In England, pay and conditions for care workers in adult social care (ASC) are among the worst in the labour market. Care work has been classed as low-paid by the Low Pay Commission since 1988, and the levels of zero-hours contracts (ZHCs) are considerably higher than in the wider labour market.
There are now, however, sources of optimism in the government’s plans, and prospects of imminent meaningful change for this neglected workforce.
The case for improvements
Enhancing the quality of paid ASC work is urgent and long overdue. Our paid care worker organising research at the Centre for Care shows that the issues workers and their representatives campaign for are wide-ranging in scope and, at times, basic in nature. Wide-ranging are the concerns that workers, campaigners and unions flagged including those around pay and conditions, treatment of migrant workers, staffing levels and safety, and recognition and public awareness. Basic are the rudimentary employment rights that are at stake: for example, sick pay is a core issue for ASC organising. These conditions have major impacts on workers’ living standards, with The Health Foundation’s research highlighting residential care workers and their families’ significant risk of poverty.
The degradations of paid care work are embedded in, and drive, a range of social inequalities, including along gender and racial lines. These stem from the overrepresentation of working-class women, including from minority ethnic groups, in this employment. Enhancing the work’s quality provides a route to addressing such disparities. Paid care work is ubiquitous and local, and improving it stands to benefit communities across the country. It is inherently green work too, and efforts to promote or boost this employment align with climate-friendly agendas. Finally, and crucially, improving the quality of paid care work promises to raise care quality for supported people.
The COVID-19 pandemic brought increased visibility to care work through the Clapping for Carers display of support. However, it intensified stress and burnout and did not prompt meaningful improvements to pay and conditions. Unsurprisingly, many workers left then or soon after the pandemic’s height. Pandemic working conditions were a catalyst for campaigns around issues such as sick pay and health and safety, and workers told us of their struggles to be treated with respect and dignity.
Reasons for optimism?
The government introduced its Employment Rights Bill to the House of Commons in October 2024, and it is now at the Committee stage. There are several measures from which paid ASC workers look set to gain. These include the establishment of an ASC negotiating body, which will set sector-specific Fair Pay Agreements. While this is welcome recognition, there are questions about the feasibility of ASC with its fragmented, uneven and complex structure, and associated limited collective representation and union influence. Other provisions in the bill not solely relating to ASC will tackle problem areas within this employment: banning ‘exploitative’ ZHCs, strengthening sick pay and parental leave and reforming trade union laws. The draft legislation contains plans to form a new enforcement body, the Fair Work Agency, which provides hope for ASC workers who lack representation and are, for example, vulnerable to pay below legal minimums.
At the Centre for Care, we collaborated with a group of workers from the peer support Homecare Workers’ Group, to respond to a consultation on the bill. The workers were enthused by the possibilities for change, while also sharing some reservations. The latter included whether reforms would act on issues such as unpaid travel time for homecare workers, and fears that employers would find ways to circumnavigate new rules on ZHCs. For these workers, it is crucial that ‘fair pay’ extends beyond obvious measures such as increasing hourly pay.
Caution and reservations
While the contents of this bill offer cause for optimism, major questions remain. Announcements in the government’s November 2024 budget on increasing legal minimum pay and raising employers’ National Insurance contribution requirements provoked consternation across ASC. Care providers will struggle to meet these costs unless there are mitigations or additional finances, and this situation underlines providers’ reliance on government funding. It also calls into question how deliverable fair pay plans are without comprehensive funding arrangements.
With regard to a long-term funding settlement, time and recent history are important here. The government’s independent commission into ASC is not due to make its final recommendations until 2028 – a timeline that has been described as ‘glacial’. The recent history of ASC in England has been characterised by stalled reforms and implementation failings. Fundamental and politically contentious questions about how care should be paid for, and by whom, have continuously evaded satisfactory long-term solutions. Paid care workers at risk of poverty and/or contemplating leaving the sector would be forgiven for wondering how long they will continue to wait for genuine, properly funded and realistic sector-wide enhancements.
While the government’s task of confronting the legacy of austerity, of which ASC has been a principal casualty, is unenviable, it does have to start somewhere, and it is showing awareness of employment injustices generally, and of the specific problems besetting ASC. These longstanding and normalised care work problems require more than a quick fix, but thus far the government’s actions have lacked urgency. Their wide-ranging plans for improving the pay, conditions, and environment of ASC work look difficult to implement without comprehensive and sustainably funded ASC reform, which is again a long way off.
Duncan U Fisher is a Research Associate based at the ESRC Centre for Care, University of Sheffield.
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