Marginalisation and pay
differentials in the UK
social care sector
Dr Shereen Hussein
King’s College London
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What is social care?
S Social care supports people of all ages
S With needs arising from physical, cognitive or disabilities
S Assist in carrying out personal care or domestic routines (activities
of daily living).
S Helps sustain paid or unpaid work, education, learning, leisure
and other social support systems.
S Supports people in building social relationships and participating
fully in society.
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Why is social care so important?
S Complex interactions of political, economical, sociological
and demographic factors
S Role of state, society and individuals
S In the forefront of political debates
S reforms, big society, mutuals, personalisation etc.
S Value of emotional work
S Duties and responsibilities
S In the heart of demographic forces
S Strong business case!
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Formal and informal spheres of
care
S Sociology of care
S Norms and traditions
S Individual, society and government responsibilities
S Working with other forms of support (social security, health and
housing)
S Complement, intersect but do not substitute one another
S Interaction with health care
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Marginalisation of the social
care as a labour market sector
S Dealing with a special kind of ‘commodity’
S Value of ‘care’ work to the society
S Gendered; emotional; for granted !
S Responsibilities and duties of care
S The role of the welfare state (means tested)
S Assumed or planned
S Pricing ‘emotional’ work
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The position of the care sector
and labour dynamics
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Secondary labour position
S Migrants and BME workers
contribution
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S Domiciliary, residential
S Individual budgets
Pay and working conditions
S Possible other rewards
S Flexibility
S Satisfaction
S Stepping stone
S Only job!
S Temporarily or continuous
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Changing structure; place; nature,
interaction with health services
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Links to government funds
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Interactions with other markets
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Role of the private and voluntary
sector
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Characteristics of the care sector
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Means tested, state-funded, less than 12% of users
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Private sector major supplier of services (75% of services)
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Different types of settings- with domiciliary care workers accounting for 48%
of the workforce
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Increase policy emphasis on personalisation and user choice
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Wages are a major cost component
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Growing demand- high vacancy and turnover rates- almost a recession proof
sector
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No signs of funding reforms!
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Workforce structure
S Gender (80% women), age (mid 40s) and education
(minimum skills required)
S Migrants and immigration policies
S International and local supply
S Grey economy and domestic work
S Lack/unclarity of career path
S Marginalisation within a marginalised sector
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Pay structure
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Marginalisation in pay
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One of the main low paying sectors (LPC)
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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
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‘Top’ tier includes professional workers (SW, OT ect.) and managers
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Pay rates are significantly lower in the private sector and in domiciliary care
settings
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Ethnic pay-gaps also exist
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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
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Sector effect: hourly pay rate statistics for different job groups working in different
sectors, SCWP 6
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Setting effect: hourly pay rate statistics for different job groups working in different
settings, SCWP 6
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Investigating pay differentials in
the sector
S Using mixed-effect models
S Controlling for measured and
unobserved factors and cluster
effects at different levels of
hierarchy
S Separate models for different job
role groups
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Managers/supervisors
Ancillary
Direct care
Professional
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Direct care workers pay
differentials
S Significant and large in magnitude effect of individual providers
(55% of variance)
S Sector variations are large and significant
S Large regional effects
S Significant fixed effects:
S Type of care setting/service type
S Ethnicity
S Interactions between age and setting
S Interactions between gender and setting
S Interactions between sector and setting
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Descriptive: Variations in hourly pay of adult direct care workers by
some selected individual and employer-level characteristics, SCWP 7
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Results of final mixed-effect model of hourly pay of adult direct care
workers, SCWP 7
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But ..
Available data don’t represent
accurate figures
S Data provided by employers (NMDS-SC)
S One figure for hourly rate (no indication of ‘enhanced’ rates etc.)
S Sector is not very well defined (LFS)
S Over represent higher wages and more stable workforce (ASHE)
S Unrecorded ‘working’ time
S Travel between clients
S Extra work
S On call – sleep in duties etc.
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Attempt to improve estimates of
those paid under NMW
S Combining different data sources
S Adjusting for unpaid travel time
S Adopt a methodology that maximises the benefit of prior
knowledge
S Focus only on direct care workers (majority of the
workforce)
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Recent estimates and analysis
S Approach
S Sector specific data (provided by employers; NMDS-SC) adjusted
by other sources (provided by workers; LoCS survey)
S Accounting for previously published estimated by the LPC and
small surveys (Bayesian approach)
S Assumptions
S Very small adjustments (average of 22.7 minutes of unpaid work
and 4.8 min of travel time per week)
S Findings
S From (9.2% to 12.9%) or 156,673 to 219,241 ‘direct care’ workers
in the UK are paid under the NMW
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Pay distribution of direct care
workers
Source: Hussein
(2011); SCWP Issue 16
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Posterior distributions of being paid under the NMW
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Risks- what to be aware of
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Pay distributions are borderline with NMW in most cases
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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
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we include ‘other’ workers- 14% of the total workforce
we include unreported work; especially through direct
payment/personalisation schemes
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Main risk areas for underpaying includes travel time/cost and night shifts
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Innovative ways to cut costs:
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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.
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Marginalision
Migrant workers
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Migrant workers
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Continue to constitute a considerable part of the workforce
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Majority non-EEA migrants (usually with nursing qualifications)
Large regional variations
Concentrated in certain jobs
No large variations in pay levels
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Linked to immigration status- minimum wage> NMW
Usually given ‘harder’ shifts which may pay more, e.g. night/weekend
Discrimination
Immigration policies:
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Differences between EU and non-EU migrants
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Attachment to employer
Qualifications
Choice and mobility
Language
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Experience of racism
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Many experience racism and or discrimination
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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).
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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).
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Differential experiences of different ethnic groups
S Visible social markers
S Being ‘foreign’
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The ‘time’ factor
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Source: Stevens, Hussein and Manthorpe (2012)
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Top nationalities of migrant
workers
Source: Hussein (2011); SCWP Issue 11
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Trends of number of migrant workers (in the care sector) entering the social
care sector from 1995-2010 by nationality groups
200
400
EEA
400
800
A8
75
150
N
A2
4000
Non-EEA
2000
Source: Hussein
(2011); SCWP 12
1995
2000
2005
2010
Year started in sector
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Migrants and pay
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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
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Next steps
S Examine the profile of those likely to be paid under the NMW
S Using sector specific data complemented by other national data
S Sector differences
S Type of settings
S Providers/employers characteristics associated with very low
pay
S Investigate pay and conditions among workers employed directly by
users (personal budgets)
S Partnership/collaborative approach
S Policy, research and practical knowledge
S Understand, educate, regulate and penalise
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References
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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.
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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’.
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Hussein S. (2011) The contributions of migrants to the English care sector. Social Care
Workforce Periodical, Issue 11- February 2011.
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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.
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Hussein S., Stevens M. and Manthorpe J. (2010) International Social Care Workers in England:
Profile, Motivations, experiences and Future Expectations, February 2010. Final Report.
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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.
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Thank You For Listening
Now Your Turn!
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