MHScot Workplace Wellbeing

We pay for the shift and take the caring for free

Care jobs are paid, and paid badly. The caring inside them, the noticing and the staying, was never priced at all. Why that matters in every workplace, not only in care.

We pay care workers for the shift. The wash, the medication round, the timed visit. What we don’t pay for is the caring itself: noticing that someone is quieter than they were last week, staying a few minutes longer because they’re frightened, remembering how they take their tea. That part never made it onto the price list.

We pay for the shift and take the caring for free.

I want to be careful with the words, because anyone who works in care will know straight away if I get this wrong. Care jobs are not unpaid. They are paid, and paid badly. It’s the care inside the job that goes unpriced. And then there is a third group, who do it with no wage and no shift to clock off from.

The care nobody pays for at all

Carers UK puts the number of unpaid carers in the UK at 5.8 million, from the 2021 Census. Research by the Centre for Care values the support they give at £184 billion a year. The same page says 1.2 million of those carers live in poverty.

So the people holding up parents, partners and children give support worth £184 billion a year, and more than a million of them are poor. The economy runs on care it refuses to count.

Nearly 3 million of those unpaid carers also have a paid job. If you manage people, some of them are in your team. They did a shift before they logged on this morning and they will do another one tonight. Their manager may not know.

We were taught that care isn’t a skill

For a century we built schools, careers and status around one ability: store information and retrieve it on demand. Memorise, recall, repeat. We called that clever, we paid for it, and we sorted people by it.

A machine now does that part better than any of us, instantly, for almost nothing. The skill we built a whole society around is the one that just got automated.

The thing the machine can’t do is the thing we decided was unskilled. Noticing what someone is carrying. Sitting with distress and not flinching. Knowing when a colleague has gone quiet for a reason.

The people who do that for a living, social care workers, support workers, nurses, are among the people we pay least. We were sold a value system where the person who memorises is clever and the person who cares is “just” kind. That was never natural. It suited the people doing the counting, because what doesn’t show up in the figures is easy to leave out of the budget.

Three centuries of data point the same way

Richard Murphy published a piece in June called Three centuries of life and health, and the politics of care, worked up with Jacqueline Murphy, a retired GP. They looked at how long people in England have lived since about 1700, and how many of those years were spent in good health. He is open that the method is approximate, and he sets out where it could be wrong.

What they found is that adult life has got a lot longer and healthy life has not kept up. In the Victorian era, someone who survived childhood could expect around five years of poor health at the end of their life. Today it’s more like fifteen to twenty. We have added years, and most of the added years are unwell ones.

His explanation is that we built a health system that treats people like machines: find the failing part, repair it, keep the body running. What keeps people well is somewhere else. Decent housing, good food, meaningful work, strong social connections, prevention rather than treatment, and, in his words, “continuity of relationship with known carers”.

I’m not an economist or a doctor. But a known carer is what I’ve been describing: someone who notices. We fund the procedure and we don’t fund the relationship. That is true in a hospital, it is true on a home-care rota timed to the minute, and I’d say it’s true at work too.

To be clear about who said what: the argument about health and prevention is Murphy’s. The line about the shift and the caring is mine.

Every workplace runs on unpriced care too

This is the work I do. I don’t teach resilience. I teach people to notice what their colleagues are carrying, and to meet it with kindness.

There’s a catch, though. You probably know who it is where you work: the person everyone goes to. The one who spots that someone is struggling, makes the time, and listens. It isn’t in their job description. It isn’t in their workload. It won’t come up at their appraisal. And when they burn out, everyone is surprised.

Training more people to notice is worth doing. I’d hardly say otherwise. But if the noticing is then taken for free, on top of a full workload, the workplace has done exactly what the care sector does. It has paid for the shift and helped itself to the caring. That is how compassion turns into a product and the causes of work-related stress stay where they were.

So, three questions for anyone who employs people:

  • Do you know which of your staff are carers at home, and would they feel safe telling you?
  • Is noticing how people are doing part of anyone’s actual job, with time set aside for it?
  • What happens to the workload of the person everyone goes to?

We’re not short of people who care. We’re short of the nerve to pay for it.