficient training or involvement of care workers in design or decision-making, leading to frustration, resistance and underuse even when the tools are effective. They argue, ‘we don’t need fancy tools – just the right tools used in the right way.’

Many workers feel that if a robot can take on physical tasks, the workers can give clients more time and attention. When the purpose of a tool is clearly explained, and workers remain present in critical moments, clients and families are more accepting of new technology.

Gender and labour in new technologies

Feminist Science and Technology Studies (FSTS) has long shown how technologies carry gendered biases. Feminist histories of computing have highlighted women’s contribution to the invention and introduction of computers and software (Browne, Stephen & McInerney, 2023). A relevant question to explore today is would new technologies using AI assisted robotics replicate the same biases. Although new technologies are often presented as objective, they are built upon datasets and assumptions that can reproduce biases and stereotypes, based on the foundations of the feeds and accesses in-built into it (1). Robots, for instance, often reflect the idealized gendered traits. Nurse robots are designed with feminine or childlike features – extroverted and friendly – versus ‘techno-police’ styled introvert security robots as stoic and masculine.

Care work remains a heavily gendered profession, though more men are joining the field. While some men care workers face occasional client push back, they are increasingly welcomed amid shortages. Many care workers worry about being replaced by robots, yet most agree that emotional presence of caregivers – especially in elderly and dementia care – remains essential and robots may support but cannot substitute the human connection that defines good care work.

Further, workers also stress that technology must be context-sensitive: its success depends on the socio-economic profile of the area, staff availability and the lived preferences of the people receiving care. They advocate for flexible, context-based implementation rather than top-down standardization of new machines. Core to the debates on digitalization and robotization in care are ethical issues often narrowly framed as privacy concerns but extending to autonomy, emotional dignity and growing surveillance and inequality.

Insights into the future

The study observe that many attempts to introduce digital technologies or robotics in care homes stall in the pilot phase, often disliked or abandoned by care professionals or clients. Care workers need time and training to trust these devices, especially regarding the risks and uncertainties involved. They emphasize early involvement through co-design as essential for building trust, transparency and accountability. For sustainable implementation, the focus should shift from what is ‘new’ to what is ‘useful’.

Future debates will likely centre around prioritizing digitization in health care versus SARs in physical care. Persistent challenges include time constraints to software failures (Huisman & Kort 2019). As efforts to create ‘smart homes’ and support independent living continue (Allaban, Wang & Padir 2020), environmental sustainability and climate resilience must become priorities.

Another important step for exploration is to critically analyze the growing corporatization and monopolization in digitization and robotization (Zuboff, 2019; Hao, 2025). Rather than leaving healthcare innovations to monopolies or private capital, public or community-based state welfare support must retain agency in how digital and robotic tools are implemented. Finally, pushing back from military robotics towards socially beneficial technologies – such as health care or waste management – needs to be prioritized.

As a work in progress, this research is significant for understanding the social impacts of digitalization and robotization. In the next step of this study, these conversations will further bring together care workers, academics and innovative managers between the global south and the global north to foster dialogue about how these changes are reshaping the healthcare economy, care homes and the future of care workers.

 

End Note:

  1. A focus on changing forms of labour, along with the concerns around gender stereotypes and gendered knowledges attributed to social robots, is important for further exploration in the fields of AI-assisted occupations. The introduction of new machines involves the invisible human labour behind them, which is mostly the ‘ghost workers’ from the global south, whether with data work, coding or mining. What is inherent to existing social contexts, including gender, class, and racial stereotypes, are already heavily compromising the digital world.

Acknowledgements: This research was supported by a small grant from Erasmus Trustfonds for 2024-2025, I embarked on this short study to explore these questions. Although the grant period concluded in June 2025, the research continues. I would like to thank Ms. Julia van Stenis for her invaluable support in making this study possible.

 

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About the author:

Sreerekha Sathi

Sreerekha Sathi works on issues of gender, political economy, and critical development studies. Her current research explores the intersections of gender, care, and labour with digitalization, AI, and the future of work, and engages with critical debates in decolonial thought. She is a member of the editorial board of Development and Change.

 

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Are We Having One or Two Capitalist Crises? Mapping Social Reproduction in Capitalism by Maryse Helbert

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In June, a colloquium called ‘capital accumulation: Strategies of Profit and Dispossessive Policies’ was organised for the 50th anniversary of the University of Paris Dauphine. The colloquium provided a snapshot of the current debates and concepts within the field of Marxism. The discussion between the main key Marxist speakers – David Harvey and Nancy Fraser– revolved around conceptualising various challenges that capitalism is facing. The different conceptual mapping of the crises provides different paths to emancipatory changes.

Capitalism is facing many heterogenous ills: Economic, financial, environmental and care deficits. Harvey analyses these ills under the single umbrella of economic crisis that found its origin in the contradictions that the capitalist system carries. Basically (and we all know the drill), capitalism is a process of circulation. Capitalists put some money to buy labour power and means of production, make them work together under a given technology and organisation to produce a commodity that will be sold on the market for a value. In this process, workers are not being paid according to the value they have produced but rather are being paid wages that barely cover the socially necessary costs of their own reproduction. The difference between waged labour and the real value produced by the workers fuels capitalist profit. Given that the capitalist system is a process, a part of that profit has to be capitalised and put again into circulation to extract more profit. The quest for more profit compels capitalists to promote endless growth rates.

