11 July 2013

The Cavendish Review: An independent review into healthcare assistants and support workers in the NHS and social care settings, has called zero-hours contracts a false economy for healthcare providers.

In the report, author Camilla Cavendish, Associate Editor at The Sunday Times, criticises zero-hours contracts as being a cost-saving attempt with so many negative impacts on staff, patients and employers that she recommends such contracts be amended and workers' voices given a hearing.

"It will not be possible to build a sustainable, caring, integrated health and social care system on the backs of domiciliary care workers who have to travel long distances on zero hours contracts, to reach people who have to see multiple different faces each week," she says.

The author warned that some workers may be taking home less than the National Minimum Wage, as a number of employers refuse to pay for travel time between clients' houses. As some employees are not waged for the time they spend travelling, and are not compensated for the expense of travelling, they are put in financially precarious positions leading to low job-fulfilment and "dangerously high" attrition rates of around 19% a year in care homes and 20.9% and 30% in domiciliary care.

Cavendish cited a report by Unison, in which it was calculated that 200,000 careworkers may be being paid less than the National Minimum Wage. The union has called for the subsidising of petrol for such workers, while Cavendish recommended that the workers are paid for their travel time as well as the time they spend with clients.

Some workers on zero-hours contracts will find it difficult to make ends meet because they are not being called in for enough hours, but others have the opposite problem and can find themselves working up to 60 hours per week.

The report suggests that workers in the NHS and social care are prey to both issues, with many staff leaving because their jobs are no longer financially viable, while 18% find themselves working up to 13-hour shifts. Of those who reported taking on such long shifts, 94% would prefer to see a change in their working hours.

Cavendish also noted that employees who are being forced to work so hard are more likely to become stressed and/or unwell. "The apparent cost saving may prove to be outweighed by a rise in physical exhaustion, sickness rates and the loss of time to have proper debriefing sessions after things go wrong: something which HCAs [Health Care Assistants] in our focus groups have said they would value."

While the author appeared to focus on much of her report on the benefits to employers and the state of providing a better deal for workers - a valid point, as when employees are happy and fulfilled in their jobs the advantages are widespread - she also highlighted that workers' voices have not been heard during the Coalition's campaign to reform the NHS.

"In all the discussions about values, standards and the quality of care it he NHS and social care, the support workforce has received the least attention," she said, describing "frontline workers" as "largely invisible" to policymakers.

"The best organisations in health and social care recognise that this workforce is a strategic resource, critical to ensuring the safety of patients or clients. These organisations recruit people for their values and commitment to caring; they invest in rigorous training and development and ensure that this translates into day to day practice; they build teams which value all members of staff; led by empowered first line managers," she said.

Sampson Low, Head of Policy at Unison, commented: "The Cavendish report confirms what our health and social care members have always told us: you can't get quality care and continuity when the dominant form of contract available is as a 'zero hours' employee."

He called for "labour standards in UK public procurement in which national collective agreements set the benchmark for pay, conditions and pensions, as in many other countries".

The Institute of Employment Rights is pleased to see a government review listening to trade unions - which can offer a wealth of informed information on UK workplaces and the problems they suffer - and the frontline staff whose voices often go unheard.

However, the Cavendish Review continues to see workers as a "strategic resource" to improve productivity and increase profits. Sickness and stress among workers is seen as a burden to businesses (and thus, thankfully, something to prevent), and paying travel costs to low-income employees is framed as a method of reducing attrition rates. There is little mention of the plainly unethical treatment of workers in some healthcare professions. Not only are our carers, clinical staff - and indeed all the hundreds of thousands of workers on zero-hours contracts in the UK - valuable national resources, they are also human beings deserving of respect and a comfortable life. It is true that aiming for greater equality among workers and improving their welfare is good for business, and good for the Exchequer; but let us not see the promise of a rise in profit margins as the main justification for doing right by one another. Although the report raises some valid points, its very wording positions it within the right-wing ideology of the current administration, which places profit over people at every turn. Each step that improves the welfare of workers is one in the right direction, but if we are to see a real revolution in the economic and social progress of the UK, it is this fundamental ideology that needs to change.