The issues that workers have protested for the past two years in the health and social services sector are not new. Lack of protective equipment, staff shortages, long hours, demanding physical and mental working conditions, etc. – these are not new problems. The pandemic did, however, bring these problems to the surface, revealing underlying long-term problems in the care sector.

High death tolls and daily images of struggling care workers in long-term care facilities and hospitals across the world shocked the public in the early days of the Covid-19 pandemic. In some countries, military staff even had to be called in to help feed the elderly.

Where to put the blame? It was governments of the Organisation for Economic Co-operation and Development (OECD) countries that allowed the care sector to develop as a lucrative business. Rather than strengthening care as a public good, they chose to pave the way for one of the biggest – and most shameful – market failures in recent history. Western societies are growing older and three decades of neoliberalism have depleted public health systems of the capacity to support elderly people. Letting that gap be filled by a plethora of profit-oriented companies that offer services for the elderly and dependent persons was a disaster waiting to happen. The Covid crisis exposed all of this.

Care is a human right first and foremost. Providing good quality care is challenging even in the best conditions. However, when care providers look primarily towards investors and see care as a business rather than a social vocation, the consequences can be devastating. A recent exposé of France’s for-profit care sector is a classic example. In Les fossoyeurs (‘The Gravediggers’), investigative journalist Victor Castanet told shocking stories of workers forced to ration food and hygiene products, while the companies that employed them – notably Orpea, the largest multinational in the care sector – were paying massive dividends to their shareholders.

The revelations about these companies seem never-ending. In the United Kingdom, the country’s largest for-profit care provider has been funnelling profits through tax havens while reporting deficits, and using these deficits to then justify demands for higher fees and lower wages.

Also, the above-mentioned French multinational Orpea has been reported to have stashed away assets in Luxembourg, while the French government has uncovered serious abuse of public funding by the company.

For years, many trade unions and citizens have had to witness the growth of these groups and the huge profits they have been making from the steady stream of public money. For years, many voices have reiterated their long-standing demand that care should be organised on a not-for-profit basis. It is good for society, good for taxpayers, good for people who need care and support, and good for care workers. During the recent Conference on the Future of Europe, citizens wholeheartedly agreed that companies should not be able to siphon off much-needed resources for universal care. It is time for this common-sense demand to become a reality.

How to build our power

Most of these for-profit care companies have shown that they are not friends of workers. For instance, the Orpea group repeatedly resisted negotiating a European Works Council (EWC) with its unions and the European Federation of Public Service Unions (EPSU). After three years, legislation forced the company to grant workers information and consultation rights at the European level. The chair of the EWC – a Ver.di worker from Germany – recently won a harassment case against the Orpea group. The court case was only the most recent example of the company’s prolonged union-busting history and opposition to the EWC chair and came on top of previous dismissal attempts and attacks against the Works Council. In France, the company has strongly favoured the in-house yellow union during trade union elections, a highly dubious practice that French unions are fighting in court.

Dozens of CGT shop stewards were sacked by Orpea when it found out they were members of the French trade union confederation. The care sector is primarily female dominated with many migrant, minority and vulnerable workers. This multinational has taken advantage of this situation and pushed workers to the limit. This has not deterred strikes and resistance, but it has made both more difficult and this is unacceptable.

How can we improve a situation that was created by 20 years of neoliberalism? It will require coordinated work at the global, European, national and local levels to bring care services back under democratic control and to restrict – if not do away with – the for-profit logic.

A few weeks ago, it was International Nursing Day, where we celebrate the work of millions of nurses in the public, not for profit and for-profit sector. The European Federation of Public Service Unions (EPSU) and Public Services International, the global union federation of public sector workers, are proud to organise these workers across the board and in whatever workplace they are.

But we are also very clear that solidarity-based systems are needed for everyone to have access to the care they need – whatever their social status and wherever they happen live. In this scenario, everyone needs to contribute, and nobody can be allowed to be selfish.

The care sector finds itself in the eye of a perfect storm. With the structural failure of for-profit care exposed by the pandemic and the Les fossoyeurs exposé, there is now momentum that should be maintained and exploited. The French government has conducted investigations that have found serious flaws in both the finances and conduct of the Orpea group, while other countries continue to investigate. The European Union is preparing a European Care Strategy, with the first proposal due in the autumn. The stage is set for policymakers to bring about true societal change.

EPSU and many others have reached the same conclusion again and again – providing health and social care on a for-profit basis is at odds with the goal of a more equal society. We are now looking forward to the work of the European Parliament’s Special Committee on Covid-19 to explore this across the EU.

Changing the care sector means changing society. PSI recently launched its Care Manifesto, in which it called for the social organisation of care. The goal of an equal and caring society is being derailed without it. To be cared for is a human right and it is linked to the quality of work of carers. Change will only come with a human approach that values both the objectives of quality care and quality work equally. That must be the compass of the international labour movement.