In David Harvey’s view, the two classes’ social relations of exploitation are at the crux of the accumulation process of capitalism, overaccumulation and consequent crisis. Overaccumulation as a crisis is defined as surpluses of labour and capital which cannot get together in a profitable enterprise. In this understanding, social reproduction of labour and nature are what Harvey calls free gifts for the capitalist system and are not conceptualised as independent mechanisms of accumulation.

The economic crisis or overaccumulation gets temporarily solved through spatio-temporal fixes or what Harvey also calls accumulation by dispossession[1]. The crises of capitalism are being temporarily tamed by geographical expansion and restructuring. Indeed, capitalist accumulation works within a fixed space where there are built environments such as transport, factories, roads etc. leading to dispossession of the local population to produce profit. The process of capitalism destroys the space as it needs to increase profit through growth. Once the space is destroyed, at a later point, capitalism re-creates a new space to reproduce the capitalist system of overaccumulation. So, this process of creation and destruction is at the very core of globalisation and understanding the geographical principles of globalisation will help to find a path for emancipatory changes.

While Fraser agrees that the crux of accumulation lies in the two classes’ social relations, she thinks that this view is too narrow[2] as it focuses only on social processes and social relations that are accorded value in the capitalist system by the capitalists and that the capitalists themselves define as having economic value. It does not integrate the non-economic phenomena of global warming, care deficits and the hollowing out of public power. Rather, Fraser believes that currently, capitalism is having two crises: the economic and the non-economic crisis. While the economic crisis is the one described by Harvey, the non-economic crisis is coming from activities which are not recognised by the capitalist system. The non-economic activities are the borders of the capitalist economy. These activities are for instance the non-wage labour of social reproduction which provides the supply of labour but also activities such as social bounds, solidarity and forms of trust. There are other spaces than the private home where activities of social reproduction and its associated care activities are occurring. For instance, public education and health care systems as well as leisure facilities are all part of the activities of care. Slavery and immigration are the two most common ways capital has replaced labour. The separation between social reproduction and production enables capitalist forms of women’s subordination while being the indispensable background precondition for the possibility of capitalist production (Fraser, 2014).

Particularly, Fraser focused on the crisis of the activities of social reproduction.  The division between social reproduction and production have shifted overtime. In the 20th century there has been mutations of social reproduction activities within the state. After the Second World War, some aspects of the social reproduction moved from the realm of the private home to the realm of public services and public good while in the Neoliberal era, social reproduction and care mutated from the realm of public services to the realm of the market forces.

The last mutation has accentuated care extractivism and hence the crisis of care. The concept of care extractivism as development by Wichterich is an analogy to the concept of resource extractivism and posits the increasing reliance of the extraction of care, through commodification and, economisation in the market forces . For instance, this concept can be used for transnational reproductive networks where the Global North recruits through the free market care workers from the Global South to provide care activities. This process creates a deficit of care in the family of the care worker of the global south. In other words, care workers who work in a family in the Global North do not have as much time for their own families in the Global South. As Wichterich argues, the neoliberalisation of care ‘depletes care as commons in societies and families of the Global South’. Moreover, the extraction of care workers in the Global South are not the only source of crisis.

The neoliberal mutation has led to a deficit – crisis – of care in other domains. It has led to a deficit of teachers and care givers because the state abandoned supporting these public good services. It also has led to a deficit of the quality of care as the persistent drive for growth and expansion while focus on profit has pushed capitalism to intensify efficiency to reduce costs. As Witchery points out, in many domains such as industrial process, efficiency can lead to quality. However, care is different. For instance, it is not possible to increase efficiency and productivity of feeding a baby or a dement person. It means that the emphasis of efficiency to cut on cost will impede the quality of the care provided.

Last, the privatisation of care has reconfigured the gender and race order as these activities are mostly carried out by cheap workers constructed along social hierarchies of gender, class, race and North South and, post-colonial division. By looking at social reproduction and care extractivism, Marxist theory opens up then to feminism, and colonialism while still acknowledging class struggles.

Mapping social reproduction is at the core of Marxist discussions. While traditional Marxists such as Harvey places it at the point of production and value, others such as Fraser wants to go at the border of the capitalist activities and consider social and care activities that occur outside and inside the private home. It also recognises social resistances outside class struggle such as movement for free education or free childcare. Finally, the points of resistances at the border of the capitalist system can be seen as sources of emancipatory changes.

References
[1] David Harvey, “The ‘New’ Imperialism: Accumulation by Dispossession,” Socialist Register 40 (2004): 63–87.
[2] Nancy Fraser, “Behind Marx’s Hidden Abode: For an Expanded Conception of Capitalism,” New Left Review 86 (2014): 55–72.

Mryse.jpgAbout the author:

Maryse Helbert is a Post-doctoral Research Fellow at the ISS. Prior to that, she was a Post-doctoral Research Fellow at the Rachel Carson Center for Environment and Society. She has been an advocate for women’s rights for decades, having worked for AWID (Association for Women in Development), DIPD (Danish Institute for Parties and Democracies), and she is a gender-based violence research expert to achieve the Sustainable Development Goals for the United Nations Development Programme. Taking an ecofeminist approach, her PhD looked at oil industry and its economic, social and environmental impacts on women in three countries. In her latest work, she takes on the lessons learnt from the fossil fuels industry to explore the challenges of a post-carbon society.