Can Europe Make It?: Opinion

Caring about social care

“I lived in Leicester and if you are a woman and you want a job there, the only jobs available are in care work. ”

Elizabeth Carney
22 May 2020
Sorry we missed you.
Sorry we missed you.
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Trailer screenshot/Ken Loach.

In the work that I have done throughout my life there have been three unifying themes, gender, race and social class. Having now left the UK to live in Turkey, I’d be particularly interested in talking about this to women in other countries. I’ll explain why.

In the 1980’s, when I was at the Leicester Outwork Campaign, that organisation was well-funded, we had premises, we had admin. support, so that as staff we could do the work. When Leicester City Council ran the home care system in what was called ‘social services’, the carers were all on proper terms and conditions. OK, they were still low paid. There were problems. But there was an infrastructure. But thirty years ago or more a shift occurred that remains a background theme throughout this entire narrative – the breakdown in infrastructure in Britain began. Jobs have changed so much. Many people became accountants, they became administrators and they started to be asked to police things. In Britain we don’t have an infrastructure any more.

I had various jobs before I became a carer that fed into my experience. I was a welfare rights officer in the social services department of Leicester City Council for 5 years, working alongside social workers, child protection workers and so forth; and I worked on different groups of people – one year for example, on the elderly. Then I worked in a women’s project for five years, with homeworkers – who in Leicester were incredibly lowpaid women working on huge overlock and lockstitch sewing machines in their own homes, making garments for Marks & Spencers, Jaegers, everywhere. When the hosiery trade declined in Leicester and the factories closed, all these hundreds and hundreds of women who worked at home for a pittance were told that they were self-employed, and therefore not entitled to any redundancy pay. I would represent people at tribunals advising that they were in fact, employees.

So that was how I became interested in employment rights. I then trained to become an employment solicitor and worked for Thompsons Solicitors, the UK trade union law firm, from 2005 for several years. Later on, I worked with the homeless; and I set up a mentoring scheme for homeless people in Leicester. But after a while, in between two jobs, as a woman over fifty I couldn’t get an interview, and of course, as you know, the highest rate of unemployment in Britain is amongst women of over 50. I lived in Leicester and if you are a woman and you want a job there, the only jobs available are in care work. So I thought, ”Well I’m desperate, so I’ll do that. I’ll apply to a care agency.” And I did care work for six months in 2011.

I am so pleased that I did. I learned so much from that. Working for a care agency was an absolute eye-opener. We were very very low paid. We didn't get paid travel time or petrol so that the actual wage you ended up with miniscule. It is a very isolating role, because this was homecare – the agencies hired people to go into someone’s home. In this COVID-19 era we are now finally hearing about care homes, but home care people haven’t actually had a look in even now, in the media. Staff were not really trained, I noticed. There was a huge distinction between physical care – for which they did receive some training, and any kind of what I would call a human approach. So there was no attention to mental health or someone’s quality of life. It was very much a sort of medical, physical model.

So for instance, carers didn’t have time to sit and talk to people, or to listen, to let people talk. We were there to clean, to feed, to prompt medication. We were there to write up notes which opened up a whole other hornet’s nest of difficulties because the paperwork when you arrived at a job was often missing – it was chaotic. There were endemic problems, like the wrong medication being given, for example, because if someone has poor literacy and they have fifteen minutes or thirty minutes to make a home visit and they have to take the notes and update them, and check the medication that is being administered – it is a big mess. There was never enough time, it’s endemic – as Ken Loach portrays so vividly in Sorry we missed you.

In the first month in my job I was sent to care for a Bangladeshi woman who had dementia. When I arrived there were two carers standing over the woman and shouting at her and pointing in her face. I was a very new carer who had had middle class jobs up till that point: these two carers had been doing these jobs for years. So I felt extremely conflicted, but I had to say something. So I gently intervened and said, “ You don’t shout at people with dementia and it will be very frightening for this woman if you are standing over her and she is sitting and you are pointing in her face. “ I went back to the managers and said, “I really don’t want anybody to get into trouble – this is not what this is about – but when I did this visit I was aware that the carers really didn't know how to handle people with dementia.” The managers were very nice – everybody was really nice – but these two managers looked at me and said “Oh no – we’ve not had our dementia training either!” So that was my introduction to care in Leicester.

During my six months working for the care agency, one thing that I did notice was that the BME people tended to be given as their cases the much more complex difficult, complex residents – the people with multiple problems, acute physical and chronic illnesses as well as dementia. There was a general lack of support for them. A lot of the managers were white, and you know how it is, just like in male hierarchies, promotions got given on the basis of who you know and get on with. You could see how black and Asian women in Leicester were losing out and given worse jobs.

I joined the Labour Party when Jeremy Corbyn became leader in 2015 and I became quite active locally. I remember sitting in a meeting in the town hall with the Peter Soulsby, the Leicester mayor, and nine or ten of us in the room. We were talking about a campaign he wanted to do locally to promote the Labour Party. We were discussing possible issues, and I said that, given that Leicester and the East Midlands generally had a very low wage economy, a very large proportion of ethnic minority/BME women working in social care, I thought that it would be a really good way to connect with people when we went out canvassing and door knocking, to raise these issues and get people talking, listen to people’s stories and in particular to get women involved. His response was incredulous. He said: “Oh, we don’t have an issue with social care in Leicester…”. My jaw dropped and he must have noticed because he said, very nicely, “No, no, I’m serious. It is very rare that we get any issues raised on social care.” I thought that was very interesting in itself, given what I knew about the state of social care in Leicester.

