Long-term care is in crisis; building worker power is the solution

If these two pandemic years have felt long to you, imagine what it was like for the hundreds of thousands of long-term care workers when Covid hit in nursing homes around the world. As the virus spread in early months of 2020, caregivers, already overworked, overlooked and underpaid, went from having incredibly difficult jobs to having incredibly difficult and dangerous ones.

In the pandemic’s first year, nursing home residents accounted for 41 per cent of all Covid-19 related deaths, and hundreds of thousands of nursing home workers also became infected. The World Health Organization estimates that as of May 2021, Covid killed 115,000 care workers, including long-term carers.

Recently, we read a flurry of reports about deeply disturbing conditions in a nursing home run by France’s biggest care operator, including lack of adequate staff, rations for food and adult diapers with tragic consequences. These and other heart breaking, enraging stories that have surfaced in nursing homes have further exposed long-standing problems wrong with long-term care. But it does not have to be this way.

The broken global long-term care system can be repaired, and worker power is a fundamental part of the solution. The pandemic has proven this. During the first wave of the virus, mortality rates were lower in unionised nursing homes. And in the subsequent months, the work we have done at UNI Global Union has continued to show that when long-term care workers have a voice on the job, outcomes are better for all.

Nursing homes with union staff tend to have more workers who are better trained and paid.

We have known for quite some time that higher staffing rates result in better quality of care for residents and a better working environment. This reduces burnout and turnover, stabilising the workforce.

Unions also demand more access to protective equipment and stronger infection prevention protocols. They provide an on-the-ground system of checks and balances to push back against abusive employment practices as well as against abuse of residents.

Raising standards

That is why UNI has been supporting care workers around the world, building power on the job and taking on multinational companies for more than a decade. For example, in 2017 we helped workers in Poland win the first union in a private nursing home, and since then, have continued fighting for better conditions across the Polish nursing home industry.

Just last month, we backed one of our affiliate unions, OPZZ Konfederacja Pracy, in winning an agreement with Orpea management in Poland that secures access to unions.

This union and its allies are pushing for a sector-wide collective bargaining agreement – a vital step in raising standards in care homes there and beyond.

Poland is just one example of many. From Czechia to Chile, Switzerland to New Zealand, we have active projects to support nursing home workers in countries across Europe, the Americas and Asia. This has led to thousands of workers joining unions and gaining collective bargaining coverage.

We have also trained more than 1,000 care union officials and workers in how to expand union power on the ground since the pandemic started, which has also led to better conditions and quality of care in these nursing homes. But it still is not enough. More needs to be done, and a growing number of stakeholders in care are recognising that.

In March 2021, we organised a coalition of more than 100 responsible investors and funds who set new expectations for the industry, including adequate staffing levels, expanded collective bargaining and union representation, improved health and safety, liveable wages, and enhanced quality of care.

This push will require us all if we are to make 2022 address the crisis in long-term care – a crisis not caused by the pandemic but made even more dire by it. This push will require us to demand real solutions for an unchecked and imbalanced care system. It will require building worker power.