The Crises in Long Term Care Work: Neoliberalism, Austerity, and the Chance to Rebuild Post-Pandemic

Submission to The Social Lens: A Social Work Action Blog by Donna Baines, Director and Professor

The recent COVID-19 pandemic exposed numerous fault lines in society, principle among them the care of older people and those with COVID, while simultaneously deepening the crisis in care work across Canada, particularly long-term care for seniors. Care work in hospitals, long-term care, and social service agencies has long been provided by women, and increasingly racialized women, under less-than-ideal conditions. But over the past decade as many governments have turned to austerity agendas that cut public funding for public services, the public has seen an erosion in the quality and equity of care while front-line workers have seen their work intensify and their wages erode.

Care work is generally viewed as a natural activity of women with few boundaries on their assumed desire and capacity to provide care, regardless of pay or working conditions. This makes it difficult to improve wages and conditions. Indeed, even associating the notion of working conditions and pay with care is seen by many to turn it into a cold economic transaction rather than a warm, family-based, rewarding labour of love. In part, this is because care is ideologically associated with being female, and care work is often located in the realms of the private: the private home; the private care chain; the private relationship; the private babysitter or private house cleaner; and the intimate realm of love, affection, relationship, dependency, and inter-dependency.

However, private care and the introduction of private care logics into public and nonprofit care has had harmful impacts demanding far-reaching reform. For example, the COVID-19 crisis showed that private chains of long-term care homes for seniors continued to pay high dividends to stockholders while residents and staff battled, and in too many cases died from, COVID-19. Evidence confirms that for-profit homes in Ontario and Quebec had much higher rates of deaths and older designs that contributed to the spread and severity of outbreaks, leading many to call for governments to step in and nationalize long term care homes or at least end for-profit care in the sector. Even economists have joined care advocates, seniors groups, unions, Oxfam and other nation-wide organizations calling for government to step decisively into de-privatizing long-term care, protecting vulnerable older people and helping to rebuild the economy in the post-pandemic era. In addition, a 2020 Angus-Reid poll found that 2/3rds of Canadians want government to take over long term care but at the time of writing, governments have yet to respond.

With this kind of strong public support, the COVID crisis provides a new opportunity to fight for better care systems and to respect the work involved in caring. Continuing the gendered expectations, care workers and other essential workers during the COVID pandemic were expected to be selfless and endlessly provide care work even when it involved risking their health and even life. Recognizing low wages in the sector and the cross contamination that could occur by moving between multiple, precarious jobs during the pandemic, some governments (notably in BC) raised the wages of long-term care workers and provided “combat pay” during COVID outbreaks. Workers were also required to only work in one site so as to limit the transmission of the virus.[i] These measures were significant and recognized the importance of these highly gendered jobs to the wellbeing of society. Increased pay and job security are also an acknowledgement that these jobs cannot be done well and safely if they are fragmented, low pay and precarious. However, rather than a permanent recognition of a new importance attached to care workers, in some jurisdictions, workers have already been told that wage top ups are not permanent, but merely an aspect of the pandemic response.

For the most part, the public has strongly supported government leadership and intervention during the pandemic, particularly in terms of health care funding, direct payments to unemployed and under-employed people, and economic stimulus. However, many governments warn that funding cuts and austerity measures will be reintroduced after the pandemic. In contrast, Stanford recommends increased deficits in order to put money into the economy and pull the world out of what will otherwise be the worst depression in the last two centuries.[ii] Stanford argues further that post-pandemic recovery requires a modern Marshall Plan, similar to the extensive, government-funded program that rebuilt Western Europe after WWII.[iii] A broad social movement and social consensus will be needed to support a Marshall-like plan. Care workers, people using care, average citizens, unions, and social movements will need to work together to build support for this kind of progressive and positive public policy agenda. There is reason for optimism, particularly if we can build on the social solidarity witnessed in the self-quarantines and the nightly cheers and banging of pots and pans for essential workers. This kind of care-based, average citizen involvement twinned with innovative and energetic social activism can generate real alternatives to austerity and build an overall more socially just, inclusive, and environmentally sustainable society.

[i] Wadhwani, A. ‘Pandemic pay’ to give temporary wage top-up to 250,000 B.C. front-line workers. Victoria News. Accessed July 14, 2020.

Zussman, R. B.C. front-line health workers to receive pandemic pay top-up. Global News. Accessed July 14, 2020.

[ii] Stanford, J. 2020.  We Are Going to Need a Marshal Plan to Rebuild After COVID. Policy Options/Options Politique. Accessed February 10, 2021.

[iii] Stanford 2020.

The Social Lens: A Social Work Blog - The views and opinions expressed in this blog are solely those of the original author(s) and do not express the views of the UBC School of Social Work and/or the other contributors to the blog. The blog aims to uphold the School's values and mission.