The Labours of Love; The Courage to Care; The Care Manifesto review – our compassion crisis in focus

It’s a shame, in a way, that Labours Of Love, Madeleine Bunting’s vital and eye-opening study of the “invisible” care crisis in the UK, couldn’t have been delayed to take into account the many ways in which all the subjects and conclusions of her five-year research have been forced centre stage by the coronavirus pandemic. She was in time to add an author’s note, written in March, acknowledging that a system already stretched to breaking point by staff shortages and relentless budget cuts has buckled under the onslaught of the current crisis. She expresses a hope that the pandemic will “trigger a massive cultural shift in which we come to recognise the foundations of care on which all human wellbeing rests”.

Labours of Love is an inescapably political book, in both the Westminster and the broader sense. The decade of cuts inflicted by the coalition and then Conservative governments since 2010 in the name of austerity makes for grim statistics on the funding of social care, and the Brexit vote in 2016 led to a dramatic shortage of care workers and nurses from the EU (nurses registering to work in the UK fell by 96%). But Bunting also considers the history and concept of care in a wider context as a feminist issue, because it’s impossible to do otherwise. Care is perhaps the feminist issue, something else the pandemic has thrown into sharp relief. But caring for those who are dependent – children, the sick, the disabled, most pertinently the elderly – has long been undervalued and overlooked precisely because it is dismissed as “women’s work”, the sort of home-based drudgery from which second-wave feminism promised to liberate women. As a result, Bunting writes, care has been “largely abandoned by liberal feminism”.

Bunting’s half-decade of research has been both practical and philosophical. She shadowed nurses on busy hospital wards and volunteered at homes for the elderly. She has interviewed professors of public health and zero-hours-contract home carers, as well as families desperate to get special-needs provision and the professionals unable to meet those needs with limited resources. Her passion and frustration burn clearly through, and with every fresh investigation you understand why; I was moved to tears repeatedly by the stories of vulnerable people failed by the system, but more often by the commitment and selflessness of those carers who told her how much they love their work, despite its lack of status and remuneration; how much it means to know that they have recognised a patient’s dignity or relieved their suffering.

This is the crux of the care crisis, she concludes: actions that are fundamentally anchored in human connection and fellow feeling have been subjected to market forces, warped into checklists and financial targets. To counter this, in alternating chapters she examines the etymology of the language historically associated with care: kindness, compassion, empathy, pity. She explores its roots in religious, ethical and community values, and considers how those have been eroded: “There has been a cultural orphaning of care as a vital human activity.” Averting a worsening crisis, she argues, requires not only significant financial investment, but a reclaiming of those unquantifiable human aspects of care – “a different language”.

Christie Watson’s The Courage to Care is an account of the various branches of nursing following on from her bestselling memoir The Language of Kindness, and takes a broader view of her profession through the lens of personal experience. The birth of her daughter, her nan’s broken hip, her father’s death from cancer and the process of adopting her son all prompt recollections of episodes in her nursing career and the small ways in which compassionate individuals can humanise an impersonal and seemingly indifferent system. Like Bunting, she does not shy away from the physical reality of care work; within the first couple of chapters she has described watching maggots eat dead flesh from a patient’s necrotising bedsore and the smell of an elderly man’s ulcer: “putrid, foul eggs or prawns, or cat-sick or rotten cabbage, sewage, ammonia, sulphate, methane – all at once”. Her point is to demonstrate how the experienced nurses she learned from taught her to overcome her instinctive revulsion at the body’s malfunctions and to focus instead on the dignity of the person.

Watson writes with wry humour and a cheerful, conversational tone, but the world of care she describes – mental health wards, dying children or neglected elderly patients – is often hard to bear. The title, repeated like a mantra throughout the book, gains in significance with each story. Social problems beget or exacerbate mental and physical ones, so that the people most in need of help often have such an overwhelming tangle of needs that nurses can only ever hope for a temporary solution; caring in these circumstances requires extraordinary resilience and takes a toll. The book is a love letter to her profession; her admiration for her colleagues shines through every story, together with her frustration that the vast wealth of expertise among nurses is still so undervalued when it comes to making policy or even designing hospitals. There are no nurses on the Covid Sage advisory panel, she observes, a situation that should be “unacceptable to all of us”. But her choice of subtitle, A Call for Compassion, is also significant. “Compassion is the thing that matters most to patients and their families,” she concludes, and the book urges us to rediscover in a wider social context this sense of common humanity that has been gradually eroded.

It’s the same argument made, in more robustly analytical language, in The Care Manifesto, a slim volume by a group of five authors from different academic disciplines under the name of the Care Collective. Written in response to the pandemic, it asserts: “Dependence on care has been pathologised, rather than recognised as part of our human condition.” They lay the blame for this squarely at the feet of neoliberalism and argue that in response “we must elaborate a feminist, queer, anti-racist and eco-socialist perspective” that rethinks our understanding of care on a broad scale. Beyond the theoretical underpinnings, their proposals – for greater community responsibility, a more ambitious rethinking of the welfare state, better international cooperation and environmental protections – seem to be stating the obvious to most people with broadly progressive values. Their optimism lies in the historical precedent that moments of upheaval – the second world war, for example – paved the way for new ways of thinking about community and interdependence. All three of these books make the same point: the current crisis has forced the always urgent issue of care into the spotlight. The question is how we respond, both on a personal and structural level.

• Labours of Love: The Crisis of Care by Madeleine Bunting is published by Granta (£20). To order a copy go to guardianbookshop.com. Free UK p&p over £15

• The Courage to Care: A Call for Compassion by Christie Watson is published by Chatto & Windus (£16.99). To order a copy go to guardianbookshop.com. Free UK p&p over £15

• The Care Manifesto by the Care Collective is published by Verso (£8.99). To order a copy go to guardianbookshop.com. Free UK p&p over £15