Researchers from King’s Business School have published a paper urgently calling for a new deal for health and care employees that acknowledges and reflects their worth to our individual and communal well-being that has been highlighted by the Covid-19 pandemic. The paper says that the sector needs a new model of employment relations, characterised as fair care work, to tackle the challenges exposed by the crisis.
The paper Fair Care Work: A post Covid-19 agenda for integrated employment relations in health and social care urges policy makers and practitioners to consider how public sentiment can be captured in the fair treatment at work of these health and social care employees. They explore four key dimensions:
Pay: The Covid-19 crisis is forcing a fundamental re-assessment of the socio-economic value traditionally placed on health and social care work, with implications for how the employees delivering it should be rewarded. As these workers take risks and, in some cases, sacrifice their lives, the undervaluing of care work, long associated with the feminised nature of the workforce, is challenged.
One option would be for the current NHS Pay Review Body to carry out this dedicated one-off review to establish fair pay rates. Given the cross-cutting nature of the proposed review, this would involve extending the remit of the NHS Pay Review Body to cover social care, again with a view to retaining an NHS and Social Care Pay Review Body to monitor and assess future pay movements.
Outsourcing: Covid-19 has exposed the inequality of employment conditions. The general tendency is for outsourced hospital workers and adult social care workers, including those subcontracted by an agency, to have worse pay, sickness benefits and leave entitlements than their colleagues directly employed by the NHS or the local authority. Moreover, it is women who account for the majority of the outsourced health and social care workforce and so the two-tier inequality has a strong gender inequality dimension. This has always seemed unjust but is particularly so now when these key workers– male and female, inhouse and outsourced – suffer the same high risks of Covid-19 exposure.
Training: To ensure that staff have the right knowledge, attitudes and skills to safely and effectively deliver care, wherever they work we need to re-imagine how employee education and development in health and social care is organised, accessed and delivered to create the optimal conditions in care organisations for all staff to learn.
This re-imagining will require not only a fundamental change in the way access to education and training is organised, but also how learning is valued and delivered. In short, it requires treating the NHS and social care workforce as one, whether they are employed in unregistered roles or not, whether they work in a care homes or hospital or in the community, whether they are trained by a further education college or university, or recruited from a local or a national labour market.
Position of migrant workers: Migrant workers are especially at risk in terms of health and safety. In part this derives from their disproportionate representation in high risk care occupations. It also reflects the fact that the migrant workforce comprises many black, Asian, and minority ethnic (BAME) workers. Covid-19 has exacted a heavy toll in terms of higher death rates amongst BAME groups in society.
Employers and those that regulate health and social care, notably the Care Quality Commission, have a responsibility to maintain minimum standards and have a duty of care to the workforce that should be underpinned by proper risk assessment. The workforce, especially those who are most at risk, need to be reassured that they will not suffer any detriment as a consequence of the Covid-19 crisis and that appropriate protection is provided for these workers and those they look after.
Professor Ian Kessler, who led the research said: “These features of employment relations have cruelly hampered the capacity of health and social care providers to deal with the Covid-19 crisis. They have led to difficulties in recruiting and retaining frontline care staff, reflected in the shortfall of around 40,000 registered nurses, and arguably contributed to a lack of preparation, not least apparent in the initial shortages of personal protective equipment for staff, especially in under-resourced care homes.
“As the initial terror of this pandemic begins to subside, it feels like the right moment to start talking about how to rebuild and re-regulate our health and social care system. It not enough to just clap for our carers, it’s time to make meaningful changes to the working practices that have seen them undervalued and dismissed for far too long”.
Download here: https://www.kcl.ac.uk/business/assets/PDF/fair-care-work.pdf