The Value of Social Care

The creation of a National Care Service is an opportunity to improve the lives of people who use social care and their families and carers. But whatever form it takes, a reformed social care system must address the undervaluation of its workforce if it’s to succeed in improving the quality and provision of care services in Scotland. To do this, we must acknowledge the reason that care work is so undervalued – because it’s seen as “women’s work”.

Care is profoundly gendered. Women do the bulk of unpaid and informal care, and comprise 85% of Scotland’s social care workforce. Social care is vital to women’s lives, as workers and as service users, and to the functioning of Scotland’s economy. Investment in the workforce is core to providing high quality personalised care. Despite this, the social care workforce remains underpaid, undervalued and under-protected.

This undervaluation is sustained by gender stereotypes and assumptions about women’s and men’s capabilities and interests. There’s a widespread assumption that caring and other unpaid work done in the home is better suited to women because historically it has been their role. This drives the undervaluation of this work when it’s done in the labour market, with jobs such as cleaning, catering, childcare and social care paid at, or close to, the minimum wage as a result. Additionally, the stereotype that women are intrinsically more caring is used to justify the low pay of care work in the labour market, with perceived job satisfaction a substitute for fair pay. This undervaluation of women’s work underpins occupational segregation, the gender pay gap and women’s poverty.

Rising demand due to demographic change and difficulty recruiting and retaining workers have combined with funding challenges to place huge pressure on the social care system in Scotland. Many care sector employers are already reporting high vacancy rates, a shortage of good quality applicants and high staff turnover. The overall vacancy rate in social care is already twice the Scottish average.

These challenges are primarily driven by the pay and conditions of social care work. Care workers cite low pay and poor conditions as a primary reason for leaving their jobs. Many report not being paid for travel time between appointments or for overnight stays, effectively reducing their hourly pay rate, alongside highly compressed appointment times. Social care workers frequently don’t have enough time to deliver high quality care to service users. This has a detrimental impact on service users, but also on workers’ mental health and wellbeing because they can’t deliver the standard of dignified and compassionate care they wish to.

These factors are driving social care workers to leave the sector, but they also affect the standards of care it is possible to deliver within the current system. Evidence shows that pay is the primary determinant of care quality. Practices such as not paying for travel time and insufficient appointment times are a major barrier to quality of care. Delivering quality social care requires delivering decent pay and conditions to the social care workforce. It’s impossible to resolve these issues while maintaining low pay in the sector. This means that a National Care Service can only improve care quality and provision if it’s accompanied by the investment needed to raise the pay and conditions of the social care workforce.

Investment in care infrastructure, including in childcare and social care, delivers wider benefits alongside improved care provision. It stimulates job creation, community regeneration, and increased opportunities for under-employed women. Research by the Women’s Budget Group found that investment in care in the UK would produce 2.7 times as many jobs as an equivalent investment in construction.

Care is as essential to our economy as bricks, steel, and fibre optic cable. Social care, along with childcare, is critical infrastructure which enables women’s labour market participation, and is a necessary step in realising women’s wider economic equality. Inclusive growth must mean investing in a care economy, with investment in childcare and care for disabled people and older people considered as necessary infrastructure for a sustainable wellbeing economy and a good society.

The social care workforce is the foundation of the social care system. A National Care Service must value the predominantly female social care workforce if it’s to tackle the longstanding challenges in social care delivery, and create a sustainable system fit for the future.

This piece was first published as part of ALLIANCE’s ‘The Future of Social Care’ series. The ALLIANCE is Scotland’s national third sector intermediary for a range of health and social care organisations. Their vision is for a Scotland where people of all ages who are disabled or living with long term conditions, and unpaid carers, have a strong voice and enjoy their right to live well, as equal and active citizens, free from discrimination, with support and services that put them at the centre. You can find out more about their work here: https://www.alliance-scotland.org.uk/