July 25, 2023
4 Steps Guest Blog: “What is the ethical defence of unequal pay?”
Old concepts of moral principle, politics and logic help explain the absence of fair work in social care, says Ron Culley
Ethos, demos and logos were concepts used by the ancient Greeks to make sense of the world around them: ethos referred to the development of a moral principle or argument, rooted in human values; demos referred to the body politic, to the rules of self-government; and logos referred to reason and rationality, the logical flow of an argument.
Two-and-a-half-thousand years later, and it seems to me these concepts are still useful in making sense of the world around us. The principle of fair work in social care, and the limited political progress that we have made towards it, can be helpfully understood by applying these concepts.
The ethical argument for fair work in social care is plainly put. If social care workers across different sectors are delivering similar taxpayer-funded public services, why should the level of pay be different? Given that care workers are providing work of equal value, is the Scottish Government justified in mandating that a Healthcare Assistant in the NHS be paid £14 per hour, a homecare worker in a council £16 per hour, a support worker in a not-for-profit social care provider £10.90 per hour, and a care worker in a private sector care home £10.90 per hour? All of these jobs are comparable in terms of skill and responsibility.
So is it fair that the Scottish Government and Local Authorities have decided in favour of unequal pay? And let’s consider the fact that most people working in the care sector are women and that, on average, women continue to receive lower pay than men. Is it right that the Scottish Government and Local Authorities have not gone further to correct this injustice? Were there to be a reprioritisation of political choices, tens of thousands of women could be taken out of a low wage job. In short, the ethical defence of unequal pay is very difficult to present.
To explain why this situation nonetheless persists, we need to understand Scottish politics. The reality – however much we might want to pretend otherwise – is that the NHS is politically more important to the Scottish Government than the social care sector. It’s why many arguments about investing more in social care are actually framed around alleviating pressure on the NHS, and not about supporting people to realise their rights as citizens or to give expression to their personal agency. By this argument, social care is only important because to get it wrong damages the NHS, and a struggling NHS is a vote loser.
The other way democratic politics plays into this is in the stewardship of the public finances. There simply isn’t a strong enough tax intake to fund the health and social care system that many people would like, so we have developed a system that supports the cheap outsourcing of public services to the third and independent sector (euphemistically referred to as ‘best value’). That would be fine if it were a level playing field and all providers (including monopolistic providers like NHS Boards and Councils) had to compete for business on the same terms. But that would risk violating one of the golden rules of Scottish politics, that public sector delivery is best (despite evidence that the third sector consistently delivers higher quality care and support).
The problem with all of this is that it contains flawed logic and makes for poor strategy. What happens if we pay public sector care workers significantly more than third or independent sector workers? The answer is there is a migration of talent and experience from one to the other. As a result, the third and independent sector is weakened, especially given that the labour market has been structurally imbalanced by Brexit and Covid.
How will providers in the third and independent sector respond? I doubt there will be a dramatic implosion – there’s too much market diversity for that to happen. Rather, what we’ll see is a gradual reduction in service delivery across the sector – less care delivered by less people. That in turn will generate more unmet need. And where will those people go? I would imagine social work, GPs and Emergency Departments. Only this time, there’ll be no-one else to turn to.
Ron Culley is CEO of Quarriers, a member of CCPS’s Board and Chair of our Committee on the National Care Service