February 1, 2022 • 30 mins
Centre for Care Co-Investigator and Deputy Director of SPERI (Sheffield Political Economy Research Institute), Tom Hunt is joined by Rachel Harrison (Public Services National Officer, GMB) to discuss the issue of mandatory vaccination for care home workers in England. Since November last year, it has been mandatory for all care home staff in England to have had 2 doses of a COVID-19 vaccine as a condition of their deployment in a care home. The introduction of this policy has led to debate and concerns about the ethics of mandatory vaccination, it has also raised questions about the employment model in the care sector, about UK government's willingness to meaningfully engage with care workers and about the respect and value given to care work, and to the people providing it.
The policy has been in effect for 3 months, today's episode explores the impact so far, and what some of the wider implications might be.
Read Tom's paper, 'Under-paid and under-valued: assessing mandatory vaccination for care home workers' here: http://circle.group.shef.ac.uk/2021/10/27/scpaper-mandatory-vaccinations/
Rachel Harrison is GMB's Public Services National Officer, responsible for health and social care. Rachel has worked for GMB for 21 years, the last 3 1/2 in post as National Officer. Tom Hunt is a Co-Investigator at the ESRC Centre for Care and Deputy Director and Policy Research Associate at the Sheffield Political Economy Research Institute (SPERI) at the University of Sheffield. He is a Senior Fellow at Unions 21. Tom is co-leader of SPERI’s Labour and Decent Work research theme. His research focuses on the changing nature of work and the effects for workers.GMB website: https://www.gmb.org.uk/ CIRCLE website: http://circle.group.shef.ac.uk/
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:12):
The Sustainable Care
Team, led by Professor SueYeandle at the University of Sheffield,
is exploring how care arrangements,currently in crisis in parts of the UK,
can be made sustainable and deliverwellbeing outcomes.
We aim to support policy and practiceactors and scholars
to conceptualise sustainabilityin care as an issue of right values,
(00:35):
ethics and justice,as well as of resource distribution.
Our Care Matters series includespublications, podcasts and blogs
from our team and others working towardssustainable care
Hello and welcome
(00:56):
to another episode of CareMatters, the podcast
from the Centre for International Researchon Care, Labour and Equalities,
or CIRCLE at the University of Sheffield.
My name is Tom Hunt and I'm a researcher
in the new ESRC Centre for Carethat will begin its work this year.
(01:17):
I'm alsoa research fellow and deputy director
of the SheffieldPolitical Economy Research Institute.
In today's episode,we're going to be discussing the issue
of mandatory vaccinationfor care home workers in England.
Since November last year,it's been mandatory for all care.
(01:38):
Home workers in Englandto have had two doses of a COVID
19 vaccine as a conditionof their deployment in the care home.
The introduction of this policyhas led to debate
and concernsabout the ethics of mandatory vaccination.
It's also raised questions aboutthe employment model in the care sector.
(02:00):
About the government willingnessto meaningfully engage with care workers
and about the respectand value given to care work
and to the people providing it.
Prior to the policy coming into effect,
many in the sector warnedthat introducing mandatory vaccination
would lead to thousands of care workersleaving their jobs
(02:20):
and exacerbate chronic staffshortages in the care sector.
The Government's own
analysis also forecastthat there would be high
staff departuresas a result of introducing the policy.
That policy has now been in effectfor nearly three months.
And so we wanted tolook at what the impact of it has been
(02:41):
and what some of its wider implicationsmight be.
And I am delighted that to do this,we're joined today by Rachel Harrison
from the GMB trade union,a union with over
500,000 members who work in all typesof jobs across public services
and in the private sector,including many in social care.
(03:03):
Rachel is the GMB's Public ServicesNational Officer.
Rachel, thank you very muchfor joining us today to kick us off.
Could you tell me about whatyour role entails
and how you represent GMB membersin social care?
Hi. And yes,thank you for inviting me along today.
(03:23):
Really appreciate the opportunity.
So yeah, I work for GMB Union
and we represent care workersin a variety of roles
right across England,Wales, Scotland and Northern Ireland.
And they could be care workers that dowork for private residential care homes.
They work in domiciliary careroles, delivering care in people's homes,
(03:47):
they work within the NHS, so you name it,we represent those workers and again
we're not just talking care assistance,we're talking domestic
kitchen support, admin supportand every role
you can think of ,we support them in a variety of ways.
So, so nationallymy role as national officer
is to obviously make representations on
(04:10):
behalf of our members to the governmentand to the Department of Health.
And we're constantly campaigningfor improvements right
across the caresector to make work better for them.
We're involved in collective bargainingwith with national care
providersand with local government and employers.
And obviously in the NHSwhere we've got care as well
(04:30):
and we campaignnationally and work with the Labour Party
where we need to on onsetting out what the agenda should be.
And we also represent locally.
So again we provide representationson a local level
to councils and councillorsand MP and commissioners of care.
Collective bargaining again and individualrepresentations is a big one within,
(04:53):
within care homes of our membersfacing disciplinary grievances
and the likes and issuespecific organising.
So every care home will have a differentissue that members unite around.
And we campaign to make small improvementsthat that make big differences
in their lives.
So we're a member led organisationultimately
(05:14):
and our care workerstell us what their priorities are.
We go out and represent those priorities.
Thanks, Rachel.
That's a really good overviewof what you do in the ways
in which GMB supportsmembers in in social care.
Now the mandatory vaccination
policy for care home workers.
(05:35):
So not all people who work in social careand just care home
workers came into effect in November.
GMB was opposedto the introduction of the policy.
Could you tell uswhy the union took that stance?
Yeah, I think first of all, it's important
to say that GMB supportsthe vaccine programme.
(05:59):
We are actively, proactivelyencouraged our members to take the vaccine
and we've held thingslike online events and webinars to try
and educate people about the vaccineand the safety of the vaccine.
