Marginalisation and pay differentials in the UK social care sector

1. Marginalisation and pay differentials in the UK social care sector DrShereen Hussein King’s College London

2. What is social care? • Social care supports people of all ages • With needs arising from physical, cognitive or disabilities • Assist in carrying out personal care or domestic routines (activities of daily living). • Helps sustain paid or unpaid work, education, learning, leisure and other social support systems. • Supports people in building social relationships and participating fully in society. shereen.hussein@kcl.ac.uk

3. Why is social care so important? • Complex interactions of political, economical, sociological and demographic factors • Role of state, society and individuals • In the forefront of political debates • reforms, big society, mutuals, personalisation etc. • Value of emotional work • Duties and responsibilities • In the heart of demographic forces • Strong business case! shereen.hussein@kcl.ac.uk

4. Formal and informal spheres of care • Sociology of care • Norms and traditions • Individual, society and government responsibilities • Working with other forms of support (social security, health and housing) • Complement, intersect but do not substitute one another • Interaction with health care shereen.hussein@kcl.ac.uk

5. Marginalisation of the social care as a labour market sector • Dealing with a special kind of ‘commodity’ • Value of ‘care’ work to the society • Gendered; emotional; for granted ! • Responsibilities and duties of care • The role of the welfare state (means tested) • Assumed or planned • Pricing ‘emotional’ work shereen.hussein@kcl.ac.uk

6. The position of the care sector and labour dynamics • Changing structure; place; nature, interaction with health services • Domiciliary, residential • Individual budgets • Links to government funds • Interactions with other markets • Role of the private and voluntary sector • Secondary labour position • Migrants and BME workers contribution • Pay and working conditions • Possible other rewards • Flexibility • Satisfaction • Stepping stone • Only job! • Temporarily or continuous shereen.hussein@kcl.ac.uk

7. Characteristics of the care sector • Means tested, state-funded, less than 12% of users • Private sector major supplier of services (75% of services) • Different types of settings- with domiciliary care workers accounting for 48% of the workforce • Increase policy emphasis on personalisation and user choice • Wages are a major cost component • Growing demand- high vacancy and turnover rates- almost a recession proof sector • No signs of funding reforms! shereen.hussein@kcl.ac.uk

8. Workforce structure • Gender (80% women), age (mid 40s) and education (minimum skills required) • Migrants and immigration policies • International and local supply • Grey economy and domestic work • Lack/unclarityof career path • Marginalisation within a marginalised sector shereen.hussein@kcl.ac.uk

9. Pay structure shereen.hussein@kcl.ac.uk

10. Marginalisation in pay • One of the main low paying sectors (LPC) • Before and after the introduction of the NMW • Two tier pay levels; with direct care and ‘other’ workers paid on, below or just above the NMW • ‘Top’ tier includes professional workers (SW, OT ect.) and managers • Pay rates are significantly lower in the private sector and in domiciliary care settings • Ethnic pay-gaps also exist • BME workers paid lower than white workers after accounting for other factors • More people leave care work due to low pay from the private than statutory sector shereen.hussein@kcl.ac.uk

11. Sector effect: hourly pay rate statistics for different job groups working in different sectors, SCWP 6 shereen.hussein@kcl.ac.uk

12. Setting effect: hourly pay rate statistics for different job groups working in different settings, SCWP 6 shereen.hussein@kcl.ac.uk

13. Investigating pay differentials in the sector • Using mixed-effect models • Controlling for measured and unobserved factors and cluster effects at different levels of hierarchy • Separate models for different job role groups • Managers/supervisors • Ancillary • Direct care • Professional shereen.hussein@kcl.ac.uk

14. Direct care workers pay differentials • Significant and large in magnitude effect of individual providers (55% of variance) • Sector variations are large and significant • Large regional effects • Significant fixed effects: • Type of care setting/service type • Ethnicity • Interactions between age and setting • Interactions between gender and setting • Interactions between sector and setting shereen.hussein@kcl.ac.uk

15. Descriptive: Variations in hourly pay of adult direct care workers by some selected individual and employer-level characteristics, SCWP 7 shereen.hussein@kcl.ac.uk

16. Results of final mixed-effect model of hourly pay of adult direct care workers, SCWP 7 shereen.hussein@kcl.ac.uk

17. But ..Available data don’t represent accurate figures • Data provided by employers (NMDS-SC) • One figure for hourly rate (no indication of ‘enhanced’ rates etc.) • Sector is not very well defined (LFS) • Over represent higher wages and more stable workforce (ASHE) • Unrecorded ‘working’ time • Travel between clients • Extra work • On call – sleep in duties etc. shereen.hussein@kcl.ac.uk

18. Attempt to improve estimates of those paid under NMW • Combining different data sources • Adjusting for unpaid travel time • Adopt a methodology that maximises the benefit of prior knowledge • Focus only on direct care workers (majority of the workforce) shereen.hussein@kcl.ac.uk

