This Article by PSI Assistant General Secretary Daniel Bertossa is extracted from the Friedrich Ebert Stiftung Geneva Publication "Building Back Better," featuring 13 think pieces from authors of diverse backgrounds working for international organisations, NGOs, and trade unions.
How is it possible that after years of booming stock markets and technological advances, even many wealthy countries have struggled to keep their older members of society safe, their economies running and their health services from collapsing? And if these are the countries whose example is to be emulated, what does it say about the development policies they have promoted for decades?
THE DELIBERATE UNDERMINING OF THE PUBLIC SECTOR
The root cause of too many of these problems is the slow, but deliberate hollowing out of public services, made possible by a destructive narrative which has sought to undermine the value of our public sector. The influential US conservative strategist Grover Norquist said in an interview with US National Public Radio (NPR) in 2001 »I don’t want to abolish government. I simply want to reduce it to the size where I can drag it into the bathroom and drown it in the bathtub.« This choice of words expressed a disturbing contempt for our public sector. But perhaps more importantly, it implicitly acknowledged the tactics required to convince people to give up one of their most valuable assets – cut it down so it is no longer universal, accessible, or of high quality – then quietly kill it. Norquist was specifically arguing that conservatives should tempt people with lower taxes and then use rising government debt to force through cuts to government spending. Reaganite and Thatcherite leaders across the world have used strategies such as privatisation, arguing that the private sector was more efficient. Many centrist governments – typified by Blair’s Third Way – have argued that public services can be more effectively delivered by introducing private sector practice and outsourcing. What unites all these approaches is fundamental undervaluing of public services. The implication of the promise of market reform is that quality public services are not worth paying for and, instead of investing in them, we should reform, outsource and marketize them. These approaches avoid the political task of valuing public sector work and the practical task of building quality public services. They abdicate this responsibility with the false promise that the private sector will provide more value and better services, run more efficiently and for the same cost – or less!
COVID-19 LAYS BARE THE FALSE PROMISES OF THE MARKET
These lies have now been brutally exposed. In the UK the privatised supply chain that provides personal protective equipment (PPE) to the NHS has been implicated in the unnecessary deaths of many health workers (Hall et al. 2020). Run by a complicated web of more than 11 outsourced procurement contracts, it was brought in to deliver efficiency savings. Only now can we see the true cost. Meanwhile the global outsourcing giants SERCO and Sitel have been awarded contracts worth 730 million pounds to implement the UK government’s track and trace system. After receiving 170 million pounds for the first three months of the programme, they had failed to reach nearly half of people potentially exposed to COVID-19 (Halliday 2020). The largest outbreak in Australia has been linked to private security firms who had been awarded outsourced quarantine- related contracts, and who reportedly engaged »self employed« workers at below minimum wage rates and with little training (Schneiders 2020). The failure of private provision in the long-term care sector has been no less dramatic. In Eastern Ontario, the epicentre of Canada’s longterm care deaths, 82 per cent of deaths occurred in for profit facilities, even though they have fewer overall beds (Ireton 2020). Private nursing homes were also at the epicentre of the COVID-19 outbreak in Melbourne, with 100 per cent of COVID-19 related old-age care deaths in privately run facilities as of late July (Boddy and Burton 2020). The Australian Financial Review noted that this equated to 45 per cent of all deaths in the state and that the »180 publicly run care centres have had only a small number of infections.« Precarious work is now also widespread in the provision of public services. Some of the worst outbreaks of COVID-19 have been tracked to staff who have continued to work in precarious employment because they could not afford to stop working. Many spread the virus to multiple workplaces because one job was not enough to survive. From municipal workers in South Africa to higher education staff in the USA and waste workers all over the world, public sector workers in many sectors are now amongst some of the most precariously employed – and we all suffer for it. Workers’ safety should never be sacrificed to cost cutting. Putting their lives at risk because of »savings« from outsourcing the provision of PPE is foolish and immoral, and is only conceivable if there is a widely-held belief that these workers are not of value. The undervaluing of much public sector work is also deeply gendered. Women make up the majority of the public sector workforce in most countries and are often over-represented in precarious work. Women continue to be partitioned into the lower paid segments of the workforce in settings such as health, education, childcare, and old-age care, while men dominate in management roles. The historical association of care work with women’s unpaid domestic work continues to reinforce the idea that this work is of little value, and too often leads to women facing precarious work, demands to work for free, and the denial of formal employment rights. Austerity programmes often rely on women stepping in to provide care and public services when the state fails in its responsibilities. Across South Asia, there are at least 1.2 million women working as community health workers (CHW) delivering public primary health services. They are now at the frontline of the fight against the COVID-19 pandemic, delivering community education, helping to identify infections, supporting tracing strategies, and ensuring isolation procedures are complied with. They are likely to be the primary means of vaccine delivery in rural and remote communities. With the exception of Pakistan, these women are not recognised as public health workers and are instead treated as volunteers paid as little as two US dollars per week. In Pakistan, CHWs provide these services to almost 60 per cent of the population. Despite this, the workforce was not paid, faced long hours, had no clear job description, lacked safety measures, and had no legal rights as public sector workers. These issues were only addressed in 2017 after they unionised (Mir 2019). Whilst this was perhaps one of the most blatant examples, gendered notions of care work undermine the perceived value of public health and care, and contribute to the low pay and poor conditions of nurses and other health workers across the globe. It should come as no surprise that it is difficult to attract and retain staff when they are undervalued. The UN High Level Commission on Health Employment and Economic Growth (COMHEEG) estimates the world will face a shortage of 18 million health workers by 2030 (WHO n.d.). Post COVID-19, this is probably a major underestimate. The sector will not be able to attract these staff unless they show that they value the work, by investing in training, protective equipment, secure employment, and decent wages and conditions.
