Almost a third of COVID-19 deaths, over 16,000 people, have occurred in care homes. Careworkers are twice as likely to die of COVID-19 as the general public.
A little acknowledged but major factor in these carehome deaths is the low pay and insecure employment of careworkers. It is estimated that around 440,000 care workers have no rights to occupational sick pay. If they develop symptoms of Coronavirus or a member of their household develops symptoms, then they are faced with an impossible choice: take time off on Statutory Sick Pay (just £95.85 a week) or continue to work potentially infecting vulnerable adults.
A Unison survey of 2600 careworkers found 8 out of 10 would not get paid if they had to self-isolate. The survey found many careworkers and their co-workers are not always self-isolating because of poverty and fear of poverty. A GMB survey found 78% of careworkers feared getting a test in case it meant they had to take time off on Statutory Sick Pay.
In the words of Nadia Whittome MP: “Those least able to afford to self-isolate are working with those most likely to die if they catch Coronavirus.”
But careworkers have been organising with the Safe and Equal campaign and in their unions and have been winning victories.
Unison North West has won a number of victories, securing full isolation pay for careworkers in Salford and a number of other local authority areas.
In Scotland the government announced on 24 May that it was introducing an “Enhanced” Statutory Sick Pay for careworkers. The details of this scheme are yet to be confirmed.
In Northern Ireland, the Department of Health announced on 3 June that it would pay 80% wages for any careworker that needs to isolate following public health advice.
In England in mid-May, the government announced a £600 million Infection Control Fund for carehomes. Among other measures this money is for “ensuring that staff who are isolating in line with government guidance receive their normal wages while doing so”. At the time of issuing this grant determination this included staff with suspected symptoms of Covid 19 awaiting a test, or any staff member for a period following a positive test.
Local authorities were supposed to write to the government by 29 May explaining how the money has been used and reporting any problems. These returns were supposed to be made public. Some local authorities have complied, others have not.
Safe and Equal are encouraging supporters to lobby councils and collating information to find out if the £600 million taxpayers' money is reaching the frontline and specifically ensuring that careworkers do not miss out if they need to selfisolate.
So far, Safe and Equal have information on 65 local authorities with responsibilities for over 6200 care homes. Of these just 40% say they pay isolation pay.
The information from the councils is very confused. Very few councils appear to understand the connection between sick pay and infection control. Throughout the pandemic there has been a staggering failure by the work-from-home management class and their allies in the media and top ranks of the labour movement to grasp the fact that millions of low paid, precariously employed workers cannot afford to isolate on the government’s £95 a week Statutory Sick Pay scheme.
The government and public health authorities obviously understand the connection very well but have tried to address the problem within health and social care as quietly as possible for fear of rousing demands from other sections of the workforce.
Just 4 out of the 65 councils appear to understand that full sick and isolation pay is necessary to safeguard vulnerable adults from risk of infection. Derbyshire County Council is one of those four councils: “if care staff are paid their normal wages there is greater chance they will take the right decision to self-isolate rather than needing to work to maintain family income”.
Overwhelmingly the response from councils is a lack of understanding and indifference. A good example of this is Manchester City Council. Manchester City Council has signed up to Unison’s Careworkers vs Covid19 pledge which includes full sick pay as its key demand. Its neighbouring local authority in Salford was the first council to ensure all careworkers get full isolation pay. Mayor Andy Burnham has been one of the only senior Labour politicians to argue for full sick pay for careworkers on national television.
Yet, having passed on the £3.34 million taxpayers' money to care home bosses, Manchester City Council state they have not even discussed the issue of sick pay during the daily ring round 91 carehomes. It has no data about this issue. Oxfordshire Council points out that it would be a lot easier to get carehomes to act on this issue if the government issued a clear statement.
Most councils are more concerned about the financial issues. Many say that the £600 million is not enough to pay sick pay.
It is not obvious that this is true. There are 440,000 careworkers who do not have ordinary rights to paid sick leave. If all those workers work full time (which they don’t) and are paid £10 an hour (many are paid far less than this) then it would cost around £330 million for all of them to take two weeks off work. The government money is more than enough to cover this expense and more.
The problem is that carehomes are suffering from years of underfunding, they are paid per bed and many of their residents have already died, and crucially they are private businesses that prioritise profits above all else. The Infection Control Fund money is enough for isolation pay but cannot compensate for years of underfunding and profit-extraction.
At the moment the infection control fund money can only be paid for staff who are awaiting a test result or have returned a positive test. Thurrock Council point out: “The risk of care staff returning to work whilst they should be isolating does not just relate to those who are isolating as a result of a positive test. The ‘ask’ should be broadened to include those who are shielding… There are a number of scenarios to be considered that includes zero hours workers and those staff who do regular extra overtime.”
Thurrock may have added that the tests are notoriously inaccurate and careworkers should be paid for following public health advice without the additional condition of producing a positive test. Also, Covid-19 is just one of many infectious diseases that can kill a care home resident. For these individuals to be safe, care workers need the same sick pay and job security that is enjoyed by substantive NHS staff. The government’s concession on isolation pay should be a stepping stone to a bigger union drive to win decent pay, terms and conditions and job security.
All Council returns point to the huge obstacles the privatised and fragmented care sector presents to running a safe service. After lobbying from Unison, Islington council have said they would like care homes to ensure full isolation pay but have no mechanism to force private businesses to grant this to their employees.
Nottinghamshire Council is very worried about being in breach of State Aid rules. Oldham Council is concerned about long term sustainability. Redbridge Council calls for a national approach, possibly involving emergency legislation. The picture that emerges is a system that is broken, with no accountability to users or the general public and significant difficulties trying to get it to comply with basic safety measures.
Last year firms running care homes paid £1.5bn in dividends, directors’ fees and other forms of profit, as well as rents which are many times higher than those paid by non-profit providers (ie another form of directing funds to capitalists). Six of the 26 largest providers have owners registered offshore in tax havens.
Whilst the private care sector enriches a few extremely rich individuals, it is radically failing in its duty to provide even basic level of safe care to its residents. The sector is well overdue to be taken into public ownership and run for people not profit.
Safe and Equal are encouraging people to lobby their councils and MPs, and are building a network of careworkers to campaign and unionise their workplaces.