To condemn UNISON for not being active enough in recruiting home health care workers to their ranks is perhaps too easily done, as the UK is both a hotbed of anti-union legislation, and a recipient of propaganda disseminated by the capitalist media machine. There is a constant drip-feed that a unionised workforce is synonomous with higher costs and less jobs. The plethora of agencies which take their (typically 15%) cut out of the Social Care Budget, for recruiting low paid and overworked staff, must be protected, at the cost of care recipients receiving inadequate care.
Yet, the mantra that economies can only be ‘competitive’ by operating skeletal services is not a vision of capitalism shared in many American states, where a growing number want to recognize unions to represent home health care workers. Nina Totenberg (www.npr.org/2014) quoted Illinois Attorney General Lisa Madigan: “The home services program has about 28,000 home care aides, and these people are working in homes all over the state. There isn’t a centralized workplace, and the goal for the state is creating and retaining a professional group of home care aides to meet the needs of what is an ever increasing population of older people with disabilities”.
Totenberg highlighted the benefits of the unionisation of home health care workers to Illinois, which included plugging the huge turnover rate of staff, which left ‘large gaps in coverage for disabled adults’. The greatly increased retention rates have led to savings of $632 million, according to the state. In the ten years since unionisation ‘training and supervision has increased, as well as standardization of qualifications, and workers now have health insurance’. Wages have also nearly doubled to a ‘living wage’ level of $13 an hour, benefiting local economies, with workers having more to spend in local shops and on local services.
Although no one is forced to join the union, non-union members have to pay the costs of negotiating and administering the contract. Totenberg explains: ‘Under long-established labor law, when a majority of workers approve a union, those who do not join cannot be forced to pay for political activities of the union. But if the union is accepted by the state, as it was in Illinois, non-members still have to pay their fair share of the expenses of negotiating a contract. That’s to prevent them from free-riding on the dues of members’.
Totenberg summarises objections made by non-union members: ‘Those opposing any fair-share fee have several claims. First, they say the state is not their employer, because under this program, the individual patients, known as customers, hire and fire their own aides. The state replies that the program was designed that way because these workers would be in people’s private homes. But the aides are trained and supervised by the state, equipped with supplies by the state and paid twice a month by the state, and the state can fire them’.
Under this model of organising home health care workers, UK councils would again be directly responsible for care in their local community. There would not be over 600 agencies sucking on the marrow of the Social Care Budget. Home care workers would be properly trained and supervised, with audio-cameras recording care when recipients or their families approve. There would be greater retention of staff, resulting in savings, and a happier and better paid staff, with all the benefits that would bring.
Privatisation of social care services in the UK has been nothing more than throwing a juicy bone to dogs who run in the government pack. It is not cost efficient, and it demonstrably has not delivered care fit for human beings given by those who are respected as human beings.
Before these sentiments are condemned as those of a ‘died-in-the-wool’ Trotskyite, that is, rejected on the basis of name-calling, rather than by impartial analysis, let it be rammed home that these sentiments are representative of Illinois politicians and their electorate, and a growing number of other states’ politicians and their electorates, which have perceived the considerable benefits of not operating capitalism as a series of skeletal enterprises, the bones of which are sucked by a pack of exploitative scavengers.
Where UNISON can be justifiably criticised, in the view of a ‘died-in-the-wool’ Trotskyite, is in the area of concentrating too much on the protection of NHS staff, and not putting sufficient resources into unionising other ‘foot soldiers’ of care delivery – the massed ranks of the exploited home health care worker. (To which could be added the private care home worker).
In the spirit of Leon Trotsky, I urge the UNISON leadership to unite all comrades of common interest against the common enemy.
Lifelong UNISON member, lenin nightingale 2015