So we do support the vaccine programme,
but we are againstand opposed to any form of mandatory
(06:21):
vaccinations or medical interventionsfor any group of workers,
not just any social carebut for any group of workers.
We believe it'sa very heavy handed approach
to an issue that affects a minority acrosssocial care.
So when this was being brought,
there was a
high 80% of the workforcehad already been vaccinated.
(06:42):
So in the context of things,
it was such a small minoritythat hadn't yet been vaccinated
and they hadn't been vaccinatedfor a whole variety of reasons.
And we don't believe that enoughwas done to educate and to understand,
but also to make access to the vaccineeasier.
If you think a lot of our workers workin social care, they work 12 hour shifts,
(07:04):
they are long days and then tryingto find time to go to a vaccination
centre will try and access the vaccine viayour GP is very difficult out of hours.
And then there were also the genuineconcerns about potential side effects
because care workers predominantlydo not get sick pay,
they cannot afford to take time off workgenerally and there's not been
(07:26):
as much information given as there wereacross other sectors like in the NHS.
A nurse could goand get the vaccine in their workplace.
It wasn't as easy for care workersto be able to do that
and so we believe that there was a lot
more that could have been donerather than going down this route.
And we also did a survey of our members.
As I said before,we're a member led organisation
(07:48):
and the resultswere really quite interesting.
We had a 50/50 split,you know, 50 pro-vaccine
and 50 against the mandatory sideof the vaccine.
But the overwhelming elementthat did come across
and that was from peoplewho had the vaccine themselves,
was they don't believe their colleaguesshould have had it forced upon them.
(08:09):
And if we bear in mindthat these are the very workers
that were on the front linethroughout the pandemic,
they were the ones that put themselvesin harm's way.
You know, so many care workersdied of COVID and thousands and thousands
contracted COVID at work as a resultof COVID coming into the homes.
And yet now these were
the ones that were being singled outand being told that they were a risk.
(08:31):
So it was the whole processof how it's been done.
And our other concern was thatthis would seem to be just an issue
in England, Wales, Scotlandand Northern Ireland
hadn't had any issue an increasein their uptake in social care.
So it was very much down to a systemof how that message had had been put out.
And again,I think another indicator of just
(08:53):
how fragmented social careis across England and the difficulties
that that bringswith any sort of programme like this.
Because when you've got,you know, we've got almost 18,000
private care organisations deliveringcare, how can you get a consistent message
across to that amount of,you know, organisations and workforces?
(09:14):
So we think there wasa whole cocktail of reasons as to why
there was some people withinthe sector not being vaccinated.
A lot more could have been doneto understand the reasons
and encourage people to be vaccinated.
Yeah, there's a whole range of issuesthere that it would be good to unpack
and come back to in a moment.
(09:35):
Now that we're three months onfrom the policy being introduced,
what's been the effect for your members?
Those in GMB and amongstothers were warning that this was going to
lead to people leaving their posts,some resigning,
some being essentially forcedout of their posts.
(09:58):
And, you know, this wasthere were serious concerns that
this was going to exacerbate the staffshortages that we know
are endemic in the sector.
What's been the impact?
Yes, the major oneand the most obvious one
is just impact of the staffing crisisof as we predicted.
(10:21):
I think what we didn't seeas much as we expected
was the number of dismissalsas a result of failure to be vaccinated.
Because what we actually sawwas people choosing to leave
prior to the 11th of Novemberwhen this came into effect.
People left social care,
although it was a job that people love,is minimum wage.
(10:43):
So people were choosing to leave,to go elsewhere.
If they wanted to continue careand they could go into the NHS,
they could go into local government,
they could go into community careor the domiciliary care
sectors, that there were plentyof care options available.
And what we also saw was the other roleswithin care homes, leaving
some of our national careproviders are telling us now
(11:05):
they are using agencies
to backfill roles that they've never hadto use agency staff for before.
So these are your kitchen staff,your catering staff,
your clean as your admin,because they've moved into the gap
in the market, in hospitalityand in retail
because those skills are easilytransferable into another sector.
(11:26):
So we saw thousands and thousands leave.
We also saw a little bit of a changein the government position
literally daysbefore the legislation came in
and they brought in this three monthmedical self-certification exemption.
So we're still seeing a few of thosethrough to the end now, but
(11:46):
but not in any great numbers.
And so, yeah, the biggest impact was,was the staff leaving
what was alreadya chronically understaffed, you know,
we were 110,000 staff vacanciesprior to COVID and the impacts of COVID,
the exhaustion and stuff burnout has meant
a lot more people have left,not just on the vaccine issue,
(12:06):
but the ultimate pressure that leavesis on the stuff that remain.
So they're still there picking up the workof their colleagues that have now gone,
you know, this traditionally 30%turn over each year of social care staff
because the pay and the termsand conditions are just so poor.
So those staff that are
left a mentally exhausted, physicallyexhausted now and very much facing things
(12:29):
like stress and mental health
issues, PTSD, as a result of workingthrough the pandemic
and occupancy rates within carehomes are at an all time low
as a result of COVID, but also as a resultof not being able to take in residents
because they haven't got the staffin there to meet their needs.
Ultimately, the service usersnow that are suffering as a result of this
(12:51):
and then staff morale is just at an alltime low, as I said before.
These are the people that battled throughthe pandemic to keep our loved ones safe.
And now they're the ones that are
they feel they are being targetedand singled out by a government.
And it once again, they were feelingvery inferior when compared with the NHS.
You know, social care is always on a lowerfooting to the NHS.
(13:14):
You know, there were big callsfor armies of volunteers
to come and help in the NHS.
There wasn't anything like thatfor social care.
You know, family and friends were askedto help out if you can, but but that was
there was no big grand gesturesto to plug the gap in social care.
So it's just been exacerbatedas we predicted it would.
