The other day I came across a recruitment company on the Job Centre website that was advertising two separate positions; one for private domestic cleaners and the other for healthcare support workers.The cleaning position starts at £8.50 an hour. The support worker position starts at £7.00 per hour. Sure, that is quite high for your average cleaning job, but on the whole if you compare most cleaning and support worker jobs there doesn’t seem to be a huge difference in the wages. Something isn’t quite right there.
I’m not saying cleaners don’t work hard, I’ve had a fair few cleaning jobs in the past. But they do not have nearly the same level of personal responsibility as that of a support worker in that cleaners are not ultimately responsible for the healthcare needs of other people, they don’t administer medication, do personal care, deal with seizures and other complex healthcare needs, or work with challenging behaviour on a daily basis as a standard. They’re not accountable for other people’s bank accounts or the planning of their day to day life to the advancement of that individual’s well being. One wrong move with money or medication and the accusations start flying, people could end up seriously harmed and the individual responsible could end up in court. And quite rightly so, care is a serious business, people’s lives are involved: this is exactly my point. Cleaners bear none of these responsibilities, yet cleaners and support workers seem to rate about the same on the wage scale.
A man (albeit a fairly drunk man) stopped and started chatting to me in the street recently on my way back from work. He asked me what I did, and when I replied that I was a care worker, his response was “oh, do you get their shopping and that for them?”. It got me wondering if this is the general view of care workers in society, are people really that oblivious to what care workers actually do, to how important the job is for others? I posted something resembling the first paragraph of this post (or rant, depending on how you want to look at it) on Facebook the morning after I had found the two adverts of the Job Centre website. An immediate responses from one of my friends was “The cleaner will be terrible hours no doubt. All cleaning jobs are well paid for that reason”. So, the perception there seems to be that care workers have either good hours, in terms of sociability (which is obviously nonsense, people don’t just need care and support on a 9-5 basis), or lots of hours, in terms of the quantity of work they are offered on a weekly basis. While this may be true for those who have a full time contract, it is not true for many others who, increasingly, find themselves on zero hour contracts.
Why is this?
My guess is that it’s a symptom of ever changing social care budgets, and the way in which care hours are calculated, and can be reduced or increased (generally the former) without a huge deal of notice. Take the current process of individualisation currently being rolled out across the care sector, while for many it could mean a greater control over their care budget and the hours and type of care they receive, a recent study suggests that in reality this is most likely an attempt to shift responsibility away from state based care services and collaboration between social service departments and third sector organisations in care planning, and shift care back towards family-based provision. If that sounds a bit neoliberal, that’s because it is. The result is likely to be a greater strain on the families of those who require care, a drop in care standards, and of course, an increase in job insecurity for those working in the care sector as less hours are contracted. In fact, this is exactly what we are already seeing with the increasing use of zero hour contracts and unscrupulous employment practices within the sector. The irony is that this level of insecurity on employment means that few are able to properly speak up about their concerns, for fear of being replaced.
Another issue, and one which is unfortunately more complex and less easy to find a solution to, is the growing number of people living to increasingly older ages. The way that health and social care is funded again becomes an issue. On one hand the government stresses that we need to build a sustainable system to deal with the issue of growing numbers of older people requiring care, but perhaps we should be looking again at welfare policy as a whole, and the amount of funding which local councils receive for social care budgets, particularly in the context of budget cuts in what should ideally be a demand-led, rather than a budget-led, system. This is obviously an issue for all of those involved in the care system, most importantly those receiving care, but it is very bad news for care workers. When budgets get cut, ultimately it is staff wages and hours which take the first hit.
What is needed is an approach which minimises the use of companies which operate on the basis of profit, such as private care homes and recruitment agencies (for one of which I work). Care should be provided by local councils or third sector organisations who are not for profit and who essentially operate by proxy of local councils. This is something which is in place at the moment, but more needs to be done to make sure these companies receive care contracts first and foremost, as well as more support from local councils for these kinds of companies, either to establish them or keep them afloat and manage their staffing levels. Some third sector companies use agency staff far too often. To give an example, I work for £6.29 an hour, but my agency charges companies around £12 an hour for me to be there. Yes some of this goes towards running costs and the wages of office staff, but some of it is essentially going straight into the pockets of the company owners as profit. A similar situation exists with those who live in care homes and who’s care is provided through local council care budgets, where some of this money ends up going to the private owner of the care homes. This is not what care budgets are for. No one should be making profit from money allocated to the care of those with disabilities or complex health needs.
Secondly we need to pay a fair wage for care workers, and foster an environment which offers basic employment securities, such as guaranteed hours and travel expenses. Care work is stressful. If care workers are worrying about how to pay bills, get to work, feed their kids, then this will obviously effect the level of care they provide. Distractions are never a good thing in any type of employment, but more so when that employment deals with the health and wellbeing of others.
Essentially, then, what the whole issue boils down to is funding and social welfare policy, with health and social care only one aspect of a much larger story in that sense. We need to challenge the way the current government, and any successive governments, priorotise health and social care, and welfare more widely.
The current government has adopted neoliberalism wholeheartedly, and is barely even trying to conceal it, employing and promoting a ‘help yourself or get left behind’ attitude in favour of individualism, capitalist enterprise, and above all profit. It’s focus on minimising risk and rolling back traditionally state administered and funded services such as health and social care, while at the same time allowing the privatisation and profitisation of these services, is going to leave large sections of society voiceless, marginalised and destitute, or worse.
I’ve highlighted these issues in relation health and social care, but by no means are these issues confined to that sector. We need to challenge this and prevent this neoliberal agenda from progressing any further, before we all realise it’s too late.