On 21st September, trade unions in the care sector will take action against the Flemish government's plans to privatise the public care and welfare sector. According to Rosa Pavanelli and Jan Willem Goudriaan of PSI and EPSU, Flanders would do well to learn from other countries' bad experiences with privatised care for the elderly.
- Read this in:
Around the globe, Covid-19 has exposed a chronic crisis in our system of care, with patients and carers forced to pay the price. The common experience of millions of frontline workers represented by Public Services International, in multiple countries is that years of underfunding and privatisation have only exacerbated the virus’ spread.
Just look at the region of Ottawa in Canada, where carers in private homes had to deal with resident-mortality rates four times higher than in public facilities. Or the stories coming out of Australia, where the Army had to be sent in to support chronically understaffed private care homes.
Workers in Flanders are right to oppose more privatisation. The deaths in Belgium’s care homes – 39% of which are commercially operated – represent over 50% of total Covid mortality
In 1997, Australia passed a law – similar to proposals now under discussion in Belgium - which allowed for rapid expansion of privatised care. Since then, $9.8billion was cut from aged care - enough to employ over 200,000 new carers, effectively doubling the workforce. A Commissioner in 2019 described the Australian aged care sector as “at best a national embarrassment and at worst a national disgrace." Is that the sort of example Belgium wants to follow?
These stories are not coincidences. When we hand the care sector over to the finance industry, to private equity firms and billionaires, they do what they do best: search for ways to cut costs, increase revenues and boost profits. The resulting turmoil might not be an issue when it comes to toy retailers or co-working start ups. But when it’s the vital care for our loved ones on the line, the results are disastrous. Staffing levels are slashed. The meals and living conditions get worse. More people are squeezed into smaller spaces. Wages are slashed or frozen. Long-term contracts disappear. Unions are side-lined.
Imagine finding your elderly mother left unattended in squalid conditions in an understaffed care home. Now imagine having to work double shifts as a carer at the same home through a global pandemic, juggling dozens of patients and dealing with bereaved families: all while worrying that your exposure to the virus might be putting your own loved ones at risk.
Our experience shows that it’s never the financial speculators who deal with the consequences. It's our loved ones, forced to pay ever-higher monthly costs. It’s the carers - overwhelmingly women - forced to do more work on understaffed teams for less money. And it’s we - the public - forced to fund the tax-payer subsidies needed to prop up private profits and the bail-outs required when things go wrong.
We know that private care corporations always make bold promises of better service, higher quality, lower costs or increased efficiencies. But the fact is that there is no qualitative research to support their claims. A comparative analysis examining 40 different studies from across the world published in the British Medical Journal concluded that “not-for-profit nursing homes deliver higher quality care than do for-profit nursing homes." Meanwhile, the wider social and human costs of the profit-oriented care sector – exposed by this crisis – are simply impossible to quantify.
When confronted with the evidence, politicians inevitably claim that ‘things will be different here.’ They say that clever regulation, inspections, quality standards and strong contracts will prevent bad outcomes. Of course, these same measures have been tried elsewhere - including the United Kingdom where even Conservative politicians are now admitting the sector may need to be brought back into public hands.
No amount of regulation can address the fundamental reality that care for our loved ones cannot and must not be trusted to global financial speculators whose core (and often only) interest is short term profit extraction.
Workers in Flanders are right to oppose more privatisation. The deaths in Belgium’s care homes – 39% of which are commercially operated – represent over 50% of total Covid mortality. In this context, it is simply outrageous that many politicians – including in Flanders – are now proposing further privatisation as a cure to the crisis – with no evidence to show that this is the actual cause.
Care is the foundation upon which life itself exists: and on which our economies are able to function. The solution to the care crisis is to finally acknowledge the value of care as a social good: and that starts with revaluing the people whose work makes care happen.
This Op-Ed was originally published in Flemish on the website Knack