Yes, it's it's really useful to hear that,
(13:37):
because I thinkin some of the conversation,
since the policy's come
in, but also prior to taking effect,
the focus was very much on
those care workerswho may or may not get the vaccine
and not always on their colleagueswho have had the vaccine,
(13:58):
people who do in other rolesand also on the service users.
And what you've just described theredemonstrates that
this is a policythat is having a range of effects
across all parts of the care
sector in a way, not in a positive way .
Now, last year, prior to comingin, I did a piece of research
(14:22):
which looked at the reasons whycare workers were opposed to the policy.
And and what that highlightedwas very much in line with what
you've said about the employment modelthat many care workers have.
And it showed
how that really can't be separated outfrom understanding
(14:45):
why some care homeworkers were opposed to the policy.
For example, it was very clearthe lack of sick pay in the sector
was a real concern, as you describe,
that if people were to have the vaccine
and as many people did feel
(15:05):
a littleunder the weather for a day or two,
then I knew that when I had the vaccineand if I felt unwell
I could stay at homeand my income wouldn't be affected.
That's not the case for care home workers.
And looking at the concernsof many care workers
(15:26):
and looking at the consultation responses,
it's clear that those issuesof their employment conditions can't
really be separated out from the wider
concerns about mandatory vaccination.
So how does GMB think the
employment conditions for your membersin care should be improved?
(15:48):
We've touched onsick pay as one example, but
what are the changesthat you would like to see?
And I suppose how do you think they relateto this issue of mandatory vaccination?
Yes, they do.
You obviously mentionedsick pay there and pay and sick
pay a very at the top of the agenda,really.
You know,they are minimum wage employees generally.
(16:11):
sick pay, is few and far between.
Is it paidand it should be a contractual right
if anything's being shown to usby the pandemic.
Is that sickpay is the number one infection
control measure you can put in place?
Because what we have seen for decadesprior to the pandemic were social
(16:33):
care workers going into work ill becausethey cannot afford to take time off work.
It really is as simple as that.
And it was actually acknowledgedby the government after some lobbying
from unions and othersthat is that they had to cover sick pay.
So there's been three sets of additionalfunding given by central government
to local authoritiesto distribute to care providers.
(16:55):
And a part of that was to cover sick pay
so that people could follow governmentguidance and isolate.
And it's absolutely essentialthat coming out of these contractual sick
pay becomes aright for all social care workers.
And that has to be at the topof any government agenda, agenda
looking to reform social care and pay.
You know, they are the lowest paid workersand they shouldn't be.
(17:18):
They at least expect
to be paid similar to their colleaguesin local government or in the NHS.
And they're nowhere near.
At the GMB we're campaigningfor a minimum of £15 an hour
for the social care workforcewe think is the least they deserve.
And you know, we will never addressstaffing
shortage crisisas without addressing those two issues.
(17:38):
But the other stuff is aroundthe professionalisation of the role.
These workers do not feel valued,they do not feel respected
or that that the vital rolethat they provide is recognised.
So we need to professionalise social care
and that would includenational standards for training.
So that is consistent application of thatright across
(17:59):
and England with genuine careerprogression in place for people
so that they know that there's a routeto follow if they want to follow that.
And we want a registration systemin England like they've got in Scotland,
Wales and Northern Irelandto make the role professional
and put it on that parity with the NHS.
And if people feel more
(18:20):
respectedand treat as the professionals they are,
that will in turncome on to things like the vaccine.
They'll understand why they're being asked
to take the vaccinebecause they'll understand, you know, that
it's a part of their professional rolethat they're being asked to do that
safe staffing levels is an absolutecrucial one for our members.
current crisis to one side.
(18:41):
It's always been an issue.
And the one thing our members
tell us time and time againis that they do not feel safe at work.
They do not believe
they are delivering the standards of carethat their service users deserve.
And so we have to absolutely address safestaffing levels.
We'd like to seenational sectoral bargaining
so that there are consistent payand excellent terms and conditions right
(19:03):
across the sectorand not this race to the bottom of poverty
pay that we're seeingwhere all the profits are being taken out
and sent onto offshore accounts as we seesome of the largest providers do.
And I suppose the bigthe long term aim would be
a national care servicethat was funded through taxation
and it was all about delivering carerather than the profit.
(19:26):
So I think that's the whole packagethat we need to do to really improve
social care for the workersand make them feel valued, to make it
to be a job that people want to go intoand want to stay in.
That has to be able to aimwith to address the social care crisis.
It's it's
really interesting
to hear you talk about valuebecause that connects to the next thing
(19:49):
I wanted to ask you about,which is precisely that.
And it's mandatory vaccination,I think is an interesting example
to look at this because itnot only sheds some light on the way in
which the care workers have often
felt undervalued in terms of their pay
(20:10):
and the and the conditionslike holidays and sick pay
that come with the jobor don't come with the job.
But it's also kind of shone a lightexactly in the way that you've described
on the professional status
of care workers and the value and respectthey feel.
(20:31):
So I suppose my,the question I'd be interested to hear
your thoughts on and the thoughts ofyour members is do you think the way in
which the mandatory vaccinationpolicy was introduced
tells us anything about thatstatus of care workers
or perhaps about the value
(20:52):
that the government has towards
care workersand maybe even the value that society has.
Places upon care workers.
Two years ago or just under two years ago,there were
there was clap for carersand people stood outside
on Thursday evenings and there was a sensethat there was a real respect
(21:14):
being shown to the peoplewho were delivering care.
My sense is that quickly moved into almost
an exclusive focus on the NHS
and that hasn't
really materialisedinto significant changes
around the value of the people have placedupon care work.
(21:36):
So there's a broad set of issues there.
What are your thoughtsabout that question of value?
I think it absolutely does highlight
the value and perceptionof social care workers in the country.
You said that about the clapson the doorsteps.
