Question: How did carework end up in such dire straits? Answer: outsourcing

I’m back. I’ve finished my book on austerity – more on getting a copy at the end of this article.

This article is about careworkers. Careworkers’ dreadful pay and working conditions won fleeting attention earlier this year when the coronavirus started wiping out carehome staff and residents, but alas – big media has moved onto new thrills. That can’t be the end of the story, though. Things have to change. Careworkers and carehome residents have been treated like garbage for years:

There is a problem with writing about attacks on careworker wages and working conditions over the past decades or so: I have too many examples to choose from.

Every carehome worker I met in the last decade was on a picket line in that first instance, fighting to protect already-meagre careworker wages from attacks and cutbacks. For as long as I’ve been writing, careworker wages and conditions have been targeted by a particularly witless brand of neoliberal: local councillors (of all political stripes), MPs (ditto) and the boards/trustees of private and third sector care companies who’ve been united by two of our era’s more perverted beliefs: 1) that care can be provided on the cheap and 2) if you achieve this cheapness by slashing careworker wages and standards, care can turn a profit.

Spawned in this manure, the stories are always, always the same. It all starts when care services, in one form or another, are outsourced from councils, or the NHS, to private or third sector companies. In the following months and years, managers of these companies cut careworker wages and sick-and-annual leave allowances, and direct that money elsewhere. Careworker contracts that were based on public sector wages and conditions – wages and conditions that private care companies swear they will protect – are, needless to say, quickly trashed. New carework starters begin on much-reduced wages and leave provisions – the bar set so low that it more or less disappears.

This model is so standard that you can cut and paste examples straight into it. Take the Fremantle careworkers in Barnet – a group of carerworkers who I first met on a picket line in 2007 and at plenty of strikes in the years after that. These long-time Barnet carehome workers (most were women) went home one day to find a letter from the Fremantle Trust, the company to which Barnet council had outsourced carehomes and the careworkers’ jobs.

That letter did not bring good news. The Trust told the the careworkers that their pay would be frozen and their all-important weekend enhancement pay rates removed. Many of the careworkers relied on that after-hours enhancement pay to meet their bills and mortgages. They hardly earned a fortune even with that money. Losing it was a catastrophe. The sums were simple enough – careworkers’ jobs no longer paid the bills:

“Some people are down three or four hundred (pounds) a month,” Fremantle careworker Carmel Reynolds told me at that time. Reynolds been in the job for 23 years at that point. “People organise their families around [that money].”

There was more, of course. There always is. The Fremantle Trust told the careworkers that it would also cut their annual leave allowances and slash their sick leave to the statutory minimum – the very same first-3-days-without-pay statutory sick leave “package” that many are convinced helped to fuel covid-19’s blaze through carehomes in 2020. Careworkers can’t afford to take 3 days’ sick leave unpaid, so they go to work when they’re ill. Fremantle careworkers were pointing that out even in 2007.

True to pompous form, Fremantle management told the shocked careworkers that they could either sign the new contract, or leave. Then, management rubbed the careworkers’ noses in it a little harder – managers told careworkers that if they were really worried about money, they could try and make their stolen wages back by working extra shifts. More work for less money – Fremantle Trust management seemed to reason that careworkers would be grateful for such a gig. No matter that many of the careworkers had children at home and would suddenly have childcare costs that they couldn’t cover. No matter either that the destruction of careworker wages and working conditions was grossly unfair:

“I said [to Fremantle managers] – how do you expect us to be able to cope…?” careworker Lango Gamanga told me. “They [Fremantle managers] said we could do more hours to make up the money… but what about the quality of our life – our daily life?”

Of course – careworkers’ quality of life is rarely a concern in these scenarios. Concern about workers’ quality of life was certainly nowhere to be seen in another battle I’ve picked from my list: the 2014 Care UK support workers dispute in Doncaster. That was the year that Doncaster Care UK workers took weeks-long strike action in protest at – you guessed it – wage cuts in the form of the removal of enhanced weekend and night rates, new-starter pay cut to £7 an hour and – again – cuts to sick leave.

As ever, this shambles started with privatisation. The Doncaster workers – they worked with people with learning difficulties – had their jobs transferred from the NHS to Care UK when the service was outsourced to Care UK. It didn’t take Care UK long to target their new employees. Implying that the careworkers had been spoiled by their NHS wages and working conditions – “annual holiday… for some people is close to 7 weeks on top of public holidays,” groused Care UK learning disability service boss Chris Hindle with the faux outrage that these people specialise in – Care UK proposed wage cuts that saw the Doncaster workers facing losses of £300 and £400 a month – just like the Fremantle workers

At one strike action, careworker Mags Dalton told me the wage cuts were so severe that she’d have to leave her flat and her job, and move back in with her parents in Newcastle while she found another job and saved up for the deposit on another flat. The Care UK cuts meant that she’d lose about £400 a month. Her rent was £465 a month. She couldn’t afford to keep paying:

“I made a life for myself in Doncaster with friends that I love and a job that I love. I only signed up for the house a year ago. I moved in on the 26th of June last year and the 25th of June this year, I moved out. How did that happen?”