19. Recent estimates and analysis • Approach • Sector specific data (provided by employers; NMDS-SC) adjusted by other sources (provided by workers; LoCSsurvey) • Accounting for previously published estimated by the LPC and small surveys (Bayesian approach) • Assumptions • Very small adjustments (average of 22.7 minutes of unpaid work and 4.8 min of travel time per week) • Findings • From (9.2% to 12.9%) or 156,673 to 219,241 ‘direct care’ workers in the UK are paid under the NMW shereen.hussein@kcl.ac.uk

20. Pay distribution of direct care workers Source: Hussein (2011); SCWP Issue 16 shereen.hussein@kcl.ac.uk

21. Posterior distributions of being paid under the NMW shereen.hussein@kcl.ac.uk

22. Risks- what to be aware of • Pay distributions are borderline with NMW in most cases • Any unpaid time likely to cause hourly pay rates to move under the NMW • Any changes in the NMW rates will have a large impact • Larger numbers of workers are likely to be affected if • we include ‘other’ workers- 14% of the total workforce • we include unreported work; especially through direct payment/personalisation schemes • Main risk areas for underpaying includes travel time/cost and night shifts • Innovative ways to cut costs: • reducing number of staff in shifts; increasing duties of lower paid ranks (care workers to give injections instead of nurses); shorter shifts (forcing some to work extra unpaid time); ‘real time’ shifts by the minutes etc. shereen.hussein@kcl.ac.uk

23. MarginalisionMigrant workers shereen.hussein@kcl.ac.uk

24. Migrant workers • Continue to constitute a considerable part of the workforce • Majority non-EEA migrants (usually with nursing qualifications) • Large regional variations • Concentrated in certain jobs • No large variations in pay levels • Linked to immigration status- minimum wage> NMW • Usually given ‘harder’ shifts which may pay more, e.g. night/weekend • Discrimination • Immigration policies: • Differences between EU and non-EU migrants • Attachment to employer • Qualifications • Choice and mobility • Language shereen.hussein@kcl.ac.uk

25. Experience of racism • Many experience racism and or discrimination • Then I noticed some of my colleagues started to, you know, I don’t know kind of my colleagues then so I think I noticed that, you know, people really sometimes they bully especially if you’re a different colour (Site 06, Migrant worker, Asian man 607). • Most are fine, but some clients can be rude and swear at you they can use racist comments: colour plays a big part. The excuse is often their mental health (Site 01, Migrant worker, black African woman 137). • Differential experiences of different ethnic groups • Visible social markers • Being ‘foreign’ • The ‘time’ factor Source: Stevens, Hussein and Manthorpe (2012) shereen.hussein@kcl.ac.uk

26. Top nationalities of migrant workers Source: Hussein (2011); SCWP Issue 11 shereen.hussein@kcl.ac.uk

27. shereen.hussein@kcl.ac.uk

28. Trends of number of migrant workers (in the care sector) entering the social care sector from 1995-2010 by nationality groups Source: Hussein (2011); SCWP12 shereen.hussein@kcl.ac.uk

29. Migrants and pay shereen.hussein@kcl.ac.uk

30. shereen.hussein@kcl.ac.uk

31. Another Advantage of many migrants “...are less likely to quibble and will accept worse conditions than established citizens; getting on with the job and not complaining too much.” (Refugee organisation director) Source: Hussein, Stevens and Manthorpe 2010 shereen.hussein@kcl.ac.uk

32. Next steps • Examine the profile of those likely to be paid under the NMW • Using sector specific data complemented by other national data • Sector differences • Type of settings • Providers/employers characteristics associated with very low pay • Investigate pay and conditions among workers employed directly by users (personal budgets) • Partnership/collaborative approach • Policy, research and practical knowledge • Understand, educate, regulate and penalise shereen.hussein@kcl.ac.uk

33. References • Hussein, S., Manthorpe. J. and Stevens, M. (2011) The Experiences of Migrant Social Work and Social Care Practitioners in the UK: Findings from an Online Survey. European Journal of Social Work, 14(4): 479-496. • Hussein, S. (2011) ‘Estimating probabilities and numbers of direct care workers paid under the National Minimum Wage in the UK: A Bayesian approach. Social Care Workforce Periodical, Issue 16: December 2011’. • Hussein S. (2011) The contributions of migrants to the English care sector. Social Care Workforce Periodical, Issue 11- February 2011. • Hussein S. (2011) Migrant workers in long term care: evidence from England on trends, pay and profile. Social Care Workforce Periodical, Issue 12- March 2011. • Hussein S., Stevens M. and Manthorpe J. (2010) International Social Care Workers in England: Profile, Motivations, experiences and Future Expectations, February 2010. Final Report. • Stevens, M., Hussein, S. & Manthorpe, J., (2012), 'Experiences of racism and discrimination among migrant care workers in England: findings from a mixed-methods research project', Ethnicity and Racial Studies. 35(2): 259-280. shereen.hussein@kcl.ac.uk

34. Thank You For Listening Now Your Turn! shereen.hussein@kcl.ac.uk