And I can tell you our membersworking in social care really appreciated
being recognisedby the general public at the start.
(21:59):
But those claps soon as you said,became a focus about the NHS
and then very quickly just disappearedand then it was all forgotten and care
workers continued going to work, theycontinued fighting for their inferior PPE,
they continued being paid
their minimum wage rates of payand nothing changed for them.
All they knew is that they continuedworking in extremely poor conditions.
(22:25):
I think the reason governmenttargeted care and I'll use the word target
because they were seen as an easy wayof getting this in to start with.
You know,this is a large fragmented workforce,
predominantlywomen and large number of black
Asian minority ethnic workers in therewith huge cultural and language barriers
(22:48):
and they're on poverty pay rates, inferior
terms and conditionsnot really well unionised
compared to other sectorslike local government or the NHS.
And I think a genuine beliefthat this could be pushed through
very easily without very little challengefrom the workers themselves.
And they were right because sadlyafter decades of being trodden down,
(23:12):
our care workers do think what's the pointin challenging we can't win anything.
And so we've got a job of workin building their esteem back up.
But I think it was absolutelya sign of what they could do.
And I think the sad thingis the government
massively let downsocial care workers in the pandemic.
(23:32):
They literally forgot about themat the start of the pandemic.
They were excluded from PPE guidance.
We had to fight to get them face masksand then suddenly it was realised,
Oh, you got COVID
patients in residential care homes,they're going to need access to PPE.
They were excluded from the first testingkits that were coming out.
(23:53):
Social care workersweren't entitled to those, you know,
and we all know about COVID patientsbeing discharged
from hospitals into care homesso that the hospitals could be freed up.
And then we had to fight for the sick pay.
They weren't getting the sick pay, sothey were massively let down at the start.
And I think all of that showswhat the perception is about the value
(24:14):
of care workers and how seriously we needto take them as a as a group of workers.
So I do believe thatthat's why the government started.
You know,they were the ones that let care down.
And yet it's our members that are beingpunished as a result of that.
And this is the thanks they getfor their efforts over the last two years.
And there's still been no improvementin their pay on their terms.
(24:37):
Which I presume has led
to some of them thinking I'm getting out.
You know, I don't feel respected.
Am I right to sort of assume that?
Absolutely.
When you when you look at the job advertsand you've got Aldi
and all the supermarkets, you know,
Morrisons about £10 an hour on checkoutswithout the 12 hour shifts
(24:57):
and the responsibilitiesthat come with working in a care home.
Yes. People have left and it's it'sa perfect storm of all the issues.
It's not just one issue.It's the whole lot.
And so finally then the the governmentnow plans
to extend the policy to introducemandatory vaccination in April
(25:18):
for healthcare workers in the NHS
and for all social careworkers, for example,
those who provide care to peoplein their own homes.
Now there's been some speculation thatthe policy of introduction will be paused,
but at the time of recordingset to go ahead as planned.
(25:38):
What's the view of your membersabout this, and is GMB stance
the same towards that wider
rollout of mandatory vaccinationin health and social care?
Yeah, again, we're opposed to it again,and we believe it's going to have serious,
serious implicationson the delivery of services.
As I said, many of the people that leftout of residential care
(26:01):
went into domiciliary, Carol, into the NHSand they're once again
now facinglosing their jobs on the 1st of April.
I think for us, our focus right nowis supporting our members
that are
affected by this through the processes,making sure they're being treat fairly
and that redeployment options areconsidered as a priority for all of them.
(26:22):
Our worry is
there seems to be no credible plancoming forward as to how this number
of people suddenly not being available forwork will be addressed.
And I know we share those concernswith our colleagues
in social careand with our colleagues, NHS employers.
And there's no credible plancoming forward.
(26:44):
I think just the latest figuresthat we're aware of in the NHS,
we're looking at 60,000 peoplefacing dismissal on the 1st of April
if staff uptake continues at its currentpace on the 1st of April, 60,000.
Hundreds of thoseare from the same ambulance employees.
And to suddenly take that amountof workers out of one employer.
(27:09):
And these are employeesthat are currently struggling
to staff and meet the service needsthat are currently there.
And it's to stretch to the edge.
And then in domiciliary care,you're looking at a dismissal of between
75,000 and 100,000 workers,
and that's out of a workforce of 500,000.
So a fifth of the workforceare facing dismissal in April.
(27:30):
And again, no credible plan.
And the impactthere is if you've not got care
being delivered to people in their homes,they have to stay in hospital.
And then you've gotthe beds being blocked.
So therefore you've got the ambulancehandover delays exceeding
because they can't dischargetheir patients at a hospital.
(27:50):
The longest delay in Decemberthis year was 20 hours
for an ambulanceto handover a patient at a hospital.
And what what that actually does,that causes serious harm to patients.
And the estimate for December was 3000patients were potentially put at harm
due to the delays.
So it's not just about there'sa vaccination issue in care.
(28:11):
It's the massive knock on effect it hasright across health and social care.
So that's why we're opposed to it.
We think it should be a lot moreabout education and trying to break down
those barriers and encouraging peopleto take the vaccine.
We do have concerns aboutwhat will come in the coming weeks
Yes, there are some extraordinarilylarge numbers there that you've
(28:33):
you've talked about in termsof the potential impact on staffing.
And, you know, what strikes me hearingthat is that we're being told
at this momentthat we're in the endgame of the pandemic
and even some sayingthat the pandemic is over.
And it's clear the well,for one with the case numbers
(28:54):
as they are, is clearly not.
But even if the case numbers were to drop,
the impact of the policy
and the way in which services are goingto be affected is going to be playing out
for months, if not years,from the point of introduction.
So, Rachel, it'sbeen really, really instructive to hear
(29:19):
GMB's position on thisand what your members are thinking
and feelingand the conditions that they're facing.
