• Care is a critical public service. It provides vital support to the most vulnerable in our society based on their needs - and their human rights.

• Care is provided by people: our loved ones deserve professionals who are well-trained, supported and valued.

• Caring for vulnerable people requires a well-funded, holistic approach. Quality care systems must be integrated into our health systems.

But for too long, commercialization of care has put extracting profits ahead of our care needs. It treats vulnerable users not as people but as centres of revenue and profit. It treats workers not as essential providers of quality care but as costs to be minimised by cutting wages, training and staffing levels. When care workers are undervalued, underpaid, and working in precarious conditions they cannot provide the care needed.

Privatised care also ends up siphoning public money, which should be used to build better care systems, into offshore tax havens, massive dividends and management bonuses.

Privatised care undermines our public health systems and incentivizes poor health outcomes. Health problems that could be prevented by investing in quality care are instead shifted to the health system once they become acute. Worse still, privatized care has incentives to avoid accountability and treats workers, and their unions, as forces opposed to profit maximization.

This is why PSI is campaigning and organising for well-funded quality public care systems provided by well-trained, paid and supported staff.

This can only be achieved with workers who are rewarded properly with safe, secure and well-paid work - and who are free to join and be represented by independent trade unions.

PSI supports care workers to ensure they are valued and have what they need to provide quality affordable care that users need.

PSI fights for well-funded, quality pubic care with a well-trained, secure, rewarded workforce that can give the best care possible.

Supporting Workers to Deliver the Quality Public Care that Our Loved Ones Deserve

The COVID-19 pandemic has shone a light on the vital role care workers play in our healthcare systems. They work on the front line, using their skills and expertise to ensure that the most vulnerable in our society are properly cared for.

Many of us ourselves or have family members who have either received care or will need care at some point. More than ever it is clear that care is an essential service, it is central in sustaining life.

Care work takes varied forms across multiple settings and involves varied social groups such as children, the elderly, those with long-term care needs and community health programmes. Below are just some of the roles involved in the care sector:

• Childcare

• Elderly and disability care (in both residential and home based settings)

• Nursing services

• Social services

• Community health services

• Domiciliary care, transport and leisure service

Our Shared Struggle

PSI is the Global Union Federation uniting the struggles of vital care workers across the public and private sector.

• The COVID-19 pandemic has reinforced public awareness of care work as essential yet undervalued. The problem of low wages, poor conditions, and high-risk work is now well-acknowledged in policy as a recruitment and retention problem posing a key barrier to developing the sector to ensure both current and future care needs are met.

• As care work is a highly feminised occupation, the impact of the crisis in care has disproportionately fallen on women- both inside and outside of the home.

• We support informal care workers in their fight for their progressive, worker-led formalisation and for recognition as public service workers.

• We promote more sustainable and equitable ways of financing care systems through the reform of global tax and debt architecture and moving away from a reliance on expensive and unequal private provision. 

• We promote the public provision of care and to building gender-transformative public care systems with decent work and the recognition of the human right to care at its core.

PSI advocates for a radical new approach to care

Highlighting the need to urgently rethink care in our society, to integrate transforming gender roles in the organisation of quality, universal and public care service systems, while also denouncing and opposing the privatisation, commodification and financialisaton of the sector.

Fixing the care crisis requires a shift away from notions of a ‘care economy’ towards the social organisation of care.

Our Care Manifesto calls for a global movement to rebuild the social organisation of care based on five key concepts.

• Recognise the social and economic value of care work (paid or not) and the human right to care.

• Reward and remunerate care work with equal pay for work of equal value, decent pensions, dignified working conditions and comprehensive social protection.

• Reduce the burden of unpaid care work on women.

• Redistribute care work within households, among all workers, eliminating the sexual division of labour and between households and State.

• Reclaim the public nature of care services and restore the duty and the primary responsibility of the State to provide public care services and develop care systems that transform gender relations and women’s lives - including by financing State´s capacity to invest through fair and progressive taxation and ensuring internationally equal taxing rights of nation States.

Pushing for change

In partnership with our affiliates we are calling on governments around the world to take the following action:

• Invest in universal, quality public health and care – including mental health, childcare, early childhood education, elderly care and other social care services - to ensure the creation of millions of jobs with decent work which includes fair wages, and humane working conditions; and to close gender gaps in labour force participation

• Ensure decent adequate wages and improvement in working conditions, including equal pay for work of equal value, training opportunities and occupational health and safety for workers in health, care and education, including home care and domestic workers

• Ensure equity and non-discrimination in recruitment, retention, access to training and promotion opportunities for workers across the health and care sectors

• Ensure that the rights to freedom of association and to collective bargaining are respected for all workers in the health and care sectors, whether in the formal or informal economy, as well as their representation in the decision-making process.

• Fund universal, gender-responsive social protection accessible by all workers regardless of employment status or migrant status, racial or ethnic background, disability, gender, identity expression or sexual orientation, and inclusive of workers in the informal economy

• Ensure accessibility for all to quality public health and care services, including refugees and migrants, regardless of status.

Quality Care Across all levels of Government

Local and regional governments are instrumental in the delivery of many of the care services outlined. Mayors, councillors, and local elected representatives have the power to ensure that workers in the care sector have access to decent work and that care systems are fully funded.

The burden of care falls predominately on women, both inside and outside the home. Paid and unpaid care relies on the persistent sexual division of labour and as a result, the majority of workers in the care sector are women and/or migrant workers.

Care is no longer a private issue for households. From frontline healthcare work to providing direct care in the home; it is evident that job insecurity, excessive workloads, unsafe conditions, and psychological distress are commonplace for too many care workers. These conditions are endemic across the sector and not confined to any one workplace, role, municipality or even country.  

Care workers have had enough, a vicious cycle of understaffing, and deterioration of conditions is forcing thousands with no other choice but to leave the sector. By failing to improve the pay, terms and conditions of care workers, employers will only further worsen the workforce crisis and make it harder for existing staff to deliver quality care to service users.  

Workers need access to unions to collectively bargain for better pay, terms and conditions such as enhanced health and safety in the workplace, access to training programmes, social security and protection from unfair dismissal. Time and time again we have seen workers prevented from joining unions and denied access to decent work. Organised and active workers represented by national trade unions are the only way to ensure that care workers can fight the precarity and finalization that has become endemic in many care systems around the world.

PSI will continue working directly with our affiliates within care to build worker power to secure collective bargaining, expand trade union rights and decent working conditions, to influence local, regional and national governments and expand union membership. 

Austerity programmes have only worsened the crisis. Governments across the world searching for short-term cost savings and to meet the growing demand for care has tended to move away from the concept of universal access to high-quality care as a public good and instead pursue the private provision of care.

Private providers who ultimately value profit over workers and service users. Now these providers have become embedded into systems of social care in many countries and as investors and hedge funds continue to promote the so-called ‘silver economy’ many more are looking to expand into the sector.

The evidence is clear that private provision of care services does not necessarily result in high-quality services. In reality, there have been numerous examples such as Orpea in France, HC-1 in the UK and  Regis Healthcare in Australia- forcing workers into caring for more patients with less time and resources.

Care is an essential service that is too important to leave in the hands of those whose primary motivation is the extraction of profit. Quality of care relies on well-paid, trained and supported workers – which the profit motive inevitably undermines. A new model of care is urgently needed which prioritises the workers caring for people.

As care needs continue to grow we must ensure that people have access to affordable publicly provided care services where workers are paid properly and treated with respect. It is time to recognise the social and economic value of care work (paid or not) and the human right to care.