Here in Turkey, I have been following BBC and Channel 4 news on the evolving COVID-19 situation in the UK. The minute they said that they were going to focus on hospitals, I said to myself, “Oh my God, what is going to happen to the care sector?” It’s great that Keir Starmer is raising some of the issues now in mid May – but why did they leave it to Piers Morgan? Why wasn’t the Labour Party jumping up and down from the start and saying, ”People are going to start dying in care homes.”

The reason they weren’t is because it is still largely a women’s issue, a working class women’s issue. There are some men, but hugely this is a BME women’s issue – a female issue. Just as Peter Soulsby didn’t think it was an issue, the establishment, the media and the public don’t think it is an issue now, because it's not on their radar – they are not aware of its existence and they are not interested. It doesn’t matter how many times you say it because they are not listening. And I just think, well, maybe it will be you who will end up in that care home with dementia!

After that, the following year, I worked for about a year training managers in the care agencies and care homes. The local authority asked me to do it because back then they were having such a problem in retaining carers. People frequently left working in social care, but what they found was that they actually moved on to other care homes and homecare agencies. Something massively important for the residents, as I explained to the managers, is consistency in care. It was a shame that carers themselves couldn’t get the training, because as well as information about the running of homes, I was to train managers on good employment practises, recruitment and staff retention, and how to motivate carers. I used quite a lot of my employment law knowledge, so I would train them in employment rights, discrimination and equality and diversity. And precisely how important it was to include carers in developing policy.

Of course it never happened. But it’s a pity – because as with most jobs, when you are a carer, you have got your family to run; sometimes you are going on the bus between homecare jobs; you are incredibly lowpaid and you haven’t got a car; you are really stressed. And when you start working as a carer you get hounded and told to read a whole pile of policies. Policies are great fun when you want to prevent, say, a social worker from getting sacked, because as a lawyer defending their employment rights you know that every manager interprets them differently – and the reason for this is that nobody is ever given enough time to read that pile of policies or to discuss them, and because we don’t involve the people who do the work in the development or implementation of the policy.

The other problem is that you simply never have enough carers. Here in Turkey I think there are around three hundred thousand care homes which are owned by the state, but in Britain, 85% of care homes are private.

Privatisation is a massive problem in itself and before you start, in that there is no infrastructure for privatised care homes. There is the Care Quality Commission (the CQC) but it’s not fit for purpose either. As with everything else, like the HSC, there aren't enough inspectors to police it. So these care homes are very much a free for all. But the one thing that keeps them in place is the fear of being sued. And it is exactly the same thing for local authorities. So there is this massive culture of fear throughout the sector. And there is no integration and no accountability, because after that 2012 Health and Social Care Act, everything was broken. All you had was adult social care fighting for their little pot of money; health trying to retain their little pot of money; housing trying to hang onto their little pot of money. Our infrastructure had been virtually destroyed. It's a broken, broken system.

Once again, in those private care homes, the people who do the work are not being involved in the discussion. So first of all, you have the issue of how you get the input and organisation from the carers, given that these are such put upon women! Without money and resources being allocated to support fulltime regional officers in trade unions to work with carers, I don’t see any of this changing. I saw this as a solicitor working for the trade unions. Some women are unionised. Unison are doing a little bit of the work on this. But in Leicester, there wasn’t any union work being done with these women, because again the male hierarchy of the unions is run by the men at the top. It is very difficult for women to be heard and for their problems to be aired. Yet it is essential that these women come up with some of the solutions to these problems as well as the rest of us.

When I left Britain after Corbyn had been ousted, I just thought, “Well, that’s it.” And I fully intended to retire to the countryside and read novels, out of sheer despondency. But then of course I couldn’t do it, could I? It kept coming back to haunt me. All the stories kept coming back to me. So I began to look at DiEM25 and I thought, yes, without international cooperation, without joined forces putting pressure, making demands, drawing connections between people so that we have a united voice across borders – I think it will be very very difficult to fight back. I am profoundly worried by the prospect of a UK-US trade deal which gives up all remaining workers’ rights as part of the package of a No Deal exit from the EU. So now I think the only thing I can do is to try and make links with other people who care about this – people from elsewhere. I’m hoping to make some DiEM25 connections in Izmir, two and a half or three hours away from where I live, despite my Turkish being pretty awful. You feel very frustrated, but then you wake up and somehow start feeling very hopeful again… so I’ve got to carry on.

How will we work after coronavirus?

The pandemic has profoundly changed our working lives. Millions have lost their jobs; others have had no choice but to continue working at great risk to their health. Many more have shouldered extra unpaid labour such as childcare.

Work has also been redefined. Some workers are defined as 'essential' – but most of them are among the lowest-paid in our societies.

Could this be an opportunity?

Amid the crisis, there has been a rise in interest in radical ideas, from four-day weeks to universal basic income.

Join openDemocracy at 5pm UK time/6pm CET on 4 June as we discuss whether the pandemic might finally be a moment for challenging our reliance on work.

Hear from

David Graeber Author of 'Bullshit Jobs' and Professor of Anthropology at the London School of Economics.

Other panellists will be announced soon.

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