The work of the Centre for Careis going to have a strand,
which is research in the care workforce,which I'll be involved in.
And so it would bewe will return to many of these issues,
(29:42):
and it will be great to continue thisconversation with you at a later date.
So thank you very muchfor joining us today.
If you'd like to find out moreabout the work
of the Sustainable Care Programmeor the new Centre for Care,
then more information can be foundon the CIRCLE website and social media.
(30:06):
You can also find out moreabout the work of
GMB at GMB.org.uk.
On the CIRCLE website you can
also find the research paperon mandatory vaccination by myself
and we can post a link to thatalong with this episode.
You can sign up to CIRCLE's newsletterto keep in touch
(30:29):
with news about our research,upcoming events and future
episodes of the Care Matters podcast.
Rachel, many thanks againand thank you very much for listening.
The Sustainable Care
Team, led by Professor SueYeandle at the University of Sheffield,
is exploring how care arrangements,currently in crisis in parts of the UK,
can be made sustainable and deliverwellbeing outcomes.
We aim to support policy and practiceactors and scholars
to conceptualise sustainabilityin care as an issue of right values,
(00:35):
ethics and justice,as well as of resource distribution.
Our Care Matters series includespublications, podcasts and blogs
from our team and others working towardssustainable care
Hello and welcome
(00:56):
to another episode of CareMatters, the podcast
from the Centre for International Researchon Care, Labour and Equalities,
or CIRCLE at the University of Sheffield.
My name is Tom Hunt and I'm a researcher
in the new ESRC Centre for Carethat will begin its work this year.
(01:17):
I'm alsoa research fellow and deputy director
of the SheffieldPolitical Economy Research Institute.
In today's episode,we're going to be discussing the issue
of mandatory vaccinationfor care home workers in England.
Since November last year,it's been mandatory for all care.
(01:38):
Home workers in Englandto have had two doses of a COVID
19 vaccine as a conditionof their deployment in the care home.
The introduction of this policyhas led to debate
and concernsabout the ethics of mandatory vaccination.
It's also raised questions aboutthe employment model in the care sector.
(02:00):
About the government willingnessto meaningfully engage with care workers
and about the respectand value given to care work
and to the people providing it.
Prior to the policy coming into effect,
many in the sector warnedthat introducing mandatory vaccination
would lead to thousands of care workersleaving their jobs
(02:20):
and exacerbate chronic staffshortages in the care sector.
The Government's own
analysis also forecastthat there would be high
staff departuresas a result of introducing the policy.
That policy has now been in effectfor nearly three months.
And so we wanted tolook at what the impact of it has been
(02:41):
and what some of its wider implicationsmight be.
And I am delighted that to do this,we're joined today by Rachel Harrison
from the GMB trade union,a union with over
500,000 members who work in all typesof jobs across public services
and in the private sector,including many in social care.
(03:03):
Rachel is the GMB's Public ServicesNational Officer.
Rachel, thank you very muchfor joining us today to kick us off.
Could you tell me about whatyour role entails
and how you represent GMB membersin social care?
Hi. And yes,thank you for inviting me along today.
(03:23):
Really appreciate the opportunity.
So yeah, I work for GMB Union
and we represent care workersin a variety of roles
right across England,Wales, Scotland and Northern Ireland.
And they could be care workers that dowork for private residential care homes.
They work in domiciliary careroles, delivering care in people's homes,
(03:47):
they work within the NHS, so you name it,we represent those workers and again
we're not just talking care assistance,we're talking domestic
kitchen support, admin supportand every role
you can think of ,we support them in a variety of ways.
So, so nationallymy role as national officer
is to obviously make representations on
(04:10):
behalf of our members to the governmentand to the Department of Health.
And we're constantly campaigningfor improvements right
across the caresector to make work better for them.
We're involved in collective bargainingwith with national care
providersand with local government and employers.
And obviously in the NHSwhere we've got care as well
(04:30):
and we campaignnationally and work with the Labour Party
where we need to on onsetting out what the agenda should be.
And we also represent locally.
So again we provide representationson a local level
to councils and councillorsand MP and commissioners of care.
Collective bargaining again and individualrepresentations is a big one within,
(04:53):
within care homes of our membersfacing disciplinary grievances
and the likes and issuespecific organising.
So every care home will have a differentissue that members unite around.
And we campaign to make small improvementsthat that make big differences
in their lives.
So we're a member led organisationultimately
(05:14):
and our care workerstell us what their priorities are.
We go out and represent those priorities.
Thanks, Rachel.
That's a really good overviewof what you do in the ways
in which GMB supportsmembers in in social care.
Now the mandatory vaccination
policy for care home workers.
(05:35):
So not all people who work in social careand just care home
workers came into effect in November.
GMB was opposedto the introduction of the policy.
Could you tell uswhy the union took that stance?
Yeah, I think first of all, it's important
to say that GMB supportsthe vaccine programme.
(05:59):
We are actively, proactivelyencouraged our members to take the vaccine
and we've held thingslike online events and webinars to try
and educate people about the vaccineand the safety of the vaccine.
So we do support the vaccine programme,
but we are againstand opposed to any form of mandatory
(06:21):
vaccinations or medical interventionsfor any group of workers,
not just any social carebut for any group of workers.
We believe it'sa very heavy handed approach
to an issue that affects a minority acrosssocial care.
So when this was being brought,
there was a
high 80% of the workforcehad already been vaccinated.
(06:42):
So in the context of things,
it was such a small minoritythat hadn't yet been vaccinated
and they hadn't been vaccinatedfor a whole variety of reasons.
And we don't believe that enoughwas done to educate and to understand,
but also to make access to the vaccineeasier.
If you think a lot of our workers workin social care, they work 12 hour shifts,
(07:04):
they are long days and then tryingto find time to go to a vaccination
centre will try and access the vaccine viayour GP is very difficult out of hours.
