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Australia has sleepwalked into a society where profit trumps quality care

<span>Photograph: Speed Media/REX/Shutterstock</span>
Photograph: Speed Media/REX/Shutterstock

The outbreak of Covid-19 in Victorian aged care homes has shone a harsh light on the conditions in which low-paid workers struggle to provide care to some of the most vulnerable people in society.

Most of these workers are women – as are those in disability care and childcare. The work they are engaged in has its roots in the domestic economy. Care work was once the domain of the home. It was, essentially, women’s work.

Economic orthodoxy dictates that public and private investment should be targeted to innovation, to adding monetary value to raw materials and to building wealth through the creation of new products and services that we didn’t know we needed. To men’s work.

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Yet there is a strong case to be made for investing in the female-dominated care economy as we have done in more high-profile, male-dominated sectors in the past.

Care work involves a complex mix of physical and psychological abilities but, due to its roots in the home, it is often dismissed as “unskilled labour” and accordingly is underpaid. Over recent years, the wages and conditions for many of these jobs have been eroded through casualisation, the use of labour hire, and their excision from the standard labour market into the gig economy.

Lifting wages and conditions for care workers would not only improve their individual circumstances, it would boost economic growth, as every additional dollar earned by low-income earners is spent back into the economy, lifting aggregate demand for goods and services.

More fundamentally though, investing in the care economy reaps benefits across society in more than monetary terms. Improving the quality of care increases social and mental wellbeing, reduces ill-health and social exclusion, and strengthens community and social cohesion.

The aged care royal commission has revealed incidences of neglect and abuse in residential aged care facilities across the nation that have shocked Australians. Yet the fact that the quality of services is compromised by cost-cutting in the pursuit of profit should not be a surprise. The need to ensure high-quality care is fundamentally at odds with the imperative to make a profit from a privatised system of care for vulnerable people.

There are more important values than productivity

Similarly, the for-profit model of early childhood education and care has proved to be unstable and inefficient: childcare was the first sector to find itself on the brink of collapse due to Covid-19. The government’s short-term intervention has kept centres open, but it was aimed at propping up a business model that has been teetering for years and serves no one well save the owners of large-scale, for-profit providers. Parents struggle to keep up with ever-rising fees, while workers scrape by on the minimum wage, with little job security.

Despite widespread dissatisfaction with the current system, when the ALP took policies to the 2019 election that would have made childcare free for the majority of families and at the same time provided direct-to-worker subsidies to increase childcare wages, they were excoriated by mainstream economists, who decried the wages policy as an unwarranted intervention in the market.

The policy was in fact an entirely justified response to a clear case of market failure. When markets fail – as they have so obviously done – to adequately value such important work as caring for the vulnerable, government intervention is warranted.

This is the fundamental case for reconsidering how we value and reward the jobs done by care workers in our society. The market has failed – in fact, refused – to value them properly, so we must collectively and consciously undertake an explicit revaluation of their worth.

The first step is to make the argument that there are more important values than productivity, and to frame our measures of success as a society around the concepts of care, sustainability and wellbeing, rather than profit, growth and material wealth. If we proceed from that assumption, then we must accept that government intervention in the market, where it is aimed at improving the care that we show for one another and increasing wellbeing within our communities, is an unequivocally good thing. With that acceptance can come a range of measures to make change.

In the immediate term, investment by government to directly lift wages in underpaid care jobs will be necessary, while tax concessions, such as a US-style earned income tax credit, may also be useful. Medium-term measures, such as investments in service delivery or in skills training and accreditation, are worth considering.

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Shifting business models for the provision of care away from large, for-profit multinational firms and towards local, community non-profit or cooperative models would remove the imperative to maximise profits at the expense of the quality of care, and restore trust between the users and providers of aged, disability and childcare.

Australians demand the highest level of care when we entrust our children or elderly loved ones to the custody of others. Yet we have allowed ourselves to sleepwalk into a society in which profit and productivity are considered more important values than the quality of care we provide to one another.

As we emerge from the Covid-19 pandemic, we are presented with an opportunity to redesign our economy and create a new society. We must do so by drawing on the deep-rooted, radical kindness that underpins human relationships, and demand better of our leaders, and of ourselves. It is how we care for one another, and for the planet on which we live, that must define our values now.

• Emma Dawson is executive director of Per Capita. This is an edited extract of her essay in the upcoming collection What Happens Next? Reconstructing Australia after Covid-19, of which she is co-editor with Professor Janet McCalman, to be published on 29 September by Melbourne University Press