Check out the Podcast with PSI and FES
Caroline Dommen (host) is speaking with Daniel Bertossa (PSI) and Lily Sommer (ECA). In this podcast, the guests look into a brighter future where public services and those working in the sector are adequately valued - and valued more than privatized services – and why this pandemic can be a fostering element towards a more robust and flourishing trading region called Africa.
COVID-19 HAS SHOWN THAT YOU CANNOT PUT A PRICE ON VALUE
Recognising value is not about money. You cannot pay firefighters, emergency service workers or nurses in Ebola affected countries enough to take the professional risks they do. They do it because they are committed to the values of public service. They are proud to provide quality care and to keep the community safe. Equating their value to a market exchange by outsourcing or privatising, or telling them they are inefficient or a burden on taxpayers, destroys the culture and the commitment needed to do the work. On top of recognising the value our frontline workers, we must develop the public sector’s capacity to create bold and effective policies, independently and in the public interest. COVID-19 is revealing the tragic consequences of cuts to the public administration that designs these policies. Policy failures in countries like Brazil and the USA have caused hundreds of thousands of deaths and are directly attributable to government and business undervaluing the advice of public servants and undermining their ability to give it. From the climate, to employment, to pandemic response, poor policy kills. The workers who create these policies are far from unproductive back office bureaucrats. Cutting their jobs has created a reliance on private consultants and industry groups to provide policy solutions. Not surprisingly this advice supports their interests. Until we value good quality, independent policy advice provided in the public interest, our efforts to deal with climate change, pandemics and inequality will fail. We must have the courage to demand public sector investment in skilled, independent policy-making capacity. Public sector workers need to be guaranteed their fundamental trade union rights in order to ensure that they are free to provide frank and independent advice, and are not at risk if they speak out. Yet public sector workers around the world are routinely denied their human and trade unions rights by legislation that robs them of the ability to form unions and bargain collectively. From Japan’s firefighters and prison guards (PSI 2018), to Liberia’s health workers, and South Asian Community Health workers, governments deny basic rights to public sector workers. And nothing typifies how public sector work is undervalued more than the way public sector workers are spoken about. If we continue to describe public sector workers as wasteful, faceless bureaucrats, Bolsanaro, Trump, Johnson and those of their ilk will continue to get away with their dangerous dismissal of public sector expert advice. The cuts, privatisations, and outsourcing will only continue. And when the next crisis comes, we will be even less prepared than we were this time. If we are to Build Back Better, we must start by valuing public services and the workers who provide them. When the applause stops, we must have the courage to go so much further. There is hope. The public has recognised the conditions frontline workers have had to endure – their applause reflects a growing wave of support. Now is the time to boldly reassert the value the public sector brings to our lives. Now is the time to advocate, publicly and privately, to recognise the value of quality, universal public services that are available for all
If we are to avoid future COVID-19 tragedies, we must:
Boldly advocate to revalue the public sector and public sector work and build a new positive narrative about quality public services.
Value care work in our society and economy and reward it accordingly.
End privatisation and outsourcing of public services.
Not allow tragic private sector failures to be minimised or forgotten.
Provide resources for independent, quality public sector policy making capacity.
Support public sector workers by ensuring they all have trade union rights, job security, and whistle blower protections.