And then there were also the genuineconcerns about potential side effects
because care workers predominantlydo not get sick pay,
they cannot afford to take time off workgenerally and there's not been
(07:26):
as much information given as there wereacross other sectors like in the NHS.
A nurse could goand get the vaccine in their workplace.
It wasn't as easy for care workersto be able to do that
and so we believe that there was a lot
more that could have been donerather than going down this route.
And we also did a survey of our members.
As I said before,we're a member led organisation
(07:48):
and the resultswere really quite interesting.
We had a 50/50 split,you know, 50 pro-vaccine
and 50 against the mandatory sideof the vaccine.
But the overwhelming elementthat did come across
and that was from peoplewho had the vaccine themselves,
was they don't believe their colleaguesshould have had it forced upon them.
(08:09):
And if we bear in mindthat these are the very workers
that were on the front linethroughout the pandemic,
they were the ones that put themselvesin harm's way.
You know, so many care workersdied of COVID and thousands and thousands
contracted COVID at work as a resultof COVID coming into the homes.
And yet now these were
the ones that were being singled outand being told that they were a risk.
(08:31):
So it was the whole processof how it's been done.
And our other concern was thatthis would seem to be just an issue
in England, Wales, Scotlandand Northern Ireland
hadn't had any issue an increasein their uptake in social care.
So it was very much down to a systemof how that message had had been put out.
And again,I think another indicator of just
(08:53):
how fragmented social careis across England and the difficulties
that that bringswith any sort of programme like this.
Because when you've got,you know, we've got almost 18,000
private care organisations deliveringcare, how can you get a consistent message
across to that amount of,you know, organisations and workforces?
(09:14):
So we think there wasa whole cocktail of reasons as to why
there was some people withinthe sector not being vaccinated.
A lot more could have been doneto understand the reasons
and encourage people to be vaccinated.
Yeah, there's a whole range of issuesthere that it would be good to unpack
and come back to in a moment.
(09:35):
Now that we're three months onfrom the policy being introduced,
what's been the effect for your members?
Those in GMB and amongstothers were warning that this was going to
lead to people leaving their posts,some resigning,
some being essentially forcedout of their posts.
(09:58):
And, you know, this wasthere were serious concerns that
this was going to exacerbate the staffshortages that we know
are endemic in the sector.
What's been the impact?
Yes, the major oneand the most obvious one
is just impact of the staffing crisisof as we predicted.
(10:21):
I think what we didn't seeas much as we expected
was the number of dismissalsas a result of failure to be vaccinated.
Because what we actually sawwas people choosing to leave
prior to the 11th of Novemberwhen this came into effect.
People left social care,
although it was a job that people love,is minimum wage.
(10:43):
So people were choosing to leave,to go elsewhere.
If they wanted to continue careand they could go into the NHS,
they could go into local government,
they could go into community careor the domiciliary care
sectors, that there were plentyof care options available.
And what we also saw was the other roleswithin care homes, leaving
some of our national careproviders are telling us now
(11:05):
they are using agencies
to backfill roles that they've never hadto use agency staff for before.
So these are your kitchen staff,your catering staff,
your clean as your admin,because they've moved into the gap
in the market, in hospitalityand in retail
because those skills are easilytransferable into another sector.
(11:26):
So we saw thousands and thousands leave.
We also saw a little bit of a changein the government position
literally daysbefore the legislation came in
and they brought in this three monthmedical self-certification exemption.
So we're still seeing a few of thosethrough to the end now, but
(11:46):
but not in any great numbers.
And so, yeah, the biggest impact was,was the staff leaving
what was alreadya chronically understaffed, you know,
we were 110,000 staff vacanciesprior to COVID and the impacts of COVID,
the exhaustion and stuff burnout has meant
a lot more people have left,not just on the vaccine issue,
(12:06):
but the ultimate pressure that leavesis on the stuff that remain.
So they're still there picking up the workof their colleagues that have now gone,
you know, this traditionally 30%turn over each year of social care staff
because the pay and the termsand conditions are just so poor.
So those staff that are
left a mentally exhausted, physicallyexhausted now and very much facing things
(12:29):
like stress and mental health
issues, PTSD, as a result of workingthrough the pandemic
and occupancy rates within carehomes are at an all time low
as a result of COVID, but also as a resultof not being able to take in residents
because they haven't got the staffin there to meet their needs.
Ultimately, the service usersnow that are suffering as a result of this
(12:51):
and then staff morale is just at an alltime low, as I said before.
These are the people that battled throughthe pandemic to keep our loved ones safe.
And now they're the ones that are
they feel they are being targetedand singled out by a government.
And it once again, they were feelingvery inferior when compared with the NHS.
You know, social care is always on a lowerfooting to the NHS.
(13:14):
You know, there were big callsfor armies of volunteers
to come and help in the NHS.
There wasn't anything like thatfor social care.
You know, family and friends were askedto help out if you can, but but that was
there was no big grand gesturesto to plug the gap in social care.
So it's just been exacerbatedas we predicted it would.
Yes, it's it's really useful to hear that,
(13:37):
because I thinkin some of the conversation,
since the policy's come
in, but also prior to taking effect,
the focus was very much on
those care workerswho may or may not get the vaccine
and not always on their colleagueswho have had the vaccine,
(13:58):
people who do in other rolesand also on the service users.
And what you've just described theredemonstrates that
this is a policythat is having a range of effects
across all parts of the care
sector in a way, not in a positive way .
Now, last year, prior to comingin, I did a piece of research
(14:22):
which looked at the reasons whycare workers were opposed to the policy.
And and what that highlightedwas very much in line with what
you've said about the employment modelthat many care workers have.
And it showed
how that really can't be separated outfrom understanding
(14:45):
why some care homeworkers were opposed to the policy.