It happened for the same reason that it always happens: when services are outsourced, money is re-routed from frontline staff. At Doncaster, Care UK executives tried to argue the usual toss – that cuts to workers’ wages were necessary if the rest of the business was to stay afloat financially. Curiously, senior staff and executive incomes appeared to be exempt from this do-or-die belt-tightening. Bridgepoint Capital, the private equity firm that owned Care UK, had managed to find around £14m for bonuses to senior staff while careworkers were facing pay cuts of £400 a month. Care UK was also reportedly expecting to make a profit of around 6% for the Doncaster contract. Careworker wages were obviously key to this windfall.

Windfall is always the aim. The architects of these nightmares come up with all sorts of weird and not-so-wonderful service “concepts” in their rush to turn need into cash. Let’s go back to Barnet, where, around 2013, leading Tory lights at Barnet council decided to set up a so-called Local Authority Trading Company into which it transferred services for people with learning difficulties and associated jobs. (Alan White and I wrote about this particular car crash for the New Statesman). The company was called The Barnet Group. The services-for-people-with-learning-difficulties part was named (ironically, many said at the time) Your Choice.

The (batshit) idea behind this LATC concept was that people with learning difficulties would travel from all over London to Barnet to (pay to) use Barnet’s Your Choice services. Profits of half a million a year were confidently predicted. It was no surprise, then, to hear just a year later that the Your Choice project had run aground and was in need of a £1m bailout. The promised rush of customers and cash hadn’t quite come to pass.

Needless to say, the council announced that the only way to save the ship was – you guessed right again – to cut careworker wages, removed their enhanced weekend payments and to slash staff numbers.

Some of the changes proposed to Your Choice services in the interests of cost-cutting were particularly revolting, even for the care industry. Management seemed, for example, to be considering ways to justify cuts to night staff numbers in supported living facilities by reducing cleanliness standards for disabled people with continence issues. One Your Choice report said that the 6-bed Valley Way respite centre no longer needed 2 waking staff on duty during the night, because “it is clear that support can be safely provided by one person….for continence issues, those who require changing in the night do not require the use of hoists as they are already in bed.”

I can’t tell you how often I’ve spoken in the last decade with disabled people and/or their families who’ve been told that people will have use night nappies or pads because night care is a luxury that the care industry can’t afford. The argument never changes. It just goes round and round the same pan.

Things really do go around and around. In an example of a truly perverse full circle, Fremantle careworkers – the workers whose wage-and-sick-leave-cuts story I began this article with – were told last year that their jobs would be transferred from Fremantle into the Barnet group company where Your Choice resides. Since that announcement, Barnet Unison has been fighting to make sure that the transferred careworkers are at least paid the London living wage by their new employer – their new employer being a council trading company which boasts of commercial viability and a £38m pa turnover, for all the world as though such things should count in care. It seems incredible that careworkers must still battle for a few extra coins from such an outfit, but that’s the scene, even in 2020. when careworkers are on the frontline of an actual plague. The truth is that careworkers in all parts of the country should be paid a damn sight more than the London living wage as a baseline, but here we are again, quibbling over a handful of change for workers at the covid coalface.

More soon. There really does have to be more. It took this year’s covid-19 carnage in carehomes to bring careworkers’ tiny wages, rotten sick leave allowances and witless private sector/third sector priorities to mainstream attention. Attention ain’t enough, though. Neither is clapping. It’s time for radical change.


My 2020 book “Abusing Power” is a collection of interviews with people who needed benefits and housing help in austerity. The book goes behind the scenes to jobcentre & homelessness meetings and shows how people’s experiences of the austerity state shaped their politics and thinking. Contact me for a pdf copy for review.

12 thoughts on “Question: How did carework end up in such dire straits? Answer: outsourcing

  1. I’ve sent this to my lovely friend M. She is a care home worker. A nice place for residents, and good colleagues.

    It’s not for me to tell you what else she has to go through..

  2. The Tories will never Nationalize the Care sector, but that’s what’s needed, bring it all under the auspices of the NHS.

  3. I heard about a Corvid outbreak in a local care home just a few weeks ago (same time as the meat factory in Cleckheaton) with 11 people confirmed infected including both staff and residents but there has been no mention of it in the local news. I’m told the remaining staff are now getting tested weekly.

  4. Pingback: It’s time to pay careworkers proper sick pay. Stop trying to paper over the f*cking cracks | Kate Belgrave

  5. The Tories (Boris Johnson and Therese Coffey) are now suggesting that unemployed Hospitality workers can find a new career in Care work! In fact that seems to be be the only plan they have to deal with coming mass unemployment; everyone can do Care work.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.