Christina McAnea, General Secretary of the trade union UNISON, sets out how a workforce delivering vital social value is still rewarded with low pay — and why this imbalance can no longer be ignored.
Looking after the most vulnerable in society requires expertise, compassion and commitment. The job demands long and often unsocial hours, plus the ability to cope with physical and mental challenges. Adult social care is both a vital public service and essential to the nation’s infrastructure.
Yet care work continues to be undervalued, despite its crucial role. Care staff are predominantly female, and society has historically failed to appreciate work undertaken by women. Failure by employers to reward women’s labour properly leads to financial hardship for families.
Some employers will say “it’s not all about pay”. But care workers tell us low wages are a key concern. Loving your job doesn’t pay the bills or feed your dependants. Inadequate rates combined with a lack of benefits, especially sick pay, have driven the recruitment and retention crisis, with vacancy levels around three times higher than the wider economy.
Privatised and fragmented over decades, the care sector is a victim of acute underfunding and ‘market forces’. Competition is fuelled by a large number of providers and that’s created a race to the bottom, driving down pay for what is a difficult and challenging job.
Other public services are part of visible institutions for which politicians can be held accountable. But in social care there’s no equivalent of the NHS ‘brand’ or a central mechanism to address workforce issues. For many, the sector is a hidden public service, and most people don’t realise it exists until they’re in crisis.
The economic consequences of disregarding care work are profound. Hundreds of thousands of extra posts will be required in the next decade to support an ageing population, including people with complex, lifelong disabilities.
Any responsible government should be planning for this and delivering investment and reform. But the sector hasn’t been given the resources to keep up with demand. High turnover rates and understaffing have created a lottery for those who need care in a nursing home and those living independently with the support of domiciliary staff. That has a knock-on effect on the NHS because patients who end up in hospital often struggle to get the care in place to allow them to be discharged back into the community.
What’s needed is for central government to set minimum pay standards. Leaving it to local commissioning isn’t the solution. With local authority budgets under unprecedented strain, funding for care contracts has been squeezed almost dry and that’s passed onto the workforce.
Bodies that commission care are perpetuating low pay, even inadvertently, by prioritising the cost of contracts over quality. But care firms paying unlawfully low rates shoulder the most blame, especially when they’re taking significant profits, including some owned by private equity or based in tax havens.
Fair pay and proper recognition in social care wouldn’t be possible without unions. In championing the workforce, UNISON has pushed the government to make a fair pay agreement (FPA) a reality. Bargaining nationally for the sector will be a game-changer and unions must represent the workforce in those negotiations.
Progress on the FPA is a major step recognising the value of care work. So too is the prospect of a national care service. UNISON has set out a vision for the future of social care, to put it on a par with the NHS. A service that’s fully funded, has national standards, agreed pay rates (like the NHS’s Agenda for Change) and integrated with healthcare.
Bold steps are still needed to rebalance the relationship between social value and financial reward. It’s time to be ambitious, not just tinker around the edges. Only then will those most in need get the support they deserve from a workforce that’s truly valued.