For example, it was very clearthe lack of sick pay in the sector
was a real concern, as you describe,
that if people were to have the vaccine
and as many people did feel
(15:05):
a littleunder the weather for a day or two,
then I knew that when I had the vaccineand if I felt unwell
I could stay at homeand my income wouldn't be affected.
That's not the case for care home workers.
And looking at the concernsof many care workers
(15:26):
and looking at the consultation responses,
it's clear that those issuesof their employment conditions can't
really be separated out from the wider
concerns about mandatory vaccination.
So how does GMB think the
employment conditions for your membersin care should be improved?
(15:48):
We've touched onsick pay as one example, but
what are the changesthat you would like to see?
And I suppose how do you think they relateto this issue of mandatory vaccination?
Yes, they do.
You obviously mentionedsick pay there and pay and sick
pay a very at the top of the agenda,really.
You know,they are minimum wage employees generally.
(16:11):
sick pay, is few and far between.
Is it paidand it should be a contractual right
if anything's being shown to usby the pandemic.
Is that sickpay is the number one infection
control measure you can put in place?
Because what we have seen for decadesprior to the pandemic were social
(16:33):
care workers going into work ill becausethey cannot afford to take time off work.
It really is as simple as that.
And it was actually acknowledgedby the government after some lobbying
from unions and othersthat is that they had to cover sick pay.
So there's been three sets of additionalfunding given by central government
to local authoritiesto distribute to care providers.
(16:55):
And a part of that was to cover sick pay
so that people could follow governmentguidance and isolate.
And it's absolutely essentialthat coming out of these contractual sick
pay becomes aright for all social care workers.
And that has to be at the topof any government agenda, agenda
looking to reform social care and pay.
You know, they are the lowest paid workersand they shouldn't be.
(17:18):
They at least expect
to be paid similar to their colleaguesin local government or in the NHS.
And they're nowhere near.
At the GMB we're campaigningfor a minimum of £15 an hour
for the social care workforcewe think is the least they deserve.
And you know, we will never addressstaffing
shortage crisisas without addressing those two issues.
(17:38):
But the other stuff is aroundthe professionalisation of the role.
These workers do not feel valued,they do not feel respected
or that that the vital rolethat they provide is recognised.
So we need to professionalise social care
and that would includenational standards for training.
So that is consistent application of thatright across
(17:59):
and England with genuine careerprogression in place for people
so that they know that there's a routeto follow if they want to follow that.
And we want a registration systemin England like they've got in Scotland,
Wales and Northern Irelandto make the role professional
and put it on that parity with the NHS.
And if people feel more
(18:20):
respectedand treat as the professionals they are,
that will in turncome on to things like the vaccine.
They'll understand why they're being asked
to take the vaccinebecause they'll understand, you know, that
it's a part of their professional rolethat they're being asked to do that
safe staffing levels is an absolutecrucial one for our members.
current crisis to one side.
(18:41):
It's always been an issue.
And the one thing our members
tell us time and time againis that they do not feel safe at work.
They do not believe
they are delivering the standards of carethat their service users deserve.
And so we have to absolutely address safestaffing levels.
We'd like to seenational sectoral bargaining
so that there are consistent payand excellent terms and conditions right
(19:03):
across the sectorand not this race to the bottom of poverty
pay that we're seeingwhere all the profits are being taken out
and sent onto offshore accounts as we seesome of the largest providers do.
And I suppose the bigthe long term aim would be
a national care servicethat was funded through taxation
and it was all about delivering carerather than the profit.
(19:26):
So I think that's the whole packagethat we need to do to really improve
social care for the workersand make them feel valued, to make it
to be a job that people want to go intoand want to stay in.
That has to be able to aimwith to address the social care crisis.
It's it's
really interesting
to hear you talk about valuebecause that connects to the next thing
(19:49):
I wanted to ask you about,which is precisely that.
And it's mandatory vaccination,I think is an interesting example
to look at this because itnot only sheds some light on the way in
which the care workers have often
felt undervalued in terms of their pay
(20:10):
and the and the conditionslike holidays and sick pay
that come with the jobor don't come with the job.
But it's also kind of shone a lightexactly in the way that you've described
on the professional status
of care workers and the value and respectthey feel.
(20:31):
So I suppose my,the question I'd be interested to hear
your thoughts on and the thoughts ofyour members is do you think the way in
which the mandatory vaccinationpolicy was introduced
tells us anything about thatstatus of care workers
or perhaps about the value
(20:52):
that the government has towards
care workersand maybe even the value that society has.
Places upon care workers.
Two years ago or just under two years ago,there were
there was clap for carersand people stood outside
on Thursday evenings and there was a sensethat there was a real respect
(21:14):
being shown to the peoplewho were delivering care.
My sense is that quickly moved into almost
an exclusive focus on the NHS
and that hasn't
really materialisedinto significant changes
around the value of the people have placedupon care work.
(21:36):
So there's a broad set of issues there.
What are your thoughtsabout that question of value?
I think it absolutely does highlight
the value and perceptionof social care workers in the country.
You said that about the clapson the doorsteps.
And I can tell you our membersworking in social care really appreciated
being recognisedby the general public at the start.
(21:59):
But those claps soon as you said,became a focus about the NHS
and then very quickly just disappearedand then it was all forgotten and care
workers continued going to work, theycontinued fighting for their inferior PPE,
they continued being paid
their minimum wage rates of payand nothing changed for them.
All they knew is that they continuedworking in extremely poor conditions.
(22:25):
I think the reason governmenttargeted care and I'll use the word target
because they were seen as an easy wayof getting this in to start with.
You know,this is a large fragmented workforce,
predominantlywomen and large number of black
Asian minority ethnic workers in therewith huge cultural and language barriers
(22:48):
and they're on poverty pay rates, inferior
terms and conditionsnot really well unionised
compared to other sectorslike local government or the NHS.
