OECD report calls for change in long-term care sector  

A new report published by the OECD this week, highlights the low pay and poor working conditions for long-term care (LTC) workers, and makes a number of recommendations to reduce staff shortages and the high staff turnover in the sector.  

The ‘Beyond Applause’ report finds that across OECD countries:

• Care workers earn only 70 per cent of the average national hourly wage. A quarter of long-term care workers earn less than 54 per cent of the average wage. In Estonia, Latvia, Lithuania, Poland, Portugal and United Kingdom, the wage of care workers was lower than 60 per cent of the average wage in 2018.
• Taking into account factors that might lead to lower wages – eg education, tenure, hours worked and gender – care workers earn 12-16 per cent less than similar workers.
• Women workers in the sector are paid 7-8 per cent less than their male colleagues with similar characteristics.
• Three quarters of care workers report physical health risks (heavy loads, tiring and painful positions) compared to 59 per cent of all employees. Two-thirds of care workers report mental health risks (workload, time pressure, difficult patients) compared to 43 per cent of all employees.
• Over one-quarter of LTC workers are on fixed-term contracts in Japan, Poland, Spain and Sweden.

The report makes a number of useful recommendations, including:

• Increasing wages, including by raising the national minimum wages (where they exist) and/or sectoral minimum wages (OECD cites Australia, Germany, Latvia as having done so recently.
• Reducing workloads (for example by raising the staff to client ratio as Finland did this year from 0.5 workers per client to 0.7).
• Public funding for long term care on condition of staff being covered by collective bargaining (OECD cites Germany as an example of this).
• Governments to set up a forum for social dialogue at the national level to discuss issues and find shared solutions.
• Supporting collective bargaining and social dialogue by encouraging union membership through tax policy (OECD mentions Finland, Norway and Sweden as doing this) and by extending collective bargaining to all long-term care workers (OECD mentions the examples of Australia, Belgium, France, Germany and Italy).

“As trade unions, we have known that significant labour shortages and high levels of staff turnover plague the long-term care sector. These issues create a vicious cycle for workers in the sector and undermine unionization, collective bargaining and social dialogue. The OECD’s ‘Beyond Applause’ report doesn’t just provide important statistics but also offers a way forward with its RESPECT strategy. Trade unions in every OECD country can now point to this report to make an even stronger case for respecting care workers. And OECD countries themselves need to work with social partners to turn these recommendations into reality,” said Adrian Durtschi, Head of UNI Care about the report.

During the webinar to launch Beyond Applause, UNI Care Europa presented its own study on the long-term care sector in its Retain Report, which is also quoted in the OECD study.

“The OECD has done everyone a service by highlighting the problems in long-term care and making recommendations to improve the attractiveness of working in that sector. Their report deserves attention and follow-up action to rebalance the bargaining power of workers in almost every OECD country. Taking care of our loved ones is not something that should be done on the cheap,” says Veronica Nilsson, Acting General Secretary of TUAC (the Trade Union Advisory Committee to the OECD). “Despite the applause during the COVID pandemic, long-term care remains in crisis with low pay, poor working conditions, and a high turnover and shortages of staff.”