A small group of undaunted social care workers in Doncaster will tomorrow embark on their 48th strike day. Their employer is Care UK, a company in which Bridgepoint Capital, a private equity firm, has a majority shareholding. Care UK is a company with an increasingly large slice of the flourishing business of providing residential care and social care in the home and a complex financing structure that results in a very small tax bill. As the Observer reports, it has announced cuts of up to 35% in care workers' wages in Doncaster, slashing already low pay by up to pounds 7,000 a year and imposing restrictions on holidays and sick pay.
According to Unison, directors of Care UK Health and Social Care Investments Ltd were paid pounds 1,452,000 in salaries, fees, bonuses and benefits in the year ending September 2012, when Mike Parish, the chief executive, was paid a salary of pounds 800,000. The plight of care workers in one city graphically illustrates what is a far wider malaise in our distorted and malfunctioning economy that, in spite of the thin veneer of growth, continues to display gross disparities in earnings, a total disregard for the value of vocation and an alarming lack of political interest about what ought to be done as a corrective.
Care UK's market is set to grow. Medical advances now preserve newborn life in extraordinary ways but on occasions with disabilities that require extra support throughout life. Increased longevity is also assured as millions more may reach very old age, often with complex long-term conditions. Both trends mean that demand for residential and domiciliary care is bound to rise. Almost 90% of social care is now provided by the private sector. According to the National Audit Office, local authority spending fell by 8% in real terms in 2010-1 to 2012-13.
As funding has been cut to local authorities, so eligibility criteria for social care have been raised and companies competing for local authority contracts have driven down costs, stripped out middle management and demanded greater productivity from their employees. Yet care is about two vital ingredients, which in this particular marketplace, too often carry next to no value - namely, time and relationships.
A report, Does It Pay to Care?, published by the Resolution Foundation thinktank last year, reveals how both are continually sabotaged in the hunger to increase profits and provide rich dividends for shareholders. In many cases, care workers are not paid for the time they take to travel from one client to another, an illegal practice. They are also docked wages for accommodation and uniforms. Wages can drop to as low as pounds 5 21 an hour, far short of the national minimum wage of pounds 6.31 an hour. This is labour scandalously without compassion for employees whom, as the Observer reports, are often intrinsically altruistic, demonstrating huge concern for their charges, as in the case of Cheryl Fawley, a support worker for 16 years, who coaxes the diabetic and paralysed John to take liquid by a touch on his cheek.
According to the Social Care Workforce Research Unit at King's College London, 150,000 workers are receiving less than the minimum wage. The care minister, Norman Lamb, has said that 307,000 care workers are on zero-hours contracts. Too often, in the name of "productivity", time is so severely rationed, care workers say they cannot do their job properly, an added stress.
An inquiry last year by journalist Camilla Cavendish, conducted at the request of the health secretary, Jeremy Hunt, following the Mid-Staffs scandal in which hundreds of patients are thought to have died needlessly as a result of poor care and neglect, said that a third of health trusts did not carry out checks to establish if care assistants were literate and training was minimal, while care staff turn-over ranged from 19% to 30%.
An investigation into pay, conditions and care quality in the sector by the Joseph Rowntree Foundation earlier this year highlighted the low pay and status attached to care work and the lack of understanding of the personal commitment of many care workers who are loyal to the sector because "they are motivated by a primary commitment to service users".
In blunt terms, too many employees in the care industry are exploited. They are mainly female, are increasingly immigrants, often part time and difficult to unionise, so collective action is rare. In Doncaster, Mags Dalton has been a care worker for 26 years. Pay cuts of pounds 400 a month mean she can't afford her rent, forcing her to move out of the city and leave a job she loves. New recruits to Care UK are being paid even less.
Why is care so little valued? Feminist economist Nancy Folbre in The Invisible Heart: Economics and Family Values argues that care has traditionally been part of the essential but uncounted part of the economy - women's unpaid work. If care pays poorly, then it will be avoided, to the detriment of those in need of help. Folbre argues that intensified economic competition does not countenance metrics that put a high price on wellbeing and the public good - and we all pay a price as a result. This is an area that Ed Miliband has tried to claim as his own, yet he has remained shamefully silent about the industrial action taking place in his constituency.
At the Joseph Rowntree Foundation, care workers are paid the living wage (pounds 7.65 outside London); they have opportunities to improve their qualifications; they are given time to develop relationships with those they support; there is a strong management ethic and a sense of pride in their work. "Social care is part of the economic infrastructure of this country," says chief executive, Julia Unwin. "It is right to invest properly and have high expectations."
New regulations and a toughened Care Quality Commission are intended to improve standards of care, including a "duty of candour" on providers to ensure "an open and honest" culture. That is not enough. A modern, progressive society sees care as an essential part of the economy that provides careers, pays properly, gives superlative help, makes a significant contribution to the common good and recognises the value of those who are paid to care, their capacity for compassion and their skill at forging relationships.
The Doncaster workers merit, at the very least, a living wage, as do all care workers. Government is initially the prime mover in ensuring sufficient funds; shareholders may have to see their dividends reduced. But in a fair society, that is surely is as it should be.