Ali Treacher is a care worker, Unite the Union activist and workplace rep, and Secretary of the Care and Support Workers Organise! network (CaSWO!) She is also a supporter of Anti-Capitalist Resistance. She spoke to us about care workers' fight.
CaSWO! has been meeting throughout the last year, since the start of the pandemic, after a Unison-organised call which brought together care workers around issues like workplace health and safety and PPE. The initial focus was basically offering each other solidarity and advice and sharing information. Government guidelines were so vague that we had to have a lot of conversations about what our employers were doing and what to push for.
We’ve also organised several public meetings. That’s been important for giving care workers a platform, which doesn’t happen in many arenas. We’ve had supportive MPs speak too, Nadia Whittome and Paula Barker.
Our initial demands were mostly about PPE and other safety measures. We also raised a demand about the reinstatement of whistle-blowers, which was quite a big issue early in the pandemic. However moving forward we felt we needed to broaden it out and focus on making clear demands for wider change. Social care was broken before Covid-19, and the pandemic has just made things worse, for care workers and the services we provide.
With than in mind we’ve now developed six demands: we’re advocating for £15 an hour, with holiday pay based on normal wages and pension parity with public sector workers; contracts of employment including minimum hours based on the needs of workers and those receiving support; occupational sick pay including full pay protection for absences arising from Covid; safe workplaces with genuine support for every aspect of workers’ health and well-being; trade union access to all social care workplaces and the right to union recognition; and the last one is social care being brought into democratic public ownership, guided by “co-production” of workers and those receiving support.
These are radical demands compared to what the unions are calling for, but it was easy to come to a consensus as it’s really so clear what is needed. We’re going to confirm them at a meeting on 2 June.
We’re mainly lay trade unionists, though are also some ununionised workers in the group. We’re definitely growing, though we face an issue of people dropping in and out, which is exacerbated by the nature of our work, with shift work and a lot of stress and difficulties. We’re in Unite, Unison and United Voices of the World, mainly. The Sage workers [pictured above, North London care home workers in UVW, who have been taking strike action over pay, terms and conditions and union recognition] are in the group. There are particular workplaces that are represented, and new ones are getting involved.
Because new people are getting involved all the time we have to keep coming back to our demands and some of our earlier discussions, but we’re working through it.
Unite tends to be the main union in the third sector, whereas Unison is stronger in the bulk of private provision and services that used to be public.
More broadly, what have been the issues facing care workers over the last year?
The main struggle was around the crisis in PPE, about that being distributed and actually getting down to the frontlines. That’s a struggle which has continued in different forms. Even when we finally got PPE we often found it was out-of-date, often very. There were boxes where stickers had just been stuck over, changing the expiry date. I remember being on the first Unison call and people were talking about employers saying workers didn’t need PPE and workers having to make their own PPE out of whatever they could find.
There were also a lot of issues about being trained how to use PPE, some care workers had experience of it but lots didn’t, and we weren’t given a lot of support or guidance.
Sick pay was obviously a huge issue. After a lot of pressure from the unions, in May last year the government eventually brought in the Infection Control Fund, from the point of view of public health and stopping the virus spreading, with little discussion about what was happening to care workers. The result was extreme slowness in workers getting isolation pay. Even now, a year later, 20% of care workers still aren’t getting that.
There’s a struggle in Sheffield in a provider called Exemplar, where the employer has got money from the fund but is still trying to make workers take annual leave rather than granting isolation pay.
Meanwhile, while we risked our lives to support people, most of the sector remains on the minimum wage or close to it. Long hours and understaffing are also very big issues. I don’t know a care worker who does 37.5 hours. That doesn’t exist. If you add sleep-in shifts which now aren’t counted as hours [see below], people can do 60 hours weeks, easily. There’s well over 100,000 vacancies in care and there just aren’t the staff to staff projects safely, and large numbers off sick in the pandemic has made it worse. Add all this together and there’s a massive increase in stress for workers, leading to a crisis in mental health.
Bear in mind that we’ve had huge numbers of those we support dying and that feeds into it too. It’s not just Covid either. The last year has seen drugs and alcohol deaths skyrocket, as the connections people need are cut off.
I also want to highlight an issue that is not spoken about much, which is forced vaccinations. I’m fully vaxxed and I’ve gone out of my way to work with my employer to encourage vaccination. I was really shocked when I discovered only about 50% of workers in my organisation had taken up the vaccine. I reached out to a comrade in the BMA [the British Medical Association, the doctors’ union] and arranged to get a GP to come in and speak about vaccine hesitancy. Now we’re over three quarters vaccinated – we’re getting there. However I do oppose forced vaccination. Care workers feel seriously aggrieved that the government is appealing to our professionalism when we have been and still are being treated so badly.
You also have employers saying they won’t employ people unless they’re vaccinated. Of course there’s a debate about the balance between the rights of the people using the service and workers’ bodily autonomy, but forced vaccination is not a good answer.