And I think a genuine beliefthat this could be pushed through
very easily without very little challengefrom the workers themselves.
And they were right because sadlyafter decades of being trodden down,
(23:12):
our care workers do think what's the pointin challenging we can't win anything.
And so we've got a job of workin building their esteem back up.
But I think it was absolutelya sign of what they could do.
And I think the sad thingis the government
massively let downsocial care workers in the pandemic.
(23:32):
They literally forgot about themat the start of the pandemic.
They were excluded from PPE guidance.
We had to fight to get them face masksand then suddenly it was realised,
Oh, you got COVID
patients in residential care homes,they're going to need access to PPE.
They were excluded from the first testingkits that were coming out.
(23:53):
Social care workersweren't entitled to those, you know,
and we all know about COVID patientsbeing discharged
from hospitals into care homesso that the hospitals could be freed up.
And then we had to fight for the sick pay.
They weren't getting the sick pay, sothey were massively let down at the start.
And I think all of that showswhat the perception is about the value
(24:14):
of care workers and how seriously we needto take them as a as a group of workers.
So I do believe thatthat's why the government started.
You know,they were the ones that let care down.
And yet it's our members that are beingpunished as a result of that.
And this is the thanks they getfor their efforts over the last two years.
And there's still been no improvementin their pay on their terms.
(24:37):
Which I presume has led
to some of them thinking I'm getting out.
You know, I don't feel respected.
Am I right to sort of assume that?
Absolutely.
When you when you look at the job advertsand you've got Aldi
and all the supermarkets, you know,
Morrisons about £10 an hour on checkoutswithout the 12 hour shifts
(24:57):
and the responsibilitiesthat come with working in a care home.
Yes. People have left and it's it'sa perfect storm of all the issues.
It's not just one issue.It's the whole lot.
And so finally then the the governmentnow plans
to extend the policy to introducemandatory vaccination in April
(25:18):
for healthcare workers in the NHS
and for all social careworkers, for example,
those who provide care to peoplein their own homes.
Now there's been some speculation thatthe policy of introduction will be paused,
but at the time of recordingset to go ahead as planned.
(25:38):
What's the view of your membersabout this, and is GMB stance
the same towards that wider
rollout of mandatory vaccinationin health and social care?
Yeah, again, we're opposed to it again,and we believe it's going to have serious,
serious implicationson the delivery of services.
As I said, many of the people that leftout of residential care
(26:01):
went into domiciliary, Carol, into the NHSand they're once again
now facinglosing their jobs on the 1st of April.
I think for us, our focus right nowis supporting our members
that are
affected by this through the processes,making sure they're being treat fairly
and that redeployment options areconsidered as a priority for all of them.
(26:22):
Our worry is
there seems to be no credible plancoming forward as to how this number
of people suddenly not being available forwork will be addressed.
And I know we share those concernswith our colleagues
in social careand with our colleagues, NHS employers.
And there's no credible plancoming forward.
(26:44):
I think just the latest figuresthat we're aware of in the NHS,
we're looking at 60,000 peoplefacing dismissal on the 1st of April
if staff uptake continues at its currentpace on the 1st of April, 60,000.
Hundreds of thoseare from the same ambulance employees.
And to suddenly take that amountof workers out of one employer.
(27:09):
And these are employeesthat are currently struggling
to staff and meet the service needsthat are currently there.
And it's to stretch to the edge.
And then in domiciliary care,you're looking at a dismissal of between
75,000 and 100,000 workers,
and that's out of a workforce of 500,000.
So a fifth of the workforceare facing dismissal in April.
(27:30):
And again, no credible plan.
And the impactthere is if you've not got care
being delivered to people in their homes,they have to stay in hospital.
And then you've gotthe beds being blocked.
So therefore you've got the ambulancehandover delays exceeding
because they can't dischargetheir patients at a hospital.
(27:50):
The longest delay in Decemberthis year was 20 hours
for an ambulanceto handover a patient at a hospital.
And what what that actually does,that causes serious harm to patients.
And the estimate for December was 3000patients were potentially put at harm
due to the delays.
So it's not just about there'sa vaccination issue in care.
(28:11):
It's the massive knock on effect it hasright across health and social care.
So that's why we're opposed to it.
We think it should be a lot moreabout education and trying to break down
those barriers and encouraging peopleto take the vaccine.
We do have concerns aboutwhat will come in the coming weeks
Yes, there are some extraordinarilylarge numbers there that you've
(28:33):
you've talked about in termsof the potential impact on staffing.
And, you know, what strikes me hearingthat is that we're being told
at this momentthat we're in the endgame of the pandemic
and even some sayingthat the pandemic is over.
And it's clear the well,for one with the case numbers
(28:54):
as they are, is clearly not.
But even if the case numbers were to drop,
the impact of the policy
and the way in which services are goingto be affected is going to be playing out
for months, if not years,from the point of introduction.
So, Rachel, it'sbeen really, really instructive to hear
(29:19):
GMB's position on thisand what your members are thinking
and feelingand the conditions that they're facing.
The work of the Centre for Careis going to have a strand,
which is research in the care workforce,which I'll be involved in.
And so it would bewe will return to many of these issues,
(29:42):
and it will be great to continue thisconversation with you at a later date.
So thank you very muchfor joining us today.
If you'd like to find out moreabout the work
of the Sustainable Care Programmeor the new Centre for Care,
then more information can be foundon the CIRCLE website and social media.
(30:06):
You can also find out moreabout the work of
GMB at GMB.org.uk.
On the CIRCLE website you can
also find the research paperon mandatory vaccination by myself
and we can post a link to thatalong with this episode.
You can sign up to CIRCLE's newsletterto keep in touch
(30:29):
with news about our research,upcoming events and future
episodes of the Care Matters podcast.
Rachel, many thanks againand thank you very much for listening.
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