What struggles and organising have come of this?
I don’t have figures about unionisation generally but in my workplace for sure lots more people are joining the union.
The Sage workers’ fight is really important. They’re actually taking industrial action and that’s something more of us need to be doing.
What Unison are doing in the North West is significant in a different way. They’ve run a campaign, Care Workers vs Covid, with paid organisers, and they’ve done some great work. They’ve made demands on local authorities, with some results, particularly in Salford. I’m sure that’s resulting in increased membership and density, but at the moment I don’t see a sea of shop stewards and grassroots activists coming forward out of it. I’d say the main mechanism for winning there has been political leverage rather than building organisation in the workplace. That’s what makes the Sage workers so distinctive and inspiring.
CaSWO! is the only grassroots network I know of that has emerged. I think it’s a real strength that we are independent of all the unions but have members from each of them, as there’s things we can learn from them all. We push union membership in general, but we’re not sectarian. It’s very positive to have a forum for members of different unions to discuss and work together. It’s allowed various kinds of inter-union networking that go beyond social care, for instance different unions in London talking about going to each other’s picket lines.
In my view the action taken by UVW has had some impact on the pushiness and demands of the big unions, and networks like CaSWO! will help that dynamic.
In terms of Unite, as I said, most of its membership is in the small minority of social care provision that is third-sector rather than private. We don’t have care branches generally; care workers are in composite branches, often health branches. Mostly, even when there’s recognition, union reps don’t get facility time or get a very small amount which is eaten up by doing case work. I get three hours a week and that’s for an organisation of a thousand people. A lot of full-time officials get drawn into case work which reps should be doing; there’s an awareness of the problem with that and the need to develop organisation, but it’s difficult.
Unite has created a National Social Care Forum, which brings workers from different employers and parts of the sector together. But also, at the first meeting, a question that occurred to me was, where are our disabled comrades? Unite has a unique opportunity to bring care workers together with disabled workers and disabled activists, bringing the union’s Community branches into the conversation as well, to think about what social care should look like and how we move forward on it. That’s not really happened yet but it could be really interesting.
Could you say more about what's been won in Salford?
What they’ve won so far is pretty substantial, and reflects a genuine commitment to social care. It hasn't stopped with the victory on isolation pay. On the day of the Supreme Court decision about sleep-in shifts [not qualifying for the minimum wage], [Salford mayor] Paul Dennett said not in our city, and insisted employers pay the rate for those shifts. The council has good links with Unison and has cooperated to tackle employers. By the way one of the first things Dennett said in his speech when he was re-elected was to thank the unions.
During the elections, I think it was 56 out of 60-odd Labour council candidates signed Salford Unison’s pledges for social care. There’s nowhere else in the country that I know doing that. I think in Bolton they’re making similar steps. So what Salford has done is not enough, but it’s a beacon.
Unison nationally has a wider care charter which is much more woolly and toothless than what Salford Unison has won.
At the same time it does seem that even Salford council isn’t willing to fight cuts or even make a noise about it?
I don’t know. Maybe it’s not their priority; their priority is to work as creatively as they can do to deliver for people in that city, to do what it’s in their power to do, and build consensus around left-wing policies. I’m not a housing activist but as I understand it they’ve also built more council housing. And to be fair Paul Dennett is quite vocal on the issue of local government funding. Certainly more so than other local authorities in Manchester.
You say vocal? In what way? Where?
He certainly talked about it at the meeting this week about the Salford model for care that Greater Manchester Association of Trades Councils organised.
How have Brexit and anti-migrant measures impacted care workers and the sector?
Priti Patel’s points-based immigration system is going to lock many migrants out of working in social care because of the disgustingly low rates of pay. So we’ve got a sector with gaping holes and loads of vacancies, and this is going to make it worse. I’d need to check but if I remember rightly 17% of the sector is migrant workers, and half are EU workers, so that is very substantial in a situation where we’re already short of workers. So it’s shit, not only for migrant workers but for the whole care system.
Could you say something about the issues in home care?
In CaSWO! we’ve got some personal assistants who are directly employed by disabled people. There’s a whole set of issues there. Who do they get PPE from? Is it the responsibility of the people receiving support, who we know don’t get enough money through direct payments? It was a real post-code lottery on whether people got any support at all. There was also a big issue with vaccinations. If you work in an organisation, we got it quite early on, but for individually-employed workers, who has records and who makes sure they get vaccinated? Even though they may be going into multiple different houses. You’ve got the general issues of individuals having to act as employers, and particularly if they have limited capacity for health reasons, and then you bring in all the safety issues.
The extent of those problems are only coming to light now, with the emergence of facts and figures about how many people have died with workers going into their houses. A lot of the previous discourse was just about care homes.
Are their tensions between reinstating social care as a collective public service and service-users having independence and control? [For some debate on this, see here.] You talked about “co-production”? What does that mean?
I’m not a fan of monolithic public ownership, or care homes as a system. We need a more radical rethinking of the whole thing. Are we advocating for these kind of institutions, in which the virus spread like wildfire? And when you’re 70 do you want to live with dozens or hundreds of other people you don’t know, all sitting in a big room? Is that the best we can imagine for the way care is provided? Some people would like that communal living, but does it have to be on a factory scale? In big institutions like that that’s where safeguarding concerns come in.
With more resources you could have collective living but on a much smaller scale, rather than what are effectively farms. At the same time, lots of people want to stay with their families, but again this is often isn’t possible because the resources aren’t there.
Co-production is a way to deal with all these problems. I don’t think the right to independent living, choice and control and person-centred care should be counterposed to public ownership. In the current discourse, the balance of forces in the debate, present them as counterposed. Of course the existing system of direct payments as it is has developed is neoliberal, it has individualised it. It means a vast system of bogus self-employment, a complete lack of workers’ rights and also a very problematic relationship between workers and those employing them, where there’s a constant threat you’ll sacked whenever there are bumps in the road or challenges.
However, surely we can have a system of choice and control where the workforce is still grouped collectively, delivering services collectively and able to organise and have decent terms and conditions. You could have, for instance, centres for independent living where there’s a workforce around that. You could have people receiving payments and then paying into collective systems, rather than being an employer and having to manage everything.
At its best co-production could mean workers’ power. We could be thinking about workers and disabled people working together and having a Lucas Plan for social care.
Isn’t it largely the case that the public debate in the labour movement, in Labour and most unions, has not even reached the level of advocating public ownership, in any form? What’s generally advocated is just more money for private providers.
Just increasing funding is not going to change social care. 15% of the money that goes into social care is siphoned off in private profit, in addition to the many questions about the way things are organised.
Part of the problem is that the mainstream of the labour movement is generally arguing for the “integration” of health and social care. This is yet another route for private providers to encroach into the NHS from below. It sets in stone the situation of private or third-sector organisations picking up contracts and operating under the guise of the NHS, with NHS reduced to a label. You’ll get even more of a two-tier workforce, with people doing the same jobs but on very different terms and conditions. There’s other problems too, around the medicalisation of social care, which need to be considered too.
I’m not sure Unison are even arguing that. They’re supporting the Future Social Care Coalition, which seems to just be arguing for more money for the private and third-sector providers.
In this crisis situation, and after so many cuts, of course we do need to push for more money, as an emergency measure, because things are at breaking point, but that should be on the basis of also advocating public ownership and transforming the whole system.
There’s now a few initiatives around public ownership, notably Reclaim Social Care and NCSILS [campaign for a National Care, Support and Independent Living Service]. In addition to UVW taking a strong stance, I think GMB has also taken a pro-public ownership position, and there are proposals coming forward in Unite too.
What can others in the labour movement do to support the struggle?
We should recognise this is an issue for everyone, not just care workers. It needs pushing forward. The debate, or lack of real debate, has been going on for far too long, with both main parties advocating very little. There’s debate around capping costs and various aspects of funding, but that’s not where the real debate is. Neoliberalism is destroying the care sector, far more insidiously than just in terms of underfunding. Funding is important, but what care looks like, what support looks like, should be really crucial questions for the left.
What are we even talking about? Social care is a relatively new phrase, from the Blairite era, and it’s not often considered what it means. The debate gets very easily narrowed down to old people, who are presumably respectable and deserving, but what about drug and alcohol services? Nobody’s talking about those services being smashed. Everyone needs and deserves support at some point. The current debate splits the working class into deserving and undeserving.
We need to listen to our disabled comrades. If I have to go to a meeting and hear another trade union bureaucrat describe disabled people as “vulnerable”, I might scream. It’s rude and insulting. They’re not inherently vulnerable, it’s our society which marginalises and makes them vulnerable.
The wider movement should recognise and accommodate the barriers to organising in social care. At the moment the main people taking an interest in this are pensioners, disabled comrades, sometimes NHS campaigners and then us care workers who are in a very difficult situation for organising. This is not something which younger people or the wider labour movement generally take up or talk about. We need the movement to make it a priority. At the moment there’s a huge danger that just as society has forgotten about this and moved on, the left is moving on too.
More broadly, this should be a really important struggle for socialists. There’s a debate here about the kind of world we want to live in – about pushing capitalism back, about social provision versus the profit motive, but also the social relations capitalism imposes on us and how we can challenge them by redesigning things on the basis of cooperation and power-sharing.
In CaSWO! we have enshrined in our rules that all officers have to work in social care, but we absolutely want other trade unionists and labour movement activists to be involved. There’s loads you can do to support us. Put a motion, invite a speaker and so on, but mainly please engage yourself in the issues and the debate.
• More about CaSWO! here. Email them at email@example.com
• For some recent Workers' Liberty material on the struggle in and around social care, see here (briefing including a number of further links) and here. More articles here
• Safe and Equal campaign for full isolation